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How to Counsel the Dying

Truth In Love 424

How do we care for those who are approaching death’s door and into the presence of Jesus?

Jul 24, 2023

Dale Johnson: This week on the podcast, I have with me Pastor Tim Pasma. He’s ministered at Larue Baptist Church in LaRue, Ohio, since the spring of 1985. He’s married to Rebecca and God has blessed them with three sons and three daughters, three daughters-in-law, a son-in-law, and 14 active grandchildren. Pastor Tim earned a B.A. in from Cedarville University in 1977 and an M.Div. from Grace Theological Seminary in 1981. He serves as an ACBC fellow and is on ACBC’s Board of Trustees. He lectures frequently on counseling issues at counseling conferences and for a number of Christian organizations. Tim, I’m so grateful that you’re here. 

Tim Pasma: It’s great to be here.  

Dale Johnson: And it’s always fun, I love being around Tim Pasma, such an encouragement to me, and you know, to see the faithfulness of the Lord in your life, to be in LaRue, Ohio for this many years pastoring faithfully, shepherding, but we’re going to talk about a very serious issue, even today, one that’s very difficult to think about, difficult to even minister in moments like this when we talk about those who are dying. We know it’s reality. We know that’s coming. The Bible tells us that it’s true. Our experience tells us that these things are true, but sometimes still Tim, we have hesitations about this, especially, when we’re engaging. I teach pastors, and so, guys who are preparing for ministry, this is the one of the most frightful things that they have to deal with, hesitations about going into a hospital room when they know someone is dying or even ministering in funerals. There’s a hesitation, there’s a fear that’s there. Talk about some of these hesitations for us as we engage in counseling those who are dying. 

Tim Pasma: Well, you know, people are just they’re afraid of the subject, they don’t want to say anything, you’re talking to someone who’s dying, and you don’t want to talk about that, right? You just, let’s talk about the birds that are in the feeder outside or window or how the grandkids are doing. And there’s something about death that makes people just don’t want to talk about this and the world, of course, according to the Bible is enslaved to the fear of death, right? Hebrews 2:15. And so that’s not just the people who are dying, but the people who aren’t, who are well and someone in their family is dying, they just don’t know what to do with that. They’re just scared of it. They don’t know what to say for one thing, what do I say, right? And so, we just talked about the inane things that are going on rather than what’s really happening. 

Dale Johnson: Yeah, I think that captures most of it, where we’re maybe even afraid to say the wrong thing because we don’t know what to say, and sometimes in moments like that, to be quite honest I’ve made this mistake where we say things that demonstrate that we’re nervous, that might not even be untrue. We might ask a question, you know, like we’re accustomed to how are you guys doing? Well, obviously, we’re not well, right? And so you know, we’re afraid to make mistakes like that instead of embracing a moment of weakness and with courage engaging that moment, and I think over my ministry that’s something I’ve learned to do, but I’ve had to struggle through some of that fear, for sure.

Now, we have an obligation, I think to engage especially at these moments where people are about to cross into eternity. Talk about biblically, our obligation to engage people who are at this precipice of life.

Tim Pasma: You know, a verse that I’ve kind of adopted as a ministry versus Colossians 1:28, where Paul says, Him, that is Jesus we proclaim, warning (noutheteo), counseling if you will, counseling everyone and teaching everyone with all wisdom that we may present everyone mature in Christ. And so my view of my ministry is I minister the Word publicly and privately for the purpose of producing mature people who can give a good account of themselves to Jesus when they stand before Him. And so, until that person dies, I have an obligation to prepare him for that. I want to prepare everybody for that. I want to help that person; frankly, at this stage, I want to help him die well.

Okay, we talked about the obligation, you know, we’re here, we’re actually talking about counseling here, and this is what I really want to communicate. You got to grasp the fact that you’re doing normal counseling in extraordinary circumstances. So, what I mean by that is something like this, what’s the goal of counseling? The goal of counseling is the glory of God. And so, you have the apostle Paul saying in Philippians 1:20, “I eagerly expect and hope that I will in no way be ashamed, but will have sufficient courage. So that now as always Christ will be exalted in my body whether by life or by death.” Well, I really want to help him to exalt Christ in their death. That, to me, is a powerful verse to someone who is dying. And, you know, I’m not going to say this out loud, but what I have to have in my mind for my life and for the life of this one who’s dying is, you know what? We are not the central characters in our story, this person is not even the central character in his death. Jesus is, now that seems radical. But again, you know, the gospel is radical. You want to die in such a way that people will see Jesus. That’s what the Apostle Paul wanted. 

