Pastoral Care and Contact

This article is part of The Pastor's Handbook. To learn more about the series, and how to use this resource effectively, please read our introduction.

The aim of pastoral care is to serve the flock by helping them to live in, and grow in, the grace and knowledge of our Lord and Saviour, Jesus Christ, whatever the current circumstances of their lives (2 Peter 3:18).

It is to help them to work out their salvation with fear and trembling, as God continues his good work in them (Philippians 2:12-13).

Prayer

Pastoral prayer is inseparable from the care of and love for the flock.

The faithful pastor will have some kind of prayer diary as a prompt to bring the sheep individually to God in prayer. Praying often prompts action.

Contact

Pastoral contact happens in various ways throughout the week:

• In brief conversations at church gatherings.
• Shaking hands at the church door.
• Visiting homes.
• Meet-ups for walks or coffee.
• In hospitality.
• Phone calls.
• Texts and messages.
• Letters and cards.
• Unplanned meet-ups.

Don’t underestimate the value of brief regular conversations perhaps before or after a meeting. A warm handshake and a question, reflecting your knowledge them and your prayerful concern for them, goes a long way.

If time for visitation is limited, a succession of several phone calls may be a better option than using up a lot of time travelling to just one or two people in an afternoon or evening. The fact that you have called and listened and read Scripture and prayed over the phone may mean nearly as much as an in-person visit.

In any and every circumstance, a pastor will want to proclaim Christ to His people, admonishing and teaching everyone with all wisdom, so that all may be presented fully mature in Christ. (Colossians 1:28).

It is good practice, where possible and practical, to visit people in their own homes. There is perhaps less of an emphasis on this than in previous generations, but it continues to be of great value.

The Lord Jesus spoke about the importance of visiting (Matthew 25:36) and showed it in his own ministry (Mark 1:29). It is a part of 'doing good', which the apostle Paul refers to (Galatians 6:10). Paul taught both publicly and from house to house (Acts 20:20).

The amount of visiting carried out by the pastor will vary from church to church. It is good to be methodical. Some larger churches will have an assistant pastor and other elders who visit pastorally. Some may have a woman’s pastoral worker and/or a pastoral care team. But in many churches, the responsibility for visiting falls largely to the pastor.

Although situations may vary, the principle of pastoral visiting is the same. People need to know that we care enough to visit, comfort, encourage, teach, and guide them.

While seeking to be a pastor to the whole congregation, pastors need to ensure that they pay attention to Paul's instruction to "treat … older women as mothers, and younger women as sisters, with absolute purity" (1 Timothy 5:12). There is value, therefore, in enlisting the help of pastorally gifted women to visit women in the congregation.

Proactive contact

Faithful pastors will seek appropriate ways to go towards individual members of the flock in order to spend time with them:

• To get to know them (Proverbs 27:23).
• To ascertain their spiritual health (3 John 2).
  • You can download a tool for a spiritual health check based on 3 John.
• To encourage them to remain loyal to the Lord Jesus (Acts 11:23).
• To give them the opportunity to ask questions or to raise concerns.
• To share God’s Word with them.
• To pray with them.
• To equip them for works of service in the body of Christ.

Reactive contact

Faithful pastors will also seek to make themselves available and approachable to respond to spiritual need.

As situations arise in the lives of the flock, it is our privilege and duty to be available to serve them often in both the happy and sad times of life. For example:

• Engagement and marriage
• Births
• Illness (physical and mental)
• Hospitalisation
• Terminal illness
• Bereavement
• Confession of struggles with sin
• Difficulties at work
• Tensions in families
• Fall-outs with others
• Discerning God’s will

The flock may want to seek counsel about any number of matters. Some may surprise us - like the woman who came to her pastor for counsel having just discovered that her husband (unknown to her) was about to be revealed as a Russian spy!

Here are some suggestions to help pastors consider what visiting and contact with the congregation might look like.

Visiting in general

Regular brief visits are more productive than infrequent lengthy visits – particularly for older people who are available during the daytime.

As you get to know the flock you will discover who appreciates an unannounced “drop-in-when-you-were-passing” visit, and who likes a bit of notice.

Unannounced visits are easier in very local congregations, as opposed to gathered congregations. WhatsApp and text messages make arranging visits easier than in the past.

It is good to take a physical Bible or New Testament with you, in your hand, indicating that at some point you will be turning to God’s Word.

Remember that you are visiting as a servant of Jesus Christ. If the person being visited is a Christian, they may expect you to share a brief reading from God's word. At times it is sufficient just to read one verse that will help them. It is good occasionally to ask if they have a favourite Bible reading.

