Wednesday, October 23, 2013

Understanding and Improving Spiritual Health with Palliative Care Clients and Health Care Providers

Grief and bereavement are essential to recognize in appropriate interprofessional palliative care.
I participated in an on-line course on this topic.
My expectations:
  • To determine how to better assist my clients.
  • To find some new resources.
  • To determine the barriers to positive spiritual health.
Pregrieving begins at diagnosis.

Peter Barnes, Spiritual Pathways Associates
Gravy metaphor: client is the water, all those who participate are the flour, mixing together in the pan, the mixture gets thicker and smoother during the palliative process and spiritual care.

To be a deep, warm, active, loving, nurturing presence is the role of the spiritual advisor.
Physical, psychological, spiritual, social/cultural.
Adapt to your new paradigm: I am now an orphan, widow.

Barriers to a good death, with a focus on the spiritual component can include:
  • Soul pain –when the person is out of harmony or out of their comfort zone.
  • Family members: lack thereof, dysfunctional family, distance from care recipient
  • Denial of palliation
  • Anger: towards staff, family, self, God
  • Negative interactions with 'loved ones'
  • Poverty
  • Mental illness
  • Physical illness e.g., dementia
  • Unmanaged pain (biopsychosocial pain)
  • Negative attitudes by client, family, professional, volunteer or paid caregivers
  • A spiritual advisor who has different values
  • Lack of collaboration between caregivers
  • Despair –horribilising one's situation
  • Loneliness – lack of a soul friend
  • Confusion – unanswered questions
  • Apathy – caused by mental or physical anguish?
  • Helplessness – denial of acceptance
  • Shame – the feeling that I don't deserve to be pain-free

Five Spiritual needs

  1. Recognitiondo a Life Review with the client 
  2. Companionship - a sense of belonging and relationship to self/others/God/the sacred, find volunteer, counsellor
  3. Hope – not for a cure, but for achievable goals: visitors, to go outdoors, to be pain-free.
  4. Purpose of life –through creativity, day programs, expressive arts.
  5. Meaning –writing letters to loved ones, writing your memoir, creating a scrap book or slideshow of favourite photos, creating your obituary, eulogy, farewell to family and friends.


Formulate a Spiritual Treatment Care Plan to express needs and beliefs, address questions or concerns. Do a spiritual history, a spiritual assessment (PDF), to formulate a treatment care plan.
Become a healing presence: slow down. Live in the present. 
The making of a grateful heart.

Of course, there are many more than this, but this is one article:

Ways to Connect With a Dying Loved One

• Touch -- Holding a hand can forge a profound connection.
• Read--Reading creates a shared experience, even if your loved one cannot respond.
• Sing -- Song touches the spirit and impacts the body.
• Reassure -- Let your loved one know that it is okay to go.
• Be -- Just being there can be connection enough.

Counselling theories

Task Theory (Worden)
Meaning Making Theory (Neimeyer)
Stage Theory (K├╝bler-Ross- although not truly sequential stages)

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