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Spiritual Carein a Healthcare Context

Presented by Rev Neil Hepworth,

Chaplain with particular responsibilities for the Medical

Division, Critical Care & Palliative Care

Chaplaincy-Spiritual Care 

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Why do we need to know about Spiritual Care?

NHS Policy(e.g. Nice per cancer/palliative care 2004,

EOLC Strategy 2008)

Integral to health & wellbeing

Central to good medical

and nursing care.

 An aspect of „Holistic‟ or  

„total person‟ care 

Physical symptoms can be caused by emotional or spiritualdistress or be the cause of it- humans beings are complexand health is as much about how we think and feel as thestate of our flesh and bones!

psychologica

l

Spiritual 

Social 

Physical

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Quote“He  may cry for rest, peace and

dignity, but he will get infusions,transfusions, a heart machine, or atracheotomy…He may want onesingle person to stop for one singleminute so he can ask one singlequestion- but he will get a dozenpeople around the clock, all busilypreoccupied with his heart rate,pulse, electrocardiogram orpulmonary functions, his secretionsor excretions but not with him as ahuman being”  

(Kubler-Ross, 1969, edition 1997, On Death and Dyin g ,New York, Scribner , p22, italic emphasis mine).

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What is Spirituality? „Spirit‟-Human spirit &/or Divine Spirit Connecting with the „other‟ and/or being

aware of the bigger world around us.

Human desire & quest for meaning

The essence of who I am- my unique identity Shaped by our experience & context

May be expressed & nurtured in various ways

Beyond the physical, mental, emotional yet

encompasses all of them Integral to a Religion or faith structure for many

people but not all

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  Context of being ill

When we are healthy we take life‟s pursuit for

granted

Health problems can threaten our „peace‟.

It can lead to „existential‟ questioning 

It can arouse strong emotions

It may affect self-esteem

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Basic Spiritual Care: Something we are

all responsible for! Prior things to remember:

 A duty to be aware of patient‟s religion,spiritual & cultural needs.

Inform patients about the chaplaincy and how

to access them

It is about the patient‟s spirituality and not ourown

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Basic Spiritual Care: Something we are all

responsible for!  (Ingredients of care)

Empathy

Emotional support

Listen to spiritual concerns

“As patients may express their needs only once, it isimportant for those assessing need to be highly

attuned to the spiritual dimension of patient care” (NICE, 2004,Supportive & Palliative Care Services for Adults with

Cancer, p96, section 7.7).

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Basic Spiritual Care: Something we are all

responsible for! (Ingredients of care continued )

Reminiscence 

Encouragement & Hope

*Aff i rming a pos i t ive out look is no t to be con fused

w ith proh ib i t ing any expression of negat ive and

low feel ings!!! Nor is i t giv ing false reassurance!  

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Basic Spiritual Care: Something we are all

responsible for! (Summary )

Basic Spiritual care is really nothing more andnothing less than good humane care.

“we are people first and professionals second…it is thepeople part of us that is required most in our offeringof spiritual care”

(Tom Gordon, A Need for living, 2001, page 41).

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Basic Spiritual Care: Something we

are all responsible for! 

Some final things to remember:

Refer if necessary to a „specialist‟

Look after yourself

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Specialist Spiritual Care:

Something Chaplains and staff with particularexperience and training should do. 

 All that was said under basic spiritual care plus:

Use of reminiscence for spiritual assessmentand targeted support

Theological and philosophical explorations

around existential issues

Religious support

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 A definition of „Spiritual Care‟: 

“Spiritual Care…[is] responding to the uniquenessof the individual: accepting their range of doubts,beliefs and values just as they are. It means

responding to the spoken or unspoken statementsfrom the very core of that person as validexpressions of where they are and who they are.It is to be a facilitator in their search for identity onthe journey of life and in the particular situation

without being prescriptive, judgemental ordogmatic and without preconditions,acknowledging that each will be at a differentstage on that personal spiritual journey.” 

(Stoter, D., 1995, Spiritual Aspects of Health Care. London: Mosby, page 8)

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Quote from End of Life Strategy

“Facing death and the associated pain of loss andseparation is hard to bear for all those concerned.

Each person is part of a family or community unit andhas emotional, social and spiritual needs, as well as

physical and practical needs.Every person is unique and should be treated with

dignity and respect.

They should be able to express their hopes andexpectations of what has deepest meaning for them.

In essence, this is a recognition of the spiritualdimension of each person.” 

(,Dept of Health, 2008, End of Life Care Strategy, p76, 3.99)

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How can spiritual support

 be given?

Give time & presence

Listen

Encourage them to talk about their lives-

especially achievements, sources of hope,concerns/regrets/disappointments

By being accepting- ie non-judgmental

By not pushing your own belief or unbelief butfocusing on the patient‟s agenda and their

beliefs/values

Refer to a chaplain

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Trigger questions for

Spiritual support?

When you lay in the long evenings what do

you find yourself thinking about?

What things/activities/people are important to

you? How do you see the future?

Do you consider yourself a spiritual person?

Is there anything on your mind? Does anything help you cope with all this?

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 Any questions or things you want to say?

Thank you for listening- and remember I am

here to support you as well as the patients!

Contacting a Chaplain:

Office tel 27 68792

If Urgent ring switchboard and ask for theon-call chaplain- a 24/7 provision.