What is Spirituality?

Does everyone have a spiritual side?

Alison Peers - End of Life Care Facilitator

Spirituality

Body of evidence:

spirituality, including religion, is an important coping resource for many of those approaching the end of life

Holloway et al (2011)

Spirituality- definition

Support that seeks to “help people approaching the end of life and those close to them including their relatives, carers and friends to:

Spirituality- definition

• Explore how they might understand, make sense of or find meaning in what is happening to them• Identify sources of strength they can draw

on, and• Decide whether those sources are helpful

during this period in their lives.”

National Council for Palliative Care

Spiritual issues

• Why has this happened to me?

• Does God exist, why has he allowed this?

• Am I being punished?

• Who or what has caused my suffering?

• What meaning does my life have?

• What will happen when I die?

Spirituality

• May struggle with:• Guilt• Anger• Despair

• May search for:• Forgiveness• Peace• Hope

Spiritual Pain

Unaddressed issues:

May lead to spiritual pain

Consider asking:• What is most important/meaningful to you?• What helps you through difficult times?• Do you have a faith which helps you make sense• of life?• Do you ever pray?

Spiritual Pain

“bitter anger at the unfairness of what is happening (at the end of life) and above all a desolate feeling of meaninglessness. Here lies, I believe, the essence of spiritual pain”.

Saunders (1988:29)

Holisitic Care

• Physical

• Psychological/emotional

• Social

• Cultural

• Spiritual

Spiritual Care

Whose role is it?

HOPE

Assessing Spiritual Needs

HOPE

• Hope – what are the sources of hope, meaning, peace

• Organised religion – what is its role for that person

• Problems/issues/questions they are facing

• Effect on care - how

Spiritual support

• Asking a chaplain or counsellor to see them• Finding a faith leader from their own

religion to visit• Arranging for them to go to their place

of worship• Providing a place where they can

reflect/pray

Spiritual support

• Listening, being there• Pray with them• Providing things such as a Bible, Koran• Reading scriptures to them• Arranging for certain rituals to be

carried out, e.g., Holy Communion• Playing music which they find helpful• Reading, e.g., poem

Agree/Disagree

• Every person is a spiritual being• Spirituality has nothing to do with formal religion• I would be willing to share my own beliefs with someone who is

dying• I would feel comfortable praying with a patient• I would never take a patient to church• I am afraid of dying• There is always a purpose in suffering• A person must make peace with God before death• Prayer always gets results• Forgiveness is important before death• I learn about spirituality from my patients• My faith helps me give palliative care• Only faith makes sense of death• It is essential to refer to a person’s faith advisor for spiritual support

What have you learnt?

What will you change?

Care of Significant Others

How do we involve families and friends in:

The Care?The Discussions?

Specific Wishes

• Clothes, makeup, hair, photos, music• Family, friends present, not alone• Quiet environment, dignity, privacy• Personal care• Pain relief, e.g., timing of• Toileting, pads, commode, urinals, catheter,

convene• Diet and fluids• Mouthcare, Toiletries• Spiritual care, religious needs - anticipate

Supporting families & friends

• Accomodation

• Transport

• Meals

• Washing facilities

• Emotional support

• Time

• Respect and dignity