Spiritual Assessment: A Manager Friendly Framework NACC Presentation April 6, 2008.

Spiritual Assessment: A Manager Friendly Framework

NACC PresentationApril 6, 2008

Introductions:

Rose Shandrow, M.Div.Director, Spiritual

Care ServicesFranciscan

Health SystemTacoma, WA

Gordon J. Hilsman, D.Min.Manager of CPESt. Joseph Medical

CenterTacoma, WA

Integration of Spiritual Care

Catholic Health Initiatives: Measures of Chaplain Performance and Productivity: Task Force Report published June 2002

Develop a common language to articulate what chaplains do and the value added

Develop tools for managing performance and productivity

Promote the professionalism of chaplains and the integration of spiritual care

4

Soul

Mind

Body

Person (Healthcare View)

6

Objectives

1. Framework of Spiritual Assessment

2. Chaplain Functions

3. Spiritual Care Outcomes

4. Benefits of Framework

Assumptions-Spiritual Care

1. Recordable2. Establish Rapport first3. Needs Focus (ad sedio)4. Partnering Endeavor5. Continued Learning

8

owner


1. Recordable2. Establish Rapport3. Needs Focus (ad sedio)4. Partnering Endeavor5. Continued Learning

Rapport First


1. Recordable2. Establish Rapport3. Spiritual Needs(ad sedio)4. Partnering Endeavor5. Continued Learning

SpiritualityAll that an individual values,

practices, believes, and decides in order to cope with and enjoy what can’t be controlled, including relationships with oneself, other people, Transcendence and communities of importance

Ministry to Spiritual Need

A ministry event consists of a person functioning as a caregiver addressing the spiritual need of another person experiencing a difficult life situation.

Spiritual needs are seriously unsettling challenges to the human spirit of a given individual.


1. Recordable2. Establish Rapport3. Needs Focus (ad sedio)4. Partnering Endeavor5. Continued Learning

Careful Listening Empathic Reflecting

Gentle Querying Insightful Interpreting

Establishing Rapport

Crisis Ministry Supportive Validating Informing Presence and Networking Resource Enhancing

Instructing Religious Support Spiritual Support Spiritual Counseling Facilitating Self Forgiveness Reconciling Estrangement

Grief Support Grief Counseling End of Life Care Adjustment Counseling

Emotional Support

Spiritual/Religious Concerns

Loss / Adjustment A S S E S S I N G

Ethics Consultation

Family Systems Facilitating Advocacy Mental Health/Addictions Referral Family Referral Love Life Consulting

Advocacy /Referral

Basic Axis Questions

What does this person need emotionally right now?

What has this person lost, recently and historically?

What are the ways this person maintains and nurtures her own human spirit?

What does this person need that may be beyond my relationship with him?

Axis One:

Emotional Support

What does this person need emotionally right now, (from me)?

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1. The Crisis Need for

Stabilizing

EMOTIONAL SUPPORT

2. The Expression

Need to Engage

and Share

3. The Anxious Need of Waiting Too Long

4. The Bewildering

Need for Basic

Information

5. The Regression Need to be

Empowered

2. The Expression Need to Engage and Share

Needing to cry, yell, share, or just tell somebody how you feel about what is happening to you

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2. An Expressing person

Supportive

Validating

•Talks openly

•Expresses Feelings

•Cries

•Relaxes

•Considers Resources

FunctionFunction Desired OutcomesDesired Outcomes

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4 - W a i t i n gUpset feelings from waiting too long in an important situation

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4. A person who is waiting too long

Presence & Networking

•Expresses situation

•Prays

•Acknowledges limitations

•Thankful

•Calm


Axis Two:

Loss and Grief

What has this person lost, recently and historically, that still disturbs her/him at times?

