Background:The aim of the present study was to comprehensively investigate the meaning and practices of spiritual care for older people with dementia based on the perspective and experiences of nurses and care workers. Methods: The study was designed according to qualitative research strategies and used face-to-face interview data, with a focus on the experiences of nurses and care workers who care for elderly persons with dementia. Five nurses and 13 care workers from nine care facilities participated. We conducted 10 interviews, each with one to three participants, from April to August 2017. An open-ended questionnaire concerning the meaning and practices of spiritual care for older people with severe dementia was used to comprehensively capture the participants' experiences of caring for older people with dementia. Qualitative content analysis was used to systematically identify ideas and patterns emerging from the qualitative data. Results: Three main themes emerged from the qualitative analysis of what constituted spiritual care for older people with dementia: (i) self-esteem; (ii) communication; and (iii) individual difference. Conclusions: Nurses and care workers perceived self-esteem as a core domain of spiritual care for older people with severe dementia. Reminiscing about important achievements and enjoying small pleasures in daily life enhance older people's self-esteem. Communication strategies involving active listening and therapeutic lying can help maintain older people's selfesteem and cognitive abilities. Older people with dementia respond in different ways to standardized care procedures, so care providers must employ of a variety of skilful approaches.