Spirituality in Hospice and Palliative Care Essay

Introduction

The hospice and palliative care are established in the principle of offering whole person care. The provision of quality care in this field depends on satisfying various needs in physical, social, psychological and spiritual aspects. One of the critical aspects of hospice and palliative care is spiritual care. This is critical as the parents encounter serious illness and the end-of-life situation. Spirituality is essential as it helps family members with the loss and envisions a life without that individual. In recent times, there has been an increased emphasis on the incorporation of spirituality through various strategies such as assessment of spiritual needs and ensuring healthcare practitioners are educated on matters concerning spiritual care. Spiritual condition is a critical realm of quality of life encompassing components such as religion, hope, and faith. Spirituality affects how a patient experiences symptoms and physical status. Various psychological systems which include depression and anxiety among others can be attributed to the spiritual well-being of a patient. This paper details the issue of spirituality examines spiritual assessments and discusses spiritual interventions in addition to its barriers in hospice and palliative care.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

Defining the Concept of Spirituality

Often, the term spirituality is used to mean higher power, faith or religion. In the field of palliative care, the concept has been development to be inclusive of other aspects. Spirituality has been defining as "the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature and to the significant or sacred (Ferrell 2017)." The definition has been extensively used in palliative care and directs practitioners to evaluate the various aspects of the life of the patient. In other cases, spirituality is considered to be a suffering reliever which is a fundamental aspect of palliative care.

Spirituality Assessment

The provision of the quality patient is dependent on accurate assessment for the establishment of the patient needs. Spiritual assessment is essential to accomplish care needs. It is, however, unfortunate that most of the clinical settings lack spirituality as a constituent of their periodic assessment. Additionally, the majority of the clinical settings limit spiritual assessments to only include religious affiliations. Another trend that has been witnessed is the recognition of spirituality as championed by specialists in hospice and palliative care, chaplains, and religious leaders (Ferrell 2017). It is essential that all stakeholders be dedicated to spiritual care and assessment. In the assessment and monitoring of spiritual needs, a collaboration between physicians, nurses, and nursing assistant among others is necessary. There has been the publication of extensive reviews concerning spiritual assessment tools, psychometric attributes and the relationship between spirituality and other aspects of patient care. The majority of these tools have been formulated for research reasons. However, some have been adopted for clinical purposes. Fundamental principles that have been identified to inform the hospice and palliative care professionals.

The first principle entails the necessity for spiritual screening carried at the beginning of care provision. This is meant to establish what a patient's spiritual needs which entail the need for forgiveness, spiritual longing, and fears concerning the afterlife or requirement for religious rituals which include baptism or confession. The two that have been developed to cover this first principle. First, there is the basic question "Are you at peace?" which was formulated by Steinhauser and colleagues and the FICA tool which was formulated by Pulchaski and colleagues (Ferrell 2017). The FICA tool was designed to ask open-ended questions concerning the faith community of the patient, the essence of spirituality and how they would prefer spirituality addressed as an important constituent of care provision.

Spirituality history taking is the second principle. Patients who have life-threatening ailments often encounter this experience since beliefs and value have implications on the type of treatment adopted. To better under the life and story of the patient, spiritual history encompasses more than the initial assessment (Ferrell 2017). When the patient had a strong connection with spirituality in childhood years but distanced as an adult, they tend to show a great desire to re-connect with their spirituality during the time of serious illness.

The last and third principle is the need in various cases for increased all-inclusive spiritual assessment. This is the same way patients required the initial screening for physical symptoms. There are some identifiers that categorize patients such as complex pain, constipation, difficulties managing dyspnea. From this point, the care specialists can be consulted. Similarly, if a patient gives information concerning spiritual distress and feeling distanced by God or the terminal ailment as a punishment, the specialists can consult the services of the spiritual leaders (Ferrell 2017). This means they can conduct a more comprehensive assessment for the provision of necessary spiritual care.

Spiritual Interventions

To provide appropriate spiritual interventions, the patient assessment must be completed to enable the provision of necessary services. The services include prayers, religious rituals or other spiritual services that might be needed. The services must be culturally appropriate to the patients and the families. Additionally, there is a strong support system for services that can be implemented by the staff of the interdisciplinary teams. These include, presence and listening to the story of the patient, their problems and to be present during the case of end of life. The care also helps the patients deal with uncertainty and upholding hope even during the situations of a terminal prognosis. There have been interventions which have been tested to help patients uphold their dignity. This has been referred to as a meaning-focused psychotherapy. In this context of care, the spiritual care interventions are implemented within the entire plan of care for patients (Ochman 2018). It is essential to note that the provision of quality hospice and palliative care is dependent on quality spiritual care which starts with the assessment of spiritual status and necessitates the attention by the interdisciplinary team. Spiritual requirements of various patients and family vary depending on the magnitude of the illness. The evolution of hospice and palliative care will continue to address the increasing needs in the healthcare sector.

