Towards the end of life, silence seems to take increasing prominence in caregiving relationships. A complex phenomenon, silence has been less explored than verbal interventions, yet to be an effective element of care, silence requires skill and practice from professional caregivers.
This research, undertaken in the United Kingdom between 2013 and 2016, sought a deeper understanding of a type of silence that contributes to palliative spiritual care. A two phase phenomenological methodology was adopted, using heuristic inquiry and hermeneutic phenomenology. Data were gathered through self-inquiry and unstructured interviews with 15 palliative care chaplains. A descriptive and hermeneutic analysis facilitated explication of the lived experience to produce an interpretation of the nature, meaning and value of spiritual caregiving silence in end-of-life care.
Spiritual caregiving silence emerges as a way of being with another person, complementary to speech and non-verbal communication, in which the caregiver takes both an active and participative role. It evokes a sense of companionship and connection and creates accompanied space, allowing the other person to be with themselves in a way they may not be able to be alone; this demands a depth of engagement from the caregiver. Silence provides a means of, and medium for, communication beyond the capacity of words and has the potential to enable change, leading to expression and acknowledgment of truth. It offers patients, and their families, opportunities to find acceptance, restoration and peace.
The thesis concludes that spiritual caregiving silence is a person-centred phenomenon that supports the wellbeing of patients at the end of life, and their family members, by drawing on cross-disciplinary knowledge and experience. The interpretive process, illuminated by examples of specialist lived experience, has produced a deeper understanding of the phenomenon that may find resonance with the experience of other caregivers, to stimulate further discussion and inform clinical practice.