Journeying with a dying person is a privilege
An article written by Rachael Wass, CEO Meaningful Ageing Australia
Spiritual care is an integral component of palliative care. The World Health Organisation defines palliative care as: "An approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual" (WHO, 2013).
Although many professionals working in aged care support this notion, there can be shortcomings in our medicalised Western approaches to care, as well as a lack of confidence in discussing spirituality. The new rights-based Aged Care Act and strengthened Aged Care Quality Standards underscore the importance of holistic care, yet there remain areas where improvement is needed where spirituality is concerned. Especially within diverse communities like First Nations, LGBTIQ+, and people from CALD backgrounds.
Another important aspect of the journey towards death is acknowledging an individual's life story and their connection to it, as it underpins identity and is of vital concern during the final stages of life. As Metzger has written, understanding one's life story at this time can assure individuals that their lives were worthwhile or, conversely, lead to despair if meaning is not found. By gaining a deeper understanding of the spiritual process of ageing and dying, we can better prepare for death while fully engaging in life until the end.
Many older people place greater importance on aspects of spirituality. These aspects or tasks of ageing are: Finding final meaning in life (What has my life been for? Where do I find meaning now as I grow older?); learning to transcend the disabilities and losses often experienced; affirming relationships (old and new); finding hope in the face of physical and mental deterioration and frailty.
As one stakeholder put it: ‘We are spiritual beings. While not everyone may identify as such, even those who do not would still benefit from spiritual care. This overlap includes ultimate questions and ethical frameworks, which are invaluable in a palliative care setting for patients, families, and staff. These frameworks guide important decisions and set a vision for the future’ (Stakeholder, Palliative Care in Queensland 2021: Spiritual Care).
Supporting an older person's final journey is a privilege: ‘Journeying with a dying person is an honoured journey, as Frankl wisely noted. Not everyone finds the meaning of their lives before death; some may approach death without discerning any meaning to their life’. (MacKinlay, E.B., 2024). The goal of spiritual care of older people is to affirm the older person in their life journey, to strengthen resilience and support flourishing in whatever circumstances of life the person experiences.
For further information on spiritual care and the assessment of spirituality in palliative care, reach out to Meaningful Ageing Australia.
Authors
Rachael Wass
Chief Executive Officer
Meaningful Ageing Australia
Resources
1. Meaningful Ageing Australia. What is the Value of Spiritual Care? Evidence of the value of spiritual care form aged care and beyond: A literature Summary. Melbourne; 2021.
2. Meaningful Ageing Australia. ConnecTo Spiritual Sreening Tool - Leader's Guide. Melbourne; 2018.
3. Meaningful Ageing Australia. Connect-Explore: Exploring Spirituality With Older People (ESWOP) - PDF download (free for members). Melbourne.