Skip to Main Content

++

This chapter addresses the following Geriatric Fellowship Curriculum Milestones: #1, #27

++

LEARNING OBJECTIVES

++

Learning Objectives

  • Describe characteristics of spirituality in old age.

  • Review approaches to spiritual screening, assessment, and treatment/care planning.

  • Identify tested spiritual care interventions.

  • Address ethical considerations in spiritual care.

++

Key Clinical Points

  1. Spirituality is an important coping strategy for the older adult population who experience age-related losses, disabilities, physical illnesses, and mortality confronted in old age and is associated with a number of positive outcomes.

  2. Spiritual screening or history should be a routine part of a comprehensive clinical assessment and can identify spiritual distress and spiritual resources of strength and integrate these into the whole person assessment and treatment or care plan.

  3. Generalist spiritual care is the responsibility of all members of the clinical team; the team should also include referral to and collaboration with specialist spiritual care professionals.

  4. Studies suggest benefits of spiritual interventions such as spiritual reminiscence and dignity therapy.

++

OVERVIEW

++

Aging and dying are integral and normal parts of living. In today’s society, however, dying and aging are still treated as an illness or something to be avoided at all costs. While there have been remarkable improvements in the care of chronically ill and dying patients, there is still much that needs to be done to ensure that all people can have the opportunity to be treated with dignity and respect. As people age there are challenges of chronic conditions and illnesses. For health systems that value fast-paced, shorter visits, the older adult may not get the full attention needed to address all their concerns. Further complicating this is the increased complexity of health care systems. Lengths of hospital stays are shorter than in the past and communities are ill equipped to deal with people with chronic illness and multiple health concerns. With this focus on disease and cure there is little emphasis on dignity and the value of lived life at all stages of life. The full stories of patients are being lost in an increasingly physically focused health system.

++

Thus, as people age and deal with severe illness and face dying, they often feel less of a person than when they were younger and healthier. All too often people die in hospitals or nursing homes, alone and burdened with unnecessary treatment; treatment they would have refused if they had the chance to talk about their choices with their clinicians long before their end of life. Older adults and those with serious, life-threatening illnesses are often not listened to. Their wishes, their dreams, their fears may go unheeded. This can lead to intense suffering—psychosocial and spiritual as well as physical. Yet in a complicated health system, the patient who suffers often has no one that can listen to his or her despair, grief, and isolation. There may be no one to give voice to their inner pain and sense ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.