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Last updated 30th March 2020

COVID19 Pastoral and liturgical advice and resources

Advice and ideas for clergy on pastoral and liturgical topics

Liturgical Resources for Funerals in the Current Crisis (28/03/20)

The Liturgical Commission has produced additional resources which can be found here:

https://www.churchofengland.org/life-events/funerals/clergy-funeral-and-bereavement-resources

This includes:

  • a short advice document for clergy
  • outline orders of service for funerals at crematoria and at the graveside, observing the current public health guidance
  • a simple reflection and prayers which can be shared by ministers with those who are unable to attend funerals
  • printable graphics and stationery to share prayers and to point to online light-a-candle page

 

Pastoral Visiting advice

Pastoral support for individuals is an important part of role of the church but in light of the current pandemic guidance, face to face pastoral care should only be undertaken if seen as essential and where the risks of doing so to both the person being visited and the person doing the visit have been carefully considered and appropriately managed.

During the pandemic it is inappropriate to stop ALL pastoral face to face visiting. Equally, it is inappropriate to simply continue all face to face visiting as would have happened prior to the pandemic.

If a person is in hospital or hospice then it is appropriate to ask the chaplaincy team serving those healthcare settings to provide the pastoral care under the guidance of the healthcare professionals in these institutions. There is no justification during this pandemic for parish clergy or pastoral care visitors to be undertaking hospital or hospice visits. Contact for each key NHS Trust are outlined below:

  • East Lancashire Hospitals NHS Trust                                      01254733632
  • Wigan, Wrightington and Leigh Hospitals NHS Trust             01942 822324
  • University Hospitals of Morecambe Bay NHS Trust               01524 519231
  • Lancashire Teaching Hospitals NHS                                        01772 522435

Managing the risk

Before any face to face meeting ask the following questions:

  • Why are we holding a face to face meeting - could pastoral support be offered over the phone, by email or virtually, through shared prayers or a streamed act of worship?
  • Is it essential that we meet face to face now, or could the situation wait for a time when risk could be mitigated further?

Deciding what is an essential face to face meeting will be a matter for the individuals involved and their perception of the level of risk involved in such a meeting.

  • Ensure the person making the visit is fit and well and, as far as possible, has not knowingly been in contact with COVID-19. If there is any doubt do not visit.  If the pastoral need is urgent – such as someone approaching the end of their lives – someone else should provide the pastoral support.
  • Ensure the person being visited is not in self isolation because of contact with COVID-19.  If there is any doubt or there are concerns, do not visit and meet face to face, but offer pastoral support in other ways.
  • Wash hands with soap and warm water as you enter the building for at least twenty seconds
  • Remain at least 1 meter (ideally 2 metres) away from the person
  • If at all possible, avoid physical contact – if anointing is deemed essential use disposable gloves and dispose of the gloves immediately after use in a bin before leaving the house.
  • Offer communion only in one kind as per Bishops’ Guidance
  • Wash hands with warm soap and water for at least 20 seconds before leaving the house
  • Where at all possible limit a face to face visit to 30 minutes or less and limit the number of people in the room to allow for an appropriate distance to be kept between you all.
  • If a person is being barrier nursed follow the guidance of the healthcare professionals looking after the individual and if you are told not to visit please follow that guidance.

Ensure you have the contact details for the person visiting and that they have your contact details. Inform each other immediately if either you or they are diagnosed with COVID-19 or are in contact with a case of COVID-19 and start the process of self-isolation as outlined in the government guidance.  If in doubt contact NHS 111 – do not go to a healthcare facility or a GP surgery unless directed to do by a healthcare professional.

If you are unsure consult the advice given by Public Health England:

https://www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response

Ministry for those approaching the end of their life advice

The care of the dying is an important of ministry.  We need to be prepared for a significant increase in the number of deaths in our community in the next few weeks. 

Care of the dying person and those walking alongside them, conducting funerals and supporting the bereaved can be difficult, complex and draining.  At the height of the pandemic we may be faced with some incredibly painful dilemmas around who we minister to, how we minister to them whilst balancing the risk to ourselves and those around us.  For some clergy the risk to those in their household or to themselves should exclude them from direct face to face contact with those infected with COVID-19. 

Each of us should prayerfully consider how we will respond if asked to respond to a request to pray with someone who is dying and /or administer the sacrament of the sick.  These are not normal times, we have to assume that anyone who is sick, even if they are thought to be dying of something other than the COVID-19 virus, might have the virus, so it is important that you pause and think before responding.

For some not responding to a request for a face to face meeting is the right and Godly thing to do because of the risks that exposes you or your household to.  If you have vulnerable members of the household living with you such as elderly parents or a spouse with an underlying health condition think seriously about their health and the risk to them of you going into a high-risk situation. If that is the case is there someone else in your cluster who could respond to that request if essential and unavoidable?

You should therefore only undertake a face to face visit if the presence of a priest for sacramental ministry has been specifically requested and you judge it absolutely essential. Under the current circumstances no one should feel in any way obliged to conduct this ministry. Resources will be made available that you can give to families to assist them in praying for a dying relative.

