If Jennifer Hamilton, visual artist and spiritual care practitioner, could have anything at the hospital for her patients, it would be 鈥渁 greenhouse that led out onto a roof terrace so that patients and their families could enjoy the beauty of living things.鈥�
Jennifer Hamilton first heard about spiritual care while studying theology and saw it as her life's direction. After completing her spiritual care training at the Royal Victoria Hospital, she received an art commission and painted for a few years before starting her journey as a spiritual care practitioner during the pandemic. She has worked in many hospitals, including the Lakeshore General Hospital, Douglas Mental Health University Institute, the Neuro, Montreal General Hospital, and the Glen Site of the MUHC.
Recently, she returned to the Royal Victoria Hospital as a spiritual care practitioner in palliative care and took on the mantle of leading the bereavement group every Friday morning. In this interview, Jennifer explains the unique role of spiritual care in palliative care.
Vanessa Ruan (VR): Hi Jennifer, can you briefly explain what spiritual care is?
Jennifer Hamilton (JH): The field of spiritual care is still relatively new. It evolved from pastoral care, and in Quebec, the official title of this job changed in 2011. Spiritual care is not only for people of every religion, but also for people who do not have a religious affiliation, or when religion is a complicated issue for them. It is an open, non-judgmental, non-confessional listening space. We don't have a goal in terms of finding a cure or anything. Instead, we assess the patients鈥� and their families鈥� spiritual and religious needs and do our best to support them. For example, we support people in performing specific end-of-life rituals for their traditions. We may share prayers, poems, or other words of inspiration.
VR: What rituals might benefit people who do not have a religious affiliation?
JH: In a broader sense, the end-of-life ritual is a special time. We create a special space in the room for the patient, their family, and their friends to open up. Patients can celebrate their own lives and share things with their loved ones. It鈥檚 a shared experience. When we acknowledge that we are more than our body and our lifetime, we may reach a sense of transcendence.
VR: At the end of life, palliative care patients often experience existential pain, along with psychological, social, and physical pain. Tell us more about what existential pain means.
JH: Patients may face existential pain, or spiritual suffering, especially when facing the end of life because they鈥檙e leaving everything behind, and there are a lot of unknowns. No matter what framework you're using, religious or not, we all come to the end of life with some ideas that we've inherited from our worlds, through the kinds of dialogue we had, through the places that we belong. Sometimes, the beliefs can be a source of comfort; sometimes, these ideas can cause suffering. That is existential pain.
VR: What do spiritual care practitioners do to help alleviate existential pain?
JH: We open up space to have discussions, while not necessarily forcing people to talk about their feelings. I would rarely ask somebody, 鈥渉ow do you feel?鈥� Instead, I listen at all levels. Listening to words is one part of it. Listening and being present to the full range of feelings is the other. When end of life is near, feelings such as anger, sadness, denial, joy, and gratitude can all come at once. Sometimes, we help people name it. Sometimes, all we're doing is offering a comforting presence. In fact, just accompanying people might render a little bit of healing.
VR: I found our perspectives mediate our feelings, and meditation renders changes in perspectives. Have you ever guided palliative care patients to meditate?
JH: Yeah! I learned meditation over the years through yoga and through Buddhism. Often, certain imagery comes to me when I'm with my patients. I try to find peaceful imagery that the patients connect with and reflect that back to them. For example, if a patient loves gardening, I may bring up the cycle of life that gardens go through. This can be very useful when we're thinking about the end of life.
Sometimes when people are not really moving and can鈥檛 see out the window, I'll describe to them what it's like outside today. It's not so that we can talk about the weather, but that we can talk about changes. There are constant changes happening. Right now, outside, it's snowing. Even just saying, 鈥淚 can't see the mountain because there are clouds and snow in the way鈥� would help orient people in terms of when they are in the year and make them feel that they鈥檙e part of something. By adjusting our gaze from the very microscopic parts of ourselves to the vast universes that we occupy, we can change the meaning of our moment.
VR: Would you say then that spiritual care aims to help patients transcend their existential crisis?
JH: There is no imposition of transcendence. Picture it like you're walking with somebody. We're accompanying someone on their journey. If we're there for them, we go at their speed, as slow as they need. It鈥檚 amazing what can happen when you don't try to change somebody but just accept what's happening.
VR: What if a patient refuses spiritual care?
JH: It鈥檚 ok for them to say 鈥渘o鈥� or 鈥渘ot yet鈥�. With people who are experiencing something like total pain, there are so many aspects of their situation out of their control, which can be extremely frustrating. I want to make sure that at least my relationship with them is something that they can control.
VR: Any thoughts about the future of spiritual care in palliative care?
JH: We need spaces for grief. I wish that every single floor had a welcoming little room for meditation, prayer, and families. In these spaces, people can take their time and have conversations, which is helpful for grieving. At the Neuro, they have a beautiful space for grieving - the healing garden. I see it as an amazing template for a healing space in a hospital.
While working as a spiritual care practitioner, Jennifer continued painting, which she describes as an act of devotion, self-healing, and a reflection of her life. She puts it simply: 鈥淎rt is my refuge.鈥� Jennifer is currently working on a large-scale, time-based painting project called 鈥渢he Altars to the Stars鈥�. If you would like to know more about Jennifer鈥檚 work as a visual artist, you can visit her .