It can help to print out a verse or passage on a small card to give to the person and to leave with them. Something from your own devotions will keep this fresh and unpredictable.

Having read and shared from scripture, a good question to ask is: “How would you like me to pray for you?” This may reveal something of their heart. It may be good, if appropriate, to encourage the person you are meeting with to also pray.

Visiting the sick

When visiting the sick, remember that they are the same people they were before they became unwell. So, continue to take the same general interest in them.

That includes a concern for both their physical and spiritual condition. They can still usefully serve the Lord, and even their sickness can be for the glory of God (John 11:4). For this reason, avoid referring to them as 'laid aside' or similar words as if they are out of Christian service. 

They may be interested to hear how things are going on in the church, and with your family, etc. Share with them the main contents of the Sunday messages, if appropriate and relevant.

Be sensitive and, above all else, take the time to listen. A pastoral visit is not meant to be an opportunity to share your own worries about the church or anything else. You are there to help them.

Visiting the sick should include all ages, even children (with their parents) when injured or very unwell.

For those who are long term unwell or housebound, it can be a great help to encourage engagement with the Sunday ministry (often via the internet), and church news or members’ letters, etc.

If it is possible to delegate responsibility for visiting the long term unwell to others, but it is the wise pastor who still makes time for occasional visits.

Visiting in hospital

When visiting someone in hospital, it is courteous to ask the nursing staff for permission to visit. Explain who you are and your link with the patient. In some departments, visiting will be severely restricted, for example, in a cardiac unit or in the intensive care unit.

Please remember that the medical staff have work to do. Don't let your presence become a hindrance to them.

Check whether there are special visiting hours or open visiting. You may be allowed to visit outside the regular visiting hours, particularly in an emergency, but it is courteous to check this with the nursing staff and to identify who you are. This is where having a visible Bible can help.

Make it your aim to have a brief Scripture verse or reading and prayer, particularly if the patient is a Christian. Choose an appropriate Bible verse or reading and keep your prayer fairly short.

Asking, “How may I pray for you?” may give you an insight into otherwise unspoken fears.

Always bear in mind that the medical staff and other visitors can usually hear what you are saying and praying. Be wise in what you say and how you pray.

Dane Ortlund suggests a helpful guide for hospital visits:

1. Silence the phone
2. Grab a breath mint
3. Bring a Bible
4. Talk little, listen much
5. Read Scripture, then pray it over them
6. Tears okay, but no preaching, no advice, no counsel
7. Treat them with dignity in their felt vulnerability
8. Speak of God and eternity, not the weather
9. Thank and honour the nursing staff
10. Above all: Don't stay long

Visiting the terminally ill

For a Christian, death itself holds no fear, although the thought of dying may cause deep anxiety.

In order to help the terminally ill, we need some idea of how much they and their family know. Sometimes patients are unaware of the seriousness of their physical condition even when their family has been informed. At other times, a patient may know they are dying even though their family is unaware.

The most helpful situation for all concerned is when the patient and their family understand how ill they are and yet feel able as Christians to talk openly. This gives the opportunity for precious times together in Bible reading and prayer.

It is often helpful to spend time with the terminally ill believer and their relatives on their own. They may have fears and concerns that they do not want their nearest and dearest to hear, out of concern for them. When on their own with either the patient or the relatives, it may be helpful to gently ask: “Are there any particular fears or anxieties that are troubling you at this time?”

Remind them of the precious promises that are ours in our Lord Jesus Christ, the completeness of his finished work, the certainty of heaven for Christians, and the promise of Christ's presence at all times. He will never leave them nor forsake them (Hebrews 13:5-6).

Some families may ask you to be with them as they wait for a terminally ill patient to die. This is a great privilege. Assume the person dying is able to hear you, even if their eyes are shut. Read to them. If you have a singing voice, you might sing quietly to them. Pray with them, assuming they can hear, not over them.

If you are there at the time of death, pray for the Holy Spirit to guide you as to how to react. The family may expect you to lead them in prayer. Trust the Holy Spirit to help you to respond with sensitivity and compassion.

Saying the Lord’s Prayer together may help the family to pray when they don’t know how to pray.

Suggested Bible readings:

• Psalms 23:1-6; 91:1-16; 121:1-8
• John 10:27-30
• John 14:1-6
• Romans 8:31-39
• 1 Corinthians 15:51-58
• 2 Corinthians 4:16-18; 5:1-6
• 2 Timothy 1:8-12
• Revelation 7:9-17

Visiting newborns and their parents

When a baby is born, you might arrange to visit the hospital or to wait until mother and baby go home.

