Ministry on death and dying teaches people how to plan for the end of life

“It seems to me that one ought to rejoice in the fact of death -- ought to decide, indeed, to earn one’s death by confronting with passion the conundrum of life. One is responsible to life: It is the small beacon in that terrifying darkness from which we come and to which we shall return.”

-- James Baldwin, “The Fire Next Time”

Jacqulyn Jones lived a good life, strengthened by family, a supportive church and loyal friends. One of them said her smile was “like the start of spring.” So those who knew Jones were shocked by her death in the winter of 2016 at age 66.

“I saw this vibrant woman get very sick,” said the Rev. Sabrina Gray, of Bethel African Methodist Episcopal Church in Boston’s Jamaica Plain neighborhood. “She found out she had stage 4 lung cancer in September, and she died that following January.”

Gray said Jones’ first reaction was to fight the disease. But Jones soon discovered she could not outrun the cancer that was rapidly spreading through her body.

So Jones laid out clearly written instructions to family, friends and fellow congregants about what should happen when her life ended. She made plans down to choosing her headstone; her children discovered after her death that all they had to do was go to the funeral home and show up at the church.

That event nearly four years ago was a defining moment for Gray. She realized she had to take the lead in preparing her congregation for death.

Today, she is the director of Planning Ahead, a three-part program at Bethel AME in which participants map out their end-of-life plans. Since the program’s inception, Gray has helped some 200 people prepare for their final season of life.

“Certainly, we as an African American church, we believe that there is an afterlife,” she said. “I think that for us, as far as ministry, as far as reaching out, as far as witnessing, as far as sharing, this program allows us to go through that door and to speak to others about our faith, about that day that will come, without fear.”

Death and faith

The idea for a new pastoral ministry on death and dying came from Bethel AME’s co-pastor, the Rev. Dr. Gloria White-Hammond.

“We certainly recognized that at some point in life, we will transition,” White-Hammond said, “and we wanted to create a space for people to anticipate how to plan for that. Jesus was a planner. He planned ahead.”

White-Hammond and her husband and co-pastor, the Rev. Dr. Ray A. Hammond, are rare among ministers in America. Both are medical doctors, and not surprisingly, Bethel’s pews are occupied by nurses, radiologists, psychiatrists, pediatricians and a range of other health care workers.

“It is higher than the average number,” White-Hammond said. “Obviously, you have two physicians who are your pastors. So we have medical students. We have people in various levels of training who look at us and have a sense that this is a place where people speak their language.”

Many of Bethel’s ministries emphasize health and wellness in various forms -- counseling programs and spiritual support for single black women; initiatives for fortifying marriages, confronting sexual violence, advocating for criminal reform, assisting inmates and addressing problems of troubled youth.

But until four years ago, there was no single program to address many people’s greatest fear: death. How do you prepare for what writer James Baldwin described as that “terrifying darkness”?

Don’t talk about death

Getting members of the congregation to talk about dying was quite an undertaking, Gray discovered when she was given the task of addressing the issue.

“It’s a cultural thing,” Gray said. “When I grew up, I was told, ‘Don’t talk about death; it’s going to make it happen.’ So we didn’t talk about it, and when somebody died, it was one of those taboo things. You don’t talk about death.”

But Jacqulyn Jones’ passing brought the unavoidable reality of life’s conclusion into sharp relief for Gray. Jones’ diagnosis coincided with the beginnings of a conversation with congregants on death and dying that also reflected the church’s commitment to community and social justice.

The seed for the Planning Ahead initiative was planted in 2015, when Hammond and White-Hammond invited the Rev. Rosemary Lloyd to speak to Bethel members. Lloyd is the advisor to faith communities for The Conversation Project, an initiative of the Institute for Healthcare Improvement. The organization’s aim is to help people talk about what they want at the end of their lives.

The Conversation Project offers resources for individuals and organizations to facilitate end-of-life conversations. According to their national survey, 92% of Americans say such conversations are important, but only 32% have actually had one.

White-Hammond’s experiences with patients in 30 years of practicing medicine, including some of her own parishioners, inspired her to initiate the program at Bethel. She had witnessed patients take their last breaths absent a written will, she said, and had seen the family disputes that ensued.

She had seen people die leaving many kinds of unfinished business -- from practical things like not sharing passwords for smartphones and computers to deeper things like not offering apologies or forgiveness to family and friends.

Prior to Lloyd’s address in fall 2015, Bethel’s ministers were concerned that few people would come for a presentation that zeroed in on one of their greatest fears. No more than a dozen folks were expected, but more than three times that number showed up.

White-Hammond embraced the conversation begun by Lloyd and took the lesson a step further, beginning by giving the program a name that she hoped would not alarm Bethel congregants.

“We cast [end-of-life care] in a positive light. You’re taking a big trip, you plan ahead. You have a momentous occasion in life, you plan ahead. And so it made sense to think about this also as ‘planning ahead,’” she said.

The ‘death lady’

But showing up to hear a lecture on death was one thing; discussing the steps that should precede one’s own passing was another, said Gray, the Planning Ahead director.