Dale Johnson: And Tim, I love the way you just described that is sometimes in extraordinary circumstances we think there has to be a radically different way to approach this, but what you’re doing is you’re helping us to see that we’re going to take ordinary counseling principles, ordinary goals that we have that remain regardless of the circumstances, and we’re going to be able to implement those in this difficult circumstance. And we’re going to do it in a way that’s applicable and appropriate, the way God gives us in the Scripture because the circumstances are certainly different. So, we’re not coming up with some new method or anything like that. We’re going to stick to the Scriptures, but now let’s get a little bit more practical because, you know, we all know that we’re dying. The Bible tells us in Corinthians 4 that our bodies are decaying. Don’t we love that and claim that verse, right? The idea is true, but there’s something about it when you might hear for yourself that there’s nothing more we can do, we’re sending you home and the best advice we have is we’re going to order hospice care, and you know death is imminent. And now you’ve been called, maybe as the biblical counselor, as the pastor to come and to minister. And that situation is quite different. What do you say in moments like that?

Tim Pasma: Okay, again, normal counseling, extraordinary circumstances, you know what, this is going to sound awful but you got to gather data. Okay, now I’m not going to hand Marion, who’s imminent, whose death is imminent. I’m not going to hand her a PDI, but what do I want to know? I want to know things like this, what does she think of her death? What troubles her at the end of her life? Did she view her life with regrets? Is she anxious or angry about anything? I mean, I can ask those kinds of questions in a very pastoral way. I’m not, you know, sitting there with a pad like I do in counseling, but I am trying to figure out where she is. And if I’m going to minister to her at this point of her life, the point where her days are waning, and she’s going to die, I want to know those things so I can minister to her what she needs to know at this point in her life. I’m going to minister the promises of the Gospel. I mean that’s really important. I know even okay for even my life; I’m 67 years old so I’m at the point where I’m looking back and one of the things that strikes me, as I look back, I’m filled with regrets. You know? And someone who’s dying is looking at their life and saying, my life isn’t worthy of glory and the point is where you’re right, but you got a great Savior and so, the things that we take for granted, yes, I have been made right with God through Jesus, man, you got to really emphasize that at this point, because at this point people are really thinking about their lives. And they have to understand that Jesus is a complete Savior. 

Dale Johnson: Yeah, that makes me think of Romans 5:1 “When we confess by faith, in the Lord Jesus Christ, we are at peace with God.” And we are reminding people of that. I remember C.S. Lewis said it like this: “It’s not a moral teacher who gives us a new moral code that’s the great teacher. It’s the one who reminds us of the old.” And really, at that moment, we need reminding of these truths that the writer of Hebrews in Hebrews 6:19 says, these confessions are an anchor of our soul, the tempest of life is swelling and it’s difficult, it’s blowing hard at this moment of imminent death, you’re contemplating things that maybe you’ve never given yourself permission to contemplate. And we have to remind ourselves of these truths that are anchors to us.

Now, let me flip the scenario a little bit because a person may have a little bit of more time. So we talked about imminent death. Someone is given may be days, weeks, a month to live, or so, they’re on hospice care, but let’s turn to someone who is just been given a diagnosis, either that phone call or that doctor visit that everybody fears is we don’t know what else to do. We can put you on chemo, it might extend your life a little bit, but we’re not sure what else we can do. There’s not much else that we can do that we know of and so, you know, death is approaching it’s coming, it’s more real to you. It might be six, eight months, a year out. But you know, there’s an endpoint. It becomes real to you. How do you talk to somebody like that? 

