Procesos del Pepino y Espárragos en el Ecuador

From the discussion above, a conceptual model of spiritual caregiving silence has

been developed (Figure 15). Drawing on Figure 11, this illustrates the relation of

silence, speech and non-verbal communication in a spiritual care encounter and

demonstrates the continuum from speaking to deep silence, for the caregiver and

the other person in the encounter, visualised in Figure 12. It incorporates the

different modes of ‘being’, ‘being in’ and ‘being with’ silence identified in Table 11,

The model highlights themes that contribute to the meaning of spiritual care giving

silence identified in section 7.2.2: the caregiving disposition of attending and the

sense of companionship, connection and communication that is evoked. As argued

above this, of itself, offers value. Additional value is shown in the capacity of silence

to enable change; noted in section 7.2.3 as expression of truth, verbally or non-

verbally and emotional release. Value is identified in observed outcomes of

acceptance, restoration and peace.

Silence

Spiritual care encounter A conversation

Non-verbal communication Potential

for change

Speech _{Deep silence}

Companionship Connection Communication Speech Being: . . . silent . . . in silence . . . in silence with . . . with silence Active and Participative Being: . . . silent . . . in silence Participative Other Attending Enables change expression of truth Acceptance Restoration Peace Caregiver

Figure 15. A conceptual model of spiritual caregiving silence as a way of being with another person

7.4 Conclusion

In this chapter I have discussed a type of silence described as spiritual caregiving

silence. It shares common themes with silences used or practiced in religion and

of holism, foundational to palliative care, emphasises that boundaries between

disciplines are not distinct, but findings suggest that spiritual caregiving silence, like

spiritual care itself, has a particular role and purpose in interdisciplinary palliative

care.

Spiritual care giving silence is interpreted as a way of being with another person and,

I suggest that, this is its intention and its end. Away of being exemplifies the priority

of a practice of silence, over use of silence, highlighted in the literature and

understands silence as embodied in the caregiver. Further, spiritual caregiving

silence has emerged as more than simply a quality of the caregiver; the capacity of

silence to be both interior and external means that caregiver meets the other in a

space of common humanity, in the silence, and may experience both active and

participative roles. Thus spiritual caregiving silence is complementary to the spoken

word, and also differentiated from speech by the particular contribution it offers to

CHAPTER EIGHT

Conclusion: Spiritual caregiving silence as a way of being in end-of-life

care

In this thesis I have explored and interpreted a type of silence, described as spiritual

caregiving silence, in the context of palliative spiritual care where I have suggested

that silence of the other person, whether they are a patient or family member, may

become more prevalent for a variety of reasons.

The aim of the research was to deepen understanding of the nature, meaning and

value of silence. This has emerged as a way of being with another person, which

evokes a sense of connection and companionship and has the potential to enable

change. The two phase phenomenological methodology enabled, in Phase One,

explication of tacit knowledge to reveal a personal horizon of understanding,

expanded through the shared experience of other chaplains and, in Phase Two, a

description and interpretation of twelve other chaplains’ lived experience of silence

in end-of-life spiritual caregiving encounters.

I have found that spiritual caregiving silence incorporates qualities of spiritual care

itself, with the intention of supporting the spiritual wellbeing of the other person in

the relationship. As a way of being for the caregiver, this silence operates in close

cooperation with both speech and non-verbal modes of communication. I have

interpreted a continuum, from a disposition of speech to deep silence, and a number

In my interpretation, caregiver silence is active, when caregivers use or practice

silences intentionally for the spiritual wellbeing of others, and participative when

caregivers choose to be silent themselves in order to not interrupt a silence which is

external to themselves. Therefore, to be silent is a discerned caregiving decision and

involves the risk of promoting or prolonging a period of silence, which may be

uncomfortable for the other person. It involves assessment of whether it is the

silence or the content of the silence that is uncomfortable for the other person

because silence, in itself, that is uncomfortable for the other person falls outside the

definition of spiritual caregiving silence proposed in this thesis. However the lived

experience of chaplains, in this research, demonstrates that both silences and the

content of those silences can be both comfortable and uncomfortable for the

caregiver.

The purpose of spiritual care, understood as to be with another person, informs the

caregiving decision to stay in silence with the other person in their situation, which

may be extremely difficult, and in a silence which may feel uncomfortable.

Moreover, I argue that, at these times, it is helpful for the caregiver to move deeper

into the shared silence in order to support the other person in their suffering. Thus

spiritual caregiving silence is shown to be a complex element of interpersonal human

relationship, which offers value to patient care in terms of therapeutic

companionship without the interruption or intrusion of words.

To be silent, in silence, suggests a fusion of silences which are both interior and

external to the self of the caregiver. I have argued that to ‘be silence’ in an

external silence for the other person. This contemplative characteristic seems to

denote a shift from spiritual caregiving silence as an act of the caregiver, to a silence

which is caregiving of itself. In shared silence, there is the opportunity for a person to

be with themselves in a way that they could not be when alone.