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Modules:

  • Introduction
  • 1. Advance Care Planning
  • 2. Communicating Bad News
  • 3. Whole Patient Assessment
  • 4. Pain Management
  • 5. Assisted Suicide Debate
  • 6. Anxiety, Delirium
  • 7. Goals of Care
  • 8. Sudden Illness
  • 9. Medical Futility
  • 10. Common Symptoms
  • 11. Withholding Treatment
  • 12. Last Hours of Living
  • 13. Cultural Issues
  • 14. Religion, Spirituality
  • 15. Legal Issues
  • 16. Social and Psychological
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    Back to Module 14: Religion, Spirituality, and End of Life Care
    Introduction to Religion, Spirituality

    Spirituality in Healing and Medicine: Historical Overview
    Concept of Spirituality and Spiritual Care Objectives of this Module

    Spirituality in Healing and Medicine: Historical Overview

    • Relationship among body, mind, and spirit is complex
      • Distinctions between body, mind, and spirit are a product of modern Western thought

      • Historically, mental and physical illness were understood as religious

      • Religious leaders were (and in some cases still are) at one and the same time medicine men and healers

      • The distinction between the body, mind, and spirit dimensions of the human person -- and the professional disciplines to which they correspond -- are products of the European Enlightenment

      • Not until age of the Reformation, Descartes, and the Scientific Revolution did medicine and religion became separate disciplines, at least in the West
    • Relationships between spirituality and medicine vary across cultures
      • Of course, numerous cultures throughout the world were virtually unaffected by this conceptual revolution

      • In some languages, there are no words to differentiate body from spirit, physical illness from malady of the soul

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    Concept of Spirituality and Spiritual Care

    What is Spirituality?

    • Spirituality gives transcendent meaning to life
      • Spirituality can be defined most generally as that which gives transcendent meaning to life

      • It refers to the universal human need for love, hope, relatedness, value, and dignity
    • Spirituality is concerned with the sacred
    • Spirituality often, though not always, includes a direct experience of the sacred, holy, or divine
    • Spirituality has many manifestations
      • Philosophy of life
      • Core values
      • Set of life-defining beliefs and practices

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    What Spirituality is NOT

    • Spirituality is not the same thing as religion
      • Religion is an established system of symbols, beliefs, rituals, and texts shared by a community of faith

      • Spirituality is to religion as the whole is to the part

      • Religion is a particular historical, cultural form of spirituality

      • Many persons are “spiritual” without adhering to a form system of religious beliefs and practices

      • Some examples of spirituality that are non-religious include:

        • Finding strength, peace, or a sense of vitality in nature
        • Creativity; aesthetic spiritualities
        • Humanistic philosophies
        • Life meaning in family and community
        • Personal growth as the reason for living

      • Note: Within a specific culture, these terms may have meanings that differ from our general usage in palliative care/hospice

    Example

    • Spirituality is not reducible to psychology
      • The language of psychology — indeed of the social sciences at large — fails to capture the experience of transcendence which defines spirituality
      • It cannot account for the sense of wonder, awe, and “otherness” which is at the heart of most spiritualities

    Examples

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    What is Spiritual Care and Who Provides It?

    • Spiritual care has a broad focus
      • Spiritual care includes attention to:

        • Specific religious needs
          • Examples: following dietary laws and sustaining practices which provide comfort

        • General spiritual issues that arise at the end of life
          • Examples: loss of hope, the search for meaning, or the affirmation of personhood
    • Spiritual care is the responsibility of ALL team members
      • In the context of palliative and hospice care, spiritual care is the responsibility of all members of the interdisciplinary team

      • Just as all members of the team assess for physical pain and share a general knowledge about pain management, so all members of the team don a “lens” that allows them to pay attention to the spiritual needs of patients and families
    • Chaplains play a special role in spiritual care
      • Because of their expertise, training, and role, chaplains or professional spiritual caregivers assume primary oversight for spiritual care

      • They may work very closely with the patient and family’s own religious leader or faith community

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    Objectives of this Module

    • Generate definitions of spiritual care
    • Recognize the importance of spiritual care at the end of life
    • Identify the providers of spiritual care in palliative and end of life settings
    • Discuss how to ask about spirituality and religious beliefs and practices
    • Recognize spiritual suffering
    • Describe how to address spiritual suffering
    • Identify ways that health care professionals can provide spiritual care and contribute to spiritual growth at the end of life
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