Aim to visit when both parents are present. This saves embarrassment for mum and gives an opportunity to rejoice with dad too. Leave it for a day or more before visiting.

It is very important on the maternity ward to ask the nursing staff if it is convenient to visit. Keep the visit very brief. Ask the parents if they would like you to pray with them, giving thanks for their baby.

Visiting one-to-one

A godly pastor will want to be available to every member of the congregation: young and old; male and female; growing and struggling. Some contact will be occasional; other contact will be more regular during seasons in someone’s life. Wisdom is needed in every situation, and it is impossible to cover all potential situations in a short section. 

For transparency and accountability, it is helpful for a pastor to discuss and agree protocols with his fellow elders concerning how they go about one-to-one pastoral contact.

Thought should be given to specific areas of pastoral contact, including: children and teenagers; those who are same-sex attracted; neurodivergent people; and those in vulnerable situations. In every situation it is important to follow good safeguarding practices.

Physical contact

In all pastoral contact, it is important to take care that no word or action could be misinterpreted or cause someone to feel uncomfortable.

Some pastors may feel that any physical contact beyond a warm handshake is inadvisable. An exception might be in hospital with someone seriously ill, where holding a hand or placing a hand gently on an arm or shoulder may be appropriate.

While it may be appropriate sometimes to put our arm gently around a frail elderly person, it is normally unwise to do so with a younger person, male or female.

Place of meeting

Visiting the flock in their homes is often beneficial. When visiting those who are single, it may sometimes be appropriate for a pastor to be accompanied by someone else, or to arrange to meet in a public place, where all involved feel comfortable and safe. 

Some examples:

• A vulnerable adult with special educational or relational needs may feel more comfortable with someone they know and trust present.
• Thought should be given when visiting women on their own in their homes. Alternatives may include visiting with your wife, a fellow elder or female member of a pastoral care team, or arranging meetings in a public space.
• When bereaved, someone may be particularly vulnerable. Pastors must never underestimate temptations of various kinds both for them personally and those they serve in the course of sensitive pastoral work. 

Ongoing contact

While a pastor cannot do regular one-to-ones with everyone in the congregation, he will, at any given time, be likely to be meeting one-to-one with some.

There is always a danger of emotional and spiritual dependency in these situations, so wisdom is needed as to the frequency and longevity of each particular one-to-one.

A wise pastor models and shares in this work with his fellow elders, and equips other members of the congregation, both male and female.

Visiting the unsaved

For many pastors, visiting the sick will include unbelievers as well. In these circumstances, it is appropriate to ask them if they would like you to read the Bible and pray for them. If they are not happy for you to do this, you must accept it and just continue to show them, and their family, the love of Christ. In itself, this may earn you the right later to speak about Christ to them.

Generally, however, you must use every opportunity to speak to them about the Lord Jesus and what it means to trust in Him. It may be that their heart is more tender at a time like this than at any other time.

A straightforward way to do this is to share a verse like John 3:16 with them, perhaps repeating it, inserting their name and gently explaining the invitation to believe is made by our Lord Jesus to all. Psalm 23 is another good option.

Confidentiality

The question may be raised: can we assure people that what they share with us will remain confidential?

While we want those we serve to trust us, the Bible presumes that the pastoral care of the flock is shared by a plural eldership. It is wise never to promise confidentiality. It is better to explain to someone that you might consider it necessary and wise to share with your fellow elders something that has been shared with you.

This is for your protection and their good.

Nonetheless, it is vital that an eldership maintains strict confidentiality about what is share among the elders. Likewise what is shared within a pastoral care or staff team.

If someone shares something of safeguarding or criminal nature, you have no option but to follow the appropriate procedures and protocols.

Regular systematic contact is the ideal that we should aim at if possible. In their book, On Being a Pastor, Derek Prime and Alistair Begg make the point:

"Even as preventative medicine is better than surgery, so regular pastoral visiting is preferable to crisis visiting".

There are no hard and fast rules about how to go about it. Every local church is different.

One large congregation may have very few elderly folk, while a small fellowship around the corner may have almost entirely elderly people. Therefore, the pastoral demands will vary enormously from church to church.

It is essential that the pastor develops his own pattern for pastoral visiting as best fits his own local situation.

However, the larger the congregation is, the more important it becomes for the pastor to seek to delegate and share the pastoral visiting, perhaps among the elders or among a pastoral care team. This is for the good of his health, the good of his family, and the good of the church.