Bio-Psycho-Social-Spiritual Model in Hospice and Palliative Care

In the hospice and palliative care, spirituality is a critical dimension. It has been often established that religious beliefs and practices are essential as a source of the patient's comfort, hope and meaning and especially in dealing with an ailment (Tiew et al., 2013). Dealing with the human spirit is an essential element of the person-centered continuum of care. Health practitioners are required to support and used the spiritual resources of the patient to promote the quality of care. Regrettably, it has been evidenced that the hospice and palliative care teams do not always deal with the spiritual aspect of patient care and quite unfortunate in hospice and palliative care (Puchalski 2012). Mostly, patients at the end of life come across new practitioners especially when they have no previous relationship and they are necessitated to make critical, intermediate and irreversible decisions concerning their lives. It is therefore required that all health practitioners deal with spirituality to promote the experience of care. Neglecting the spiritual aspect of care negatively affects the ability of the patient to deal with critical illnesses. Spirituality is equitable to the belief systems of any patient and their personal values. Religious beliefs and practices have been identified as the source of hope, comfort or meaning even in the absence of particular religious affiliation (Puchalski 2012).

The inter-professional staff working with patients addresses the various overlapping spheres which entail the social, the biological, the spiritual and the psychological aspects. It is quite important to care for the human spirit of each patient and especially those at the end of life. Various stakeholders such as nurses, chaplains and psychologists among others have their roles in ensuring support roles and collaborate with each other in the provision of comprehensive care inclusive of the spiritual aspect (Puchalski 2012). Health practitioners should ensure they have information concerning the patient's spiritual beliefs and ensure the spiritual needs are met.

Barriers to Spiritual Care in Hospice and Palliative Care

The need for spiritual assessment and emphasis on spiritual needs cannot be understated. Despite this requirement as part of comprehensive care, there are barriers to prevent the realization of this objective. Most practitioners consider it challenging to initiate conversations concerning the spirituality of the patients (Walker & Breitsameter, 2017). They are feelings of discomfort since it is not viewed as within the scope of their responsibilities. Other practitioners consider spiritual discussions as intrusive or intimate. Additionally, others practitioners lack spiritual or religious beliefs which makes it hard to them to address such needs in their patients. There is also the concern about the availability of enough time for the assessment and dealing with the raised concerns.

Conclusion

Hospice and palliative care are mostly concerned with the provision of quality care to the patients in additional to relieving of suffering and comforting them at the time serious ailment. Over the years, there has been increased research determining the essence of spirituality in coping with illnesses. The assessment of spiritual needs and addressing these needs have been established as the most critical in the provision of quality care. However, it has been noted that these needs are mostly not recognized or addressed. The health care practitioners are in a unique position to work with patients and their families in exploring the various mechanisms used as a guiding principle when deciding what to be done concerning serious medical cares. The unaddressed spiritual concerns may have serious effects in trying to treating some symptoms and therefore adversely impact on the quality of life. To be able to provide comprehensive care, rich resources need to be accessed by collaborating with various stakeholders in the hospice and palliative care. This will allow care providers to deal with the patient needs using a whole person approach. Provision or care concerns curing sometimes, treating often and always comforting.

References

Ferrell, B. (2017). Spiritual Care in Hospice and Palliative Care. Korean Journal of Hospice and Palliative Care, 20(4), 215. doi: 10.14475/kjhpc.2017.20.4.215

Ochman, P. (2018). Spiritual Care at the End of Life | Chapters Health System. Retrieved from http://www.chaptershealth.org/spiritual-care-end-life/

Puchalski, C. (2012). Spirituality as an essential domain of palliative care: Caring for the whole person. Progress in Palliative Care, 20(2), 63-65. doi: 10.1179/0969926012z.00000000028

Tiew, L., Kwee, J., Creedy, D., & Chan, M. (2013). Hospice nurses' perspectives of spirituality. Journal of Clinical Nursing, 22(19-20), 2923-2933. doi: 10.1111/jocn.12358

Walker, A., & Breitsameter, C. (2017). The Provisi...