Spotlight on Spiritual Care
T
ihe care of older people, especially, but not exclusively, in palliative and end of life care, should focus on several essential aspects of what ‘being human’ is all about, alongside the perhaps more obvious consideration of their physical health.
Looking at the different aspects that should be assessed, one need which might not always be discussed, sometimes for important reasons such as lack of training, is ‘spiritual care’. While it might be assumed that perceptions of ‘spirituality’ tend to focus on faith and organised religion, spirituality itself is in fact a broad concept and has a wide variety of meanings for different individuals. We all have spiritual needs throughout our lives, and it’s widely acknowledged by key organisations involved in the care of older people – including the NHS and the National Institute of Health and Clinical Excellence (NICE) – that spirituality relates to religious and to non-religious principles, beliefs and values. The Royal College of Nursing (RCN) – which conducted its own survey of spirituality in 2010 – has developed a useful and comprehensive summary to
describe what spirituality is about and, crucially, what spiritual care is not about[1]. Thinking about these different elements of spirituality and how they can enrich and enhance human lives, it is clear that effective spiritual care and support are vital for older people in care settings and, if provided, can have huge benefits for those involved. Indeed, research has shown that there is a connection between meeting older people’s spiritual needs and positive health outcomes[2]. The RCN’s spiritual survey findings also showed that nurses acknowledged that if patients are supported in their spiritual needs, this can result in the possibility of improving the quality of nursing care overall[3]. If spiritual needs are not met, especially for people who are suffering with terminal illness, people can experience ‘spiritual distress’. If someone is unable to gain a sense of essential feelings and emotions – such as hope, love, comfort and peace – due to the monumental changes in their lives that can result from ill health, their spiritual distress may cause them to question the meaning of life or turn away from their faith. Spiritual distress can also increase stress and anxiety which can have a detrimental effect on the person’s ability to cope with their illness, so they will need ongoing assessment and support which recognises their specific spiritual needs. This reinforces an important consideration in spiritual care for older people which is that it should be individualised to reflect the person’s own set of values and beliefs.
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Spirituality Encompasses[1]: People’s fundamental feelings and values such as hope and strength, trust and forgiveness, and a sense of morality Having a sense of meaning and purpose in life The value of love and relationships with other people A belief and faith in yourself and others which, for some people, will involve a belief in a deity or higher power Essential elements such as creativity and self-expression
Spiritual Care Doesn’t Mean[1]: A focus on religious beliefs and practices only Assuming that a chaplain is the only person responsible for people’s spiritual needs and care Forcing the beliefs and values that you hold on other people Utilising your position or role to convert another person
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