First national guidelines for spiritual care in aged care
The Japanese term ‘ikigai’ loosely refers to what gives the person a reason to wake up in the morning. Recognising this kernel to an individual’s identity will enhance the care provided to them and support them to maintain their identity right to the end.
We all want to live life well right to the end. It is becoming clear that in order to live well we need to care for the spirit, as well as the body and mind, at all stages of life.
People sometimes associate palliative care with just pain relief, but palliative carers take a more holistic approach that covers physical, psychological, social and emotional domains. Good palliative care also responds to the needs of the human spirit in the face of challenges associated with end of life.
People sometimes express a wish to die when they feel life has lost all meaning or purpose. Spiritual care is related to supporting the individual to discover their purpose and the meaning of their life experiences. Older people can be supported to prepare for the end of life through reflecting on their life, contribution and legacy, affirming their worth, exploring unresolved issues, and having their preferences documented and respected.
People sometimes express a wish to die when they feel life has lost all meaning or purpose.
The first national guidelines for spiritual care in aged care will be released this month, assisting organisations that provide aged care to incorporate spiritual care into routine care and services.
The guidelines were developed by Meaningful Ageing Australia (formerly PASCOP) in collaboration with Spiritual Health Victoria and Improvement Matters, with funding from the Australian Department of Health. They were piloted with a group of residential aged care and home care providers early in 2016 as the final step in a rigorous path of development throughout 2015.
The guidelines’ underlying principle is that spiritual care is everyone’s business, recognising that spiritual care practitioners also have a distinct specialised role. The guidelines explain that spiritual care is an umbrella term for both religious care and pastoral care. In many ways the mind, body and spirit are interlinked, and spiritual needs are found in most people, not just those who adhere to a particular religious faith.
Elements of spiritual care can include spiritual screening and assessment, which can be conducted in a range of ways and using a number of standardised tools. For example a health care practitioner might use the Faith, Importance and Influence, Community and Address spiritual assessment tool to assist with finding out what priorities for spiritual care are necessary.
Another element of spiritual care is providing access to rituals, which may not be religious rituals but other regular activities that assisted the person during their life. For example one resident in aged care loved to watch her favourite football team religiously every week and had done so throughout her whole life. Football regalia was provided for the lady as requested when she was dying so that she could feel supported by these reminders.
Maintaining a connection with the individual can also be considered an element of spiritual care.
Spiritual needs will be different from one person to the next.
Carers and health professionals will apply the guidelines in their everyday life through the way they communicate with their clients. Organisation leaders will use the guidelines to embed principles of spiritual care at all levels throughout the organisation.
Many people may fear the process of dying, and may be reluctant to talk about death and dying. Understanding individual wishes for care as they approach the end of their life is central to person-centred care. Palliative care practitioners working with older people understand the importance of facilitating conversations that are supportive and affirming. Ensuring that care aligns with the person’s wishes may be helped by formalising these discussions through an advance care plan or directive.
The new guidelines will assist in raising awareness of the key elements of spiritual care among people providing palliative care. The ultimate goal is that this understanding is translated into better care for people receiving palliative care, consequently enhancing quality of life through maintaining meaning to their existence right to the end.
A launch date for the guidelines is yet to be confirmed. To receive a PDF of the guidelines, email firstname.lastname@example.org
For further information about the guidelines visit www.meaningfulageing.org.au
* Colleen Doyle is principal research fellow at the National Ageing Research Institute and Professor of Aged Care, Australian Catholic University. She directed the national guidelines project under subcontract to NARI from Meaningful Ageing Australia. Elizabeth Pringle (Improvement Matters Pty Ltd) managed the project and Hannah Capon provided research assistance.
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