Pastor John Richter of Atonement Lutheran Church, Wyomissing, Pa., and
Atonement Health Ministry Advocate Jill Heidel movingly described the
challenge of representing aging and ill patients in what sometimes
becomes an adversarial health-care system.
They were the keynote presenters at “Health Ministries Advocacy – A
Matter of Love and Justice,” an event that drew about 80 pastors,
nurses, health ministry professionals and concerned people of faith to
the Lutheran Theological Seminary at Philadelphia on March 13, 2004.
Pr. Richter documented the complex and dramatic changes in the health-care
system with personal stories. He began by recalling the health decline
of his grandmother in the late 1970s. “She was dying of cancer,
but really she was dying of old age. She was winding down, becoming older
and more frail, slower, showing signs of dementia.”
He went on to describe the assistance provided by a social worker at
the Lutheran Medical Center in Brooklyn after his grandmother was moved
there, including figuring out what nursing home to select. “When
it came time for my grandmother to go to a nursing home, my mother told
the social worker she could use a few more days to get prepared, and
the social worker saw that the hospital granted that extension,” he
“Fifteen years later my father was dying,” he continued. “He
was also in his 90s and slowing down and becoming more frail with dementia.
He was in the same medical center that had cared for my grandmother.
This time, however, the social worker assigned to my father was regarded
as an adversary. Things seemed different. There was tension, strain,
and there were tears.
“The rules changed,” he said, “and I could understand this
intellectually, but at the same time I was sitting across the table from
my mother, and I was hearing her cry. There was no one in the hospital
to help her with her perception of how things had changed.”
These experiences helped open Pr. Richter’s eyes to the changes
in health care, changes driven, he said, by spiraling costs, rising health
insurance premiums, all resulting in a health-care system in need of
He began to think about the dozens of folks in his congregation on Long
Island who were elderly or who lived alone. “I thought, if my mother
had trouble, what about the members of my own flock?”
At first the Long Island congregation thought about engaging a parish
nurse to deal with issues like health education, wellness and preventative
health care. “But we were concerned about providing for our members
someone concerned about advocacy, someone prepared to see a patient through
the system. The ideal mix of skills may be a parish nurse with social
work or case management experience, or a social worker with a nursing
background,” he said.
Those two roles have come together in Jill Heidel, Health Ministry Advocate
Ms. Heidel described herself as “a registered nurse with a background
in case management.” She portrayed her role as “meeting a
child of God wherever he or she is at a time of vulnerability. We help
people live with the tensions of that time, often in the presence of
Helping people discover their health-care options, often when they do
not know what they are, is a key role for Ms. Heidel. “The options
simply are not made clear otherwise,” she said. The support may
also involve looking after caregivers who administer hospice and other
kinds of care to loved ones.
Pr. Richter noted that an appropriate role for a health ministry advocate
might be to seek changes in public policy. “That hasn’t happened
at Atonement yet, but it may be something we are heading toward,” he
said, adding that Ms. Heidel is serving an ever-widening circle of people
in need, beyond the congregation. “All are served at no financial
cost or obligation,” he stated.
Ms. Heidel said she frequently cooperates with willing hospital professionals
to work on treatment plans of patients to be released. She assists with
discharge planning and informing patients about their prognosis and options. “Sometimes
people and their relatives just don’t know what is going on. I
help them learn answers to the questions they have.”
At Atonement, Heidel also oversees a wide variety of health-care forums
and educational events, such as stewardship of the body programs, teaching
about eye care, Parkinsons, dementia and Alzheimers; running vaccination
clinics; sponsoring a caregivers support group; helping people cope with
chronic pain; and sponsoring a chronic diseases group.
“We try to teach that healing can occur even when a cure is not
told the group.