23

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9. Huge Life Adjustment

9. Huge Life Adjustment

8. Dying8. Dying

7.Prior Grief

(Lost earlier)

7.Prior Grief

(Lost earlier)

6.Acute Grief

(in past 48 hours)

6.Acute Grief

(in past 48 hours)

Major LossesMajor Losses

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7 - Prior Grief Major past loss being currently grieved

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7. Prior Grief

Grief Counseling

•Mentions previous loss•Expresses emotion•Receives validation•Shares reminiscences •Cries while talking about the lost loved one•Receives referral for further grief assistance•Expresses greater hope


Grief Counseling Outcomes(%)

0

10

20

30

40

50

60

70

80

90

1

Mention of the Loss

Observable Emotion

Receives Validation

Reminisces

Shows Tears

Considers Referrals

Signs of New Hope

Axis Three: Spiritual Resources

How does this person maintain and nurture her own human spirit?

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15. Estrangement

14. Self Forgiveness

13. Spiritual Counsel

12. Spiritual Support

11. Religious Support

10. Instruction

Religious/ Spiritual

Care

11 - Religious Support

The Need to feel the immediate positive presence of Transcendence

30

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Person who is needing God

Religious Support

•Sacrament/ spiritual ritual

•Spiritual leader of choice

•Religious questions/problems

•Prays

Desired OutcomesDesired OutcomesFunctionFunction

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15 - EstrangementNeed to re-connect with separated loved ones

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A person regretting estrangement


Reconciling

•Talks about an estranged relationship •Agrees to receiving contact with an estranged person •Agrees to take initiative to contact an estranged person•Accepts the adequacy of one’s efforts at reconciling

Axis Four:

Advocacy and Referral

What does this What does this person need person need that may be that may be beyond my beyond my relationship relationship with her/him?with her/him?

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21. Love Life

20. Family Dysfunction

Concerns19. M. Health/

Addiction Concerns

18. Advocacy

17. Family Conflict

16. Medical Ethics Concerns

Referral/Ethics

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19 - Mental Health/AddictionsNeed to explore concerns about one’s mental health or mood altering chemical abuse

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19.Person with mental illness or addiction concerns


Referral

•Concern verbalized

•Feelings expressed

•Calm conversation

•Accepts consultation

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21. Love Life PainNeed for listening, advice or referral about one’s love life

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Intimate Spirituality:The Catholic Way of Love and Sex

by Gordon J. Hilsman

Available from Sheed & Ward, a subsidiary of Rowman and Littlefield

www.rowman.com www.intimatespirituality.com

www.sermonsfromthebed.com Or 253-565-4992

Benefits of the Spiritual Assessment Framework

Documentation

Training Resource

Measurement Source

Spiritual Assessment Form

What are the needs?

What did we provide?

What is the plan of care?

