New information about linkages between religious and spiritual factors and health-related outcomes continues to be reported by both the popular media and the scientific community. From a cover story in Newsweek, to a case conference in JAMA, to a clinical trial of intercessory prayer published in Lancet, there is ongoing interest in the intersection of religion and spirituality with health and health care in the United States. Such a trend reflects America's overall fascination with spirituality—much of which lies outside of organized religion—so much so that some forecasters have projected a future view of health that places spiritual factors alongside physical, psychological, and social determinants.
This chapter provides an overview and framework for understanding the current phenomenon of spirituality and health, particularly as it relates to the care of older adults. The first section orients how religion and spirituality are defined and understood by several academic disciplines. The core part of the chapter outlines and illustrates a categorical approach to the study of spirituality that has been proposed by Bernard McGinn. The next segment briefly reviews the organization of spiritual care before the final section closes with a perspective that introduces some ideas about a spirituality of practice within a spirituality of place.
Religion and religiosity are generally understood in several ways: the totality of belief systems, an inner piety or disposition, an abstract system of ideas, and ritual practices. For communities of faith, religious doctrine and faith traditions provide a foundation for understanding the wide range of human experience in areas such as suffering, death, and relationships with God and others. The term spirituality, on the other hand, has multiple connotations and interpretations that are less easily defined; academic disciplines such as sociology, psychology, and theology have approached and conceptualized spirituality in various ways. The social work literature, for example, operationalizes spirituality as a process of making sense of self and the world. Here spirituality is proposed as a condition of asking and answering major philosophical questions: who am I, why do I exist, what is my purpose, and how do I fit in the world? Several sociological perspectives resonate with this decidedly existential orientation. Spirituality is represented as that which promotes human agency, or the power that comes from within, in addition to an ongoing search to know our deepest selves and what is held to be sacred.
A psychological perspective is often used when considering spirituality's relationship with health or well-being, since theoretical or conceptual frameworks, which postulate a causal, mediating, or moderating relationship between variables of interest, can be employed. In this way of thinking, the characteristics of spirituality are presented as a web of plausible relationships, predominantly within the domain of well-being. The growing interest in positive psychology, for example, casts an individual's subjective experience in an optimistic light and often depicts spirituality as providing a foundation for adjustment, growth, and reaching one's human potential. A related approach, one that ...