Spirituality and Bereavement in End of Life Care Rev Meg Burton MA, BTh Head of Chaplaincy, RDaSH End of Life Care Lead, CHCC Rev Debbie Hodge MA, BSc Sec Health Care Chaplaincy FCG Chief Officer HCFBG
Some definitions of spiritual care That care which recognises and responds to the needs of the human spirit when faced with trauma, ill health or sadness and can include the need for meaning, for self worth, to express oneself, for faith support, perhaps for rites or prayer or sacrament, or simply for a sensitive listener. Spiritual care begins with encouraging human contact in compassionate relationship, and moves in whatever direction need requires. NHS Education for Scotland, 2009 in Spirituality in nursing care, RCN, 2011
A quality that goes beyond religious affiliation; that strives for inspiration, reverence, awe, meaning and purpose, even in those who do not believe in any God. The spiritual dimension tries to be in harmony with the universe, strives for answers about the infinite and comes into focus when the person faces emotional stress, physical illness and death Talking About Spirituality in Healthcare Practice Gillian White (Jessica Kingsley Publications: London: 2006
Spirituality enables us to not only connect and relate to other people, but also experience some higher or other state relating to humanity and the rest of the world. It is what gives our life, as an individual, meaning and purpose. It involves needs of reassurance, comfort, peace, happiness, dealing with guilt and forgiveness, listening and being listened to, feeling valued and having self esteem. From Religion and Belief Matter NHS Scotland Information Resource for Healthcare Staff
Spirituality is about body, mind and spirit hope and strength trust meaning and purpose forgiveness belief and faith in self, others, and for some this includes a belief in a deity/higher power peoples values love and relationships morality creativity and self expression RCN 2011
In a nutshell, spirituality is about Meaning Identity Consciousness Connectedness
Spiritual care is not just about religious beliefs and practices about imposing your own beliefs and values on another using your position to convert a specialist activity the sole responsibility of the chaplain [or spiritual care giver] RCN 2011
Practising spiritual care The practice of spiritual care is about meeting people at the point of deepest need. It is about not just doing to but being with them. It is about our attitudes, behaviours and our personal qualities i.e. how we are with people. It is about treating spiritual needs with the same level of attention as physical needs. RCN 2011
Palliative Care Symptom Management Total Pain Before Alice, when I saw patients in pain I focused primarily on the physical components of pain... I rarely asked questions about the impact of the disease on their life, their hopes and dreams, their relationships with others, or their belief system. David Kuhl M.D., What Dying People Want, Anchor Canada, 2003, pp xv-xix
The story from Soweto
Spiritual Physical Pain Social/Cultural Emotional
Spiritual Physical Peace Social/Cultural Emotional
Model of Practice:- Encounter Reflection Relationship D Hodge 2015 Transaction 13
Assessing spiritual needs One spiritual care assessment tool: Faith Importance and Influence Community Address Dr. Christina Puchalski 1999
Ways into spiritual conversations What gets you out of bed in the morning? If you get discouraged, are you able to pull yourself round? If so, how? What feels fulfilling? What does not? How are your spirits? Who or what helps you to keep positive? Do you have any memories that give you pleasure?
Do you have any memories that are difficult to think about? Could what you are remembering be resolved? Do you want it to be? What would you want staff to know about you if you were a resident of a care home? What would you want included in a book about your life?
Do you follow a particular faith or philosophy? What is most important to you? What are your worries? Being Mortal Illness, Medicine, and What Matters in the End. Atul Gawande (2014)
Priorities for Care of the Dying Person What they mean for that person and those who are important to them A person only dies once. There is no going back to try again. If everything has been done to fulfil my wishes and every support given to those important to me, and has been seen to be done to the best efforts of everyone involved, then nothing more can be asked or expected.
Is bereavement care important?
Any questions?
Bibliography Gawande, A. (2014) Being Mortal. London, Profile Books. Gordon, T. et al (2011) Spiritual Care for Healthcare Professionals. London, Radcliffe Publishing Ltd. Pye, J. et al (2015) Critical Care. Delivering Spiritual Care in Healthcare Contexts. London, Jessica Kingsley. Royal College of Nursing (2011) Spirituality in nursing care. London, RCN.