Data Collection Tool

Pastoral Care EncountersDepartment

Able to identify the workload of the chaplains

Family31%

Patients51%

Staff18%

4%14%

11%

50%

5%

16%

Phone

Pager

STAROrders

DirectContact

Code

DirectStaff

Types of Referrals

0

5000

10000

15000

20000

25000

30000

Spiritual Care Needs 26116 6493 12,249 2297

Emotional Support Loss & AdjustmentSpiritual & Religious

SupportAdvocacy/Referral/Ethics

Spiritual Care Needs Addressed

Types of Functions to Address Needs

0

2000

4000

6000

8000

10000

12000

1

Emotional Support

Crisis Ministry

Supportive Validating

Informing


Resource Enhancing


0

500

1000

1500

2000

2500

3000

1

Loss/Adjustment

Grief Support

Grief Counseling

EOL Spiritual Care

AdjustmentCounseling


0

1000

2000

3000

4000

5000

6000

1

Spiritual & Religious Support

Instructing

Religious Support

Spiritual Support

Spiritual Counseling

Self Forgiveness

Estrangement


0

100

200

300

400

500

600

700

800

900

1

Advocacy & Referral

Ethics Consultation

Family Facilitating

Advocacy

Addiction Referral

Family Referral

Love Life

Chaplain to Department Comparisons

0

2000

4000

6000

8000

10000

12000

1

Emotional Support

Crisis Ministry


Informing


Resource Enhancing

0

200

400

600

800

1000

1200

1

Emotional Support

Crisis Ministry


Informing


Resource Enhancing

Chaplain Ima Nun

Department

Chaplain to Chaplain Comparisons

0

200

400

600

800

1000

1200

1

Emotional Support

Crisis Ministry


Informing


Resource Enhancing

0

50

100

150

200

250

300

350

400

450

500

1

Emotional Support

Crisis Ministry


Informing


Resource Enhancing

Chaplain Ima Nun Chaplain Andy Wokswitme

Spiritual and Religious Support

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

FY06 FY07 FY08

Instructing

Religious Support

Spiritual Support


Self Forgiveness

Estrangement

Year to Year Comparisons

Chaplain Sean DeaconeryChaplain Sean Deaconery

Students to Chaplains Comparisons

0

500

1000

1500

2000

2500

3000

1

Grief Support

Grief Counseling

EOL Spiritual Care

Adjustment Counsel

0

100

200

300

400

500

600

1

Grief Support

Grief Counseling

EOL Spiritual Care

Adjustment Counsel

Loss and Adjustment

Students Chaplains

Per Diem to Staff Chaplain Comparisons

0

10

20

30

40

50

60

70

80

1

Instructing

Religious Support

Spiritual Support


Self Forgiveness

Estrangement

0

50

100

150

200

250

300

1

Instructing

Religious Support

Spiritual Support


Self Forgiveness

Estrangement

Religious and Spiritual Support

Staff Chaplain Per Diem Chaplain

Facility to Facility Comparisons

0

200

400

600

800

1000

1200

1400

1600

1800

1

Emotional Support-St. Catherine Hospital

Crisis Ministry


Informing


Resource Enhancing

0

200

400

600

800

1000

1200

1400

1

Emotional Support--St. Alan Hospital

Crisis Ministry


Informing


Resource Enhancing

Spiritual Care NeedsClinical Area

0%

20%

40%

60%

80%

1

Spiritual Care Needs AddressedEmergency Department

Emotional Support

Loss and Adjustment

Spiritual & ReligiousSupport

Advocacy, Referral,Ethics

0%

5%

10%

15%

20%

25%

30%

1

Emotional Support--ED

Crisis Ministry


Informing


Resource Enhancing

Spiritual Care NeedsStaff

0%

10%

20%

30%

40%

50%

60%

70%

1

Spiritual Care Needs AddressedStaff

Emotional Support

Loss and Adjustment

Spiritual & ReligiousSupport

Advocacy, Referral,Ethics

0%

5%

10%

15%

20%

25%

30%

35%

40%

1

Emotional Support--Staff

Crisis Ministry


Informing


Resource Enhancing

A Means for Identifying Areas for Growth/Development of chaplain

skills

What is my pattern of practice? If it is so different from my

colleagues, what can I learn about their perspective in order to enhance my own?

What further training do I need?

A Means for Examining Effectiveness of Spiritual Care

Functions

What are the desired outcomes for rendering a chaplain function?

To what degree do I see the desired outcomes from the services I provide?

Data Collection Tool

Summary of Observable Outcome

40 40

3634

31

25

21

0

10

20

30

40

# of Outcomes

Crisis MinistryN=44

Emotional needsexpressed

Conversationalengagement

Increased relaxation

Support personcontacted

Prayerrequested/accepted

Realistic Planning

Expressed gratefulness

Results Gained from Spiritual Assessment Framework

Improved care to the patient/family/staff Improved documentation Identifiers for Growth and Development

of Chaplains Facilitated discussions in depth by staff

chaplains regarding each of the Chaplain functions

Interdisciplinary Education Community/Patient Education

Questions?

Thank you for your attendance and participation in our break-out session.

Spiritual Assessment: A Manager Friendly Framework NACC Presentation April 6, 2008.

Documents

Transcript of Spiritual Assessment: A Manager Friendly Framework NACC Presentation April 6, 2008.