“I found church people started avoiding me because, they said, ‘There’s the death lady. She’s the one who talks about death.’ So, you know, we really had to get people comfortable,” she said. “We really had to get people to come to grips with the reality that one day they are going to die.”

Gray and her husband, Bob, a Boston Celtics chaplain and assistant pastor at Bethel, were among the first to complete the three-part program, along with Hammond and White-Hammond and another ministerial couple.

For White-Hammond, it was deeply personal. Her family is afflicted by a degenerative neurological disease that was inherited by six of her seven siblings; four have died. She knows that death can come suddenly.

While some doctors might view death in clinical terms, White-Hammond -- who says she is a minister first and foremost -- sees the end of life through the prism of faith.

“I’m grateful for a faith that says there’s something else to look forward to. And to be able to see some of my people, and my people’s people, is very powerful for me,” she said.

She constructed the Planning Ahead ministry as a pragmatic tool in a spiritual setting for individuals like Shaya Gregory Poku, a member of the Planning Ahead class of 2018.

When Poku was a child, she knew several people who died young, including cousins who perished in a plane crash.

“I have known my whole life that there’s a very fine line between life and death, and something can happen instantaneously, even when you’re young,” she said.

Planning ahead in three stages

Planning Ahead programs, which generally involve five to 10 people, take place in winter and spring and are divided into three sessions, once a month for three months. The program is free for participants, with the church providing funds for Gray’s modest salary.

The first step, Gray said, is simply to have a conversation about death and dying.

The second step is to write down five wishes to guide those providing your future end-of-life care, including options for palliative care.

“For example, if you’re in a coma and likely not to wake up, what would you like to happen? Would you like to be cremated or buried? How do you want people to treat you? How do you want to be remembered?” Gray said.

The five wishes advance directive format encourages people to consider medical, personal, emotional and spiritual issues, including identifying a health care proxy in case they aren’t able to make decisions for themselves.

And the third step?

“All we do is celebrate, because people have gotten the process started,” Gray said. “We give them a little trophy, a little certificate, and then we have a potluck dinner, and it’s just a time for us to reaffirm one another.”

Planning Ahead is best done when the end of life is still theoretical, White-Hammond said. Most of the program’s current participants are in their 30s or just entering middle age. Some are teenagers who have lost friends and loved ones to drugs, homicide or much-too-early natural death.

Despite the care she takes to be aware of people’s feelings, Gray said that not everyone completes the program.

“Some people come and go, and I see them sort of withdraw, or they get very quiet,” she said. “And sometimes I reach out to them afterwards, and they say, ‘This is too much.’”

Poku, who oversees the Center for Social Justice and Community Impact at Wheaton College in Massachusetts, said she has always been a planner but until recently had not planned for the inevitable.

“I’ve gotten more comfortable talking about death. I’ve been able to get my father to finally write down some of his thoughts about what he would actually want to happen,” she said. “It’s still a work in progress, but it’s on paper, and he actually talked about it with us for the first time.”

Another participant, Gloria Weekes, said the manner in which her mother passed away motivated her to be more prepared. Weekes, a forensic clinician in the juvenile court system, said her mother planned for everything imaginable -- except her death. She said that her mother “never planned for what our lives would look like after she was to leave this earth and expire.”

After her mother died of breast cancer, “it really left a lot of close family members really hurt that they didn’t have a chance to say goodbye and transition,” Weekes said.

Bethel spreads the faith

In a promotional video on the Bethel website, a Planning Ahead participant, the Rev. Carrington Moore, stares straight into the camera and says, “Often, we think about dying in the sense that we are going to die alone, when in fact we actually die in a community.”

Bethel AME is working to replicate the Planning Ahead curriculum in communities throughout Greater Boston, including churches, hospitals and teaching institutions.

All are part of the Massachusetts Coalition for Serious Illness Care, a network of more than 100 organizations dedicated to helping people align their health care with their values and preferences.

White-Hammond, a resident practitioner in ministry studies at Harvard Divinity School, also teaches a class with divinity and medical school students predicated on the three-step Planning Ahead program.

She said clinicians with the American Academy of Hospice and Palliative Medicine “are now looking at the importance of spirituality for their patients in the context of wanting to provide more comprehensive, especially palliative care.”

The minister said health care providers are reaching out to Bethel AME to understand how spirituality fits into health care decisions.

Breaking the silence

On a recent evening, the voices of the rehearsing choir wafted through Bethel’s halls and vestibule and into the main chapel where Gray was wrapping up an interview. After a 30-year teaching career in Massachusetts and her native Kansas, Gray considers Bethel AME her home.

She and Bob Gray were married here, and it is here where she hopes one day to say her final goodbyes, among community and friends.

The so-called “death lady” -- raised to refrain from discussing the finality of life -- is no longer afraid to talk about her own inevitable death.

Gray shared her five wishes with her children last Christmas. Her husband warned her that it might be the wrong time to have the discussion, but Gray gathered the family together in the living room beneath the sparkling tree.

It didn’t go well at first, Gray said: “The one daughter who I knew was going to scream and cry and run out the room did.”

But her daughter returned moments later.

“She said, ‘Mommy, it was just too much, but I have to really come to the reality that one day you’re not going to be here. … I guess I should do it too, huh?’”