Delivering spiritual care to the ALS clinic

“I’ve learned about resilience and hopefulness in the face of devastating disease”

The ALS clinic at The Neuro sees some of the patients most in need of guidance. For Lana Kim McGeary, the clinic’s spiritual counsellor, whatever comfort she provides is paid back with the inspiration she gets from those facing life’s toughest challenges.

“I learn as much about living and dying from the patients as any benefit I provide,” she says. “I’m touched on a daily basis.”

McGeary has been working at The Neuro since 2009, when she completed an internship at the former Royal Victoria Hospital across the street. With an academic background in religious studies and experience doing community outreach, she had an excellent background to take on the job of counseling patients with life-threatening and life-altering diseases. Yet when she was asked to work at the ALS clinic, she was at first reluctant.

“It was just so outside my comfort zone,” she says. “I imagined the communications challenges to be much bigger. I always worked more with marginalized, diverse communities, and women’s issues. It was very different from what I’d done before. But my supervisor knew it would be a good fit for me, and he was right.”

Spiritual counsellors are among several types of allied health professionals at The Neuro that take care of patients’ non-medical needs, including social work and psychology. While McGeary is assigned to the ALS clinic, she can be called away to other departments if needed. The profession has changed a lot over the years, McGeary says, from one centred on religious Judeo-Christian tradition to counseling that includes people of all faiths and even those who don’t believe in a higher power. Spiritual counselling is about helping patients find and use their inner resources to overcome the physical challenges they are facing.

She is also someone patients can talk to about things they do not want to share with their family, friends or doctors, and if the patient wants to speak to clergy, McGeary helps arrange it.

With COVID-19, most ALS patient and family counselling at The Neuro is happening over the phone, which has been an interesting adjustment for McGeary.

“Part of me hates it,” she says. “I don’t like the phone, but I’ve also had some amazing interventions with patients. There is undivided attention, and no pressure to hurry up for another appointment. I’m not sure not how long this will last. It’s about being adaptable at this point.”

The life expectancy for ALS patients after diagnosis is two to five years, which means McGeary spends a lot of time helping patients and families cope with death. While that may be too much for some, it is not for McGeary.

“I’m constantly surprised by the amount of resilience patients manage to find,” she says. “Patients are diagnosed and they somehow find a way, knowing they will die, to still experience joy, and levels of hope and gratitude.”

McGeary says the job is still demanding, and requires a lot of self-care. She has a spiritual supervisor she speaks to often to ease the burden. But overall, she is glad she took her supervisor’s advice back in 2009.

“The team has been wonderful,” she says. “I’ve been both challenged and nourished. People with ALS and their caregivers have touched and educated me. I’ve learned about resilience and hopefulness in the face of devastating disease. It’s been a benefit to me.”



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The Neuro (Montreal Neurological Institute-Hospital) is a bilingual academic healthcare institution. We are a McGill research and teaching institute; delivering high-quality patient care, as part of the Neuroscience Mission of the McGill University Health Centre. We are proud to be a Killam Institution, supported by the Killam Trusts.



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