Before you undertake any face to face pastoral visit consider the following points carefully:

  • Think carefully about the risk to you and the risk to your household if you undertake a face to face meeting.  Do not be under any illusion, you are being asked to take a significant risk in undertaking a pastoral, face to face visit
    • Is there another way to provide support – telephone, skype, video message, sending the family or cares a set of prayers they can use via email?
    • Can the risk of a face to face meeting be justified? Is this person imminently approaching the end of their life?
    • Are you the right person to go?
  • Where is the person who is dying?
    • If in hospital, even if they are someone you know well, sensitively but firmly hand the response to the hospital-based chaplaincy service.
    • If the person is in a hospice, ask about chaplaincy provision and in discussion with the healthcare team in the hospice decide who can respond. Some hospices will have access to their own chaplaincy teams, some will have access to hospital-based services, some will rely on parish clergy to come and minister to their parishioners.
    • if the person is in a care home or other care facility such as mental health care facility, discuss with the nursing staff what is needed and why
  • If you decide that a face to face visit is essential, then follow all the precautions being used by healthcare professionals including:
    • Washing your hands and wrists (remove your watch, bracelets etc) for at least 20 seconds with warm water and soap on entering the house or care facility (to protect the care facility). Hand gel is less effective and so should not be relied on.
    • Maintain physical distance between you and others in the room. Ideally there should be three people or less in the room – you, a close relative or care worker and the person you are ministering to.
    • If possible do not use a liturgy book – but print the liturgy out on to a piece of paper that can be left with the patient once completed. If inappropriate to leave, make sure you dispose of the sheet before leaving the care facility (to prevent the virus spreading on the book or paper)
    • If personal protective equipment (PPE) is being used by health professionals you must use it too – in most cases that will be a plastic apron, disposable gloves and a face mask that covers your mouth and nose. These must be removed and placed in the bin provided before you leave the room.  In addition, you must wash your hands and wrists for at least twenty seconds with warm water and soap before you leave the room (to protect yourself)
    • Even if personal protective equipment is not being used, use disposable gloves if you are going to touch the patient as part of prayers / sacramental anointing and dispose of the gloves before leaving the room or care facility. Wash your hands and wrists with warm water and soap for at least 20 seconds before you leave the room or if that is not possible as soon as you can and definitely before you leave the care home or the house.
    • Keep the visit as short as possible whilst being pastorally sensitive.
    • Consider leaving some additional resources such as simple prayers or short bible readings that can be used by family or care workers as part of ongoing support for the person approaching the end of life. These should be printed out and left with the family.
    • Make sure you leave your contact details with the care home or a key member of a family and politely but firmly ask them to let you know if a case of COVID-19 is diagnosed in the home or household as soon as possible.

If there is any suspicion that you have been in contact with a person with COVID-19 then you must self-isolate – following the NHS guidelines and inform the Diocese. Do not take any risks.

https://www.nhs.uk/conditions/coronavirus-covid-19/

Prayers

We also now have prayers available to be said by a family or carer at end of life. Click here for those. 

 

Care after death advice

Whilst most clergy will not be involved in the care of a body after death it is useful to be aware of the guidance around care after death for someone who has died from COVID-19 or is suspected of being infected, as this may influence the pastoral support needed in the future.

  • The body may be put into a body bag and treated as highly infectious – local guidelines may differ – the risk of infection diminishes as the time from death extends.
  • Any mementos from the body such as locks of hair or handprints can be taken but must be kept in a sealed bag for 7 days before being opened.
  • The family will not be allowed to see the body in the hospital mortuary and may not be able to view the body at the undertakers because of the infection risk.  In some instances, they may be able to view the body virtually.
  • Patients who have died with implantable devices such as pacemakers may be prevented from being cremated, even if that is their wish because of the danger of infection to the staff who would normally remove the device after death.
  • COVID-19 can be used as a cause of death on a medical certificate of the cause of death (MCCD). Some families may struggle with this as a cause of death.
  • It is likely that there may be delays around families getting the medical certificate of the cause of death, which means there may be lengthy delays in being able to register the death even before the likely delay in being able to hold a funeral
  • In some cases, there may need to be a coroner’s inquest which will build in significant delays to registering the death and disposal of the body.

Pastoral support around funerals advice

It is possible that several of the family will be in self isolation during the initial days after a death and possibly at the time of the funeral.  In addition, the number attending the funeral will be extremely limited. Consider:

  • Encouraging the family members to light a candle or a virtual candle around the time of the funeral. You can light a virtual candle on the Church of England website around funerals.    https://www.churchofengland.org/life-events/funerals
  • If possible, ensure they have a copy of the funeral service being used so they can follow it at home
  • Think about the role of memorial services later in the year to which families who have been unable to attend a funeral might be invited to.  Ensure you have the all relevant contact details needed and consent to contact them if this is something you plan to do.