Spirituality is a universal human expression. It “is the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred.” [1] It is different from religion, though this provides a spiritual expression and spiritual community for some people. Spirituality can help people make sense of their lives.
Spirituality is individual and subjective and means different things to different people. Some people may not call it by name or know how to identify it. It is just part of what makes them who they are. Others have a more conscious awareness of and connection with their spirit and with what nurtures it. What constitutes the human spirit? It is seen and named in different ways, and includes dignity, hope, joy, love and humour. This means that people will express their spirituality in different ways.
When someone is nearing the end of their life they may start to question their beliefs, reflect on their life or wonder at the meaning of life. This is a normal process. However if there is ongoing inner conflict, spiritual distress or spiritual pain may become an issue for some people. Spiritual distress can sometimes be communicated in physical symptoms.
To ensure a holistic approach to care, it is important to address spirituality and to assess this dimension of care as for pain or sexuality. Not everyone will know what ‘spirituality’ means. Asking the question “Are you at peace?” or "where do you find strength in difficult times?" are ways in which to start to explore spiritual issues. [2] [3]
Sometimes all an individual needs is not to be alone, and a supportive, listening presence or ‘being there’ can help. All members of the palliative care team can provide this form of caring for the spirit. Sometimes people need more than this and referral is also needed to a member of the team trained specifically in spiritual care at the end of life, or another spiritual resource such as someone from the person’s own spiritual community or tradition.
Resources
Related CareSearch Pages
Clinical Practice
Suffering
Existential Distress
Professional Groups
Pastoral Care Workers
Life, Hope, Reality
Spirituality
What may help (for consumers)
Free Full Text Articles:
Grant L, Murray SA, Sheikh A. Spiritual dimensions of dying in pluralist societies. BMJ. 2010 Sep 16;341:bmj.c4859. doi: 10.1136/bmj.c4859.
Penman J, Oliver M, Harrington A. Spirituality and spiritual engagement as perceived by palliative care clients and caregivers. Aust J Adv nurs. 2009 Jun-Aug;26(4):29-35.
Rumbold BD. A review of spiritual assessment in health care practice. Med J Aust. 2007 May 21;186(10 Suppl):S60-2.
van Leeuwen R, Tiesinga LJ, Post D, Jochemsen H. Spiritual care: implications for nurses’ professional responsibility. J Clin Nurs. 2006 Jul;15(7):875-84.
Rumbold BD. Caring for the spirit: lessons from working with the dying. Med J Aust. 2003 Sep 15;179(6 Suppl):S11–3.
Rumbold B. Attending to Spiritual Care Health Issues. 2003, 77:14-7.
References
- Puchalski C, Ferrell B, Virani R, Otis-Green S, Baird P, Bull J, et al. Improving the quality of spiritual care as a dimension of palliative care: the report of the Consensus Conference. J Pall Med. 2009 Oct;12(10):885-904.
- Steinhauser KE, Voils CI, Clipp EC, Bosworth HB, Christakis NA, Tulsky JA. “Are you at peace?” one item to probe spiritual concerns at the end of life. Arch Intern Med. 2006 Jan 9;166(1):101-5.
- Hegarty M. Care of the spirit that transcends religious, ideological and philosophical boundaries. Indian J Palliat Care 2007;13:42-7.
Last updated 01 December 2011