Tim Pasma: Again, I don’t want to forget what I just said, I want to be gathering data. I want to be giving hope, I want to be doing those things, but with someone like this, here’s something I need to realize, and that is the nagging reality of death’s approach is hanging over everything that he does now, he’s eating lunch with his wife, he wants to go work in his workshop, would work in his workshop and for him, there’s this: “Yeah, I’m not going to be able to enjoy my wife much longer, I’m enjoying working with my hands but you know what that’s going to end soon.” So for someone like that there’s the shadow of that hanging over everything, and again you want to minister the promises of the Gospel, you don’t want to ignore the obvious. You need to talk about his impending death but in light of the Gospel, you need to understand what are his thoughts and his attitudes and his speech, all those sorts of things. But with someone like this, I want them to understand that the call to discipleship still remains for them, and what’s fascinating here. This is what again shows me the wonderful sufficiency of the Word of God. You go to 2 Timothy 4 and you see the reflections of a man who is facing certain death just around the corner for him, unlike Philippians 1:20 where he might die, in 2 Timothy 4, Paul is going to die. He’s in that situation and it’s just amazing. So what does he do? He says, well, I got to continue to minister, and so, he says, get Mark, Luke’s with me but get Mark because he’s very useful to me for ministry. Well yeah, I got work to do before they chop off my head. So I need some help with that, right? That’s incredible. He still has time to grow spiritually. He says I still want to grow spiritually. So, what does he say? He says to Timothy, when you come, bring the cloak that I left with Carpus in Troas, and also, the books and, above all the parchments, death is around the corner, and he still wants to do reading and writing. It’s amazing. And they still have an opportunity to grow 2 Corinthians 4:16-18. You know what I say? I’ve said this, 2 Corinthians 4:16-18 can be great life versus for people that are facing certain death. You know, where the Apostle Paul says we don’t lose heart though our outer self is wasting away, our inner self is being renewed day by day, says for our light and momentary affliction is working for us an eternal weight of glory as I think about the things that are eternal. And so, here’s someone who’s still can be renewed, right? And hope is there.

There are so many things that you see with the apostle Paul, and one of the things that really stands out for me is the point where he says, “for I am already being poured out like a drink offering and the time for my departure is near.” What is amazing about that statement is he saying when my blood splashes on the floor, that’s like the wine of a drink offering being splashed and he’s saying my death is going to be my last act of worship. Those are the sorts of things I want to communicate to my friend. 

Dale Johnson: Yeah. Because now that radically changes everything where Psalm 90 becomes real, they’re learning to number their days, they’re seeing the ways in which they invest in time here on earth, but with an eternal cause. They’re changing their mind Colossians 3 to truly set their mind on things above. And that changes the way that we live, where faith now becomes something that’s tangible in the ways in which they spend their days, things become more valuable with how they invest their time, and it just changed perspective. And as you mentioned earlier, learning to die well, they really become a testimony to other believers on how to do that with peace. 

Tim Pasma: Yeah, and you know, when I look at that, that’s what really strikes me is the fact that when the Apostle Paul says, I want to exalt Christ, whether by life or by death, he’s saying things like you know, what if the emperor lets me go, I want people to see Jesus, if the emperor condemns me, I want people to say he walked to his execution, he went through it, it looked like Jesus, right? And so, this gives purpose to the person who’s dying. When you say, you can die for the glory of God, you can die in such a way that people will see Jesus, man, and that’s going to resonate with a believer, that’s going to say, yeah, there’s a real purpose in my dying now, right? And, for a believer that’s going to resonate with them and help them say yes, there’s a great purpose now. I want them to see my devotion to my Father. I want them to see the Lord Jesus in my demeanor. I want to die in such a way that people will see God and see the Lord Jesus.

Dale Johnson: Paul’s statement, whether by life, or by death and Tim, I’m going to remember something that you said, I hope our listeners do as well, that death becomes our final act of worship to the Lord, that changes everything. When I think about glorifying the Lord even in this act of death that the Lord is bringing us to because He does, He numbers are days and we can worship Him in that well. T

his has been a helpful conversation. Thanks so much for helping us squelch our fears, root our faith and hope in the Gospel and teach us to minister to those who are who are dying. 

Tim Pasma: This was really, as I thought through these things, it was very helpful for me. I am so, again, I’m so thankful for the Scriptures that are full of truth for every situation. 

Dale Johnson: Amen, to that. So grateful for this. I want to mention to you Tim has written a little booklet on this subject, “How to Counsel the Dying?” I’m going to tell you more about that as well.

Helpful Resources:

How to Counsel the Dying? Booklet by Tim Pasma.

The Journal of Biblical Soul Care.

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