An Exploratory Study of Spiritual Care at the End of Life

Abstract

PURPOSE Although spiritual care is a core element of palliative care, it remains unclear how this care is perceived and delivered at the end of life. We explored how clinicians and other health care workers understand and view spiritual care provided to dying patients and their family members. METHODSOur study was based on qualitative research using key informant interviews and editing analysis with 12 clinicians and other health care workers nominated as spiritual caregivers by dying patients and their family members.RESULTS Being present was a predominant theme, marked by physical proximity and intentionality, or the deliberate ideation and purposeful action of providing care that went beyond medical treatment. Opening eyes was the process by which caregivers became aware of their patient's life course and the individualized experience of their patient's current illness. Participants also described another course of action, which we termed cocreating, that was a mutual and fl uid activity between patients, family members, and caregivers. Cocreating began with an affi rmation of the patient's life experience and led to the generation of a wholistic care plan that focused on maintaining the patient's humanity and dignity. Time was both a facilitator and inhibitor of effective spiritual care.CONCLUSIONS Clinicians and other health care workers consider spiritual care at the end of life as a series of highly fl uid interpersonal processes in the context of mutually recognized human values and experiences, rather than a set of prescribed and proscribed roles.

Impact of death and dying on the personal lives and practices of palliative and hospice care professionals

“…[6][7][8][9][10][11][12][13][14][15] They are also comparable to findings from studies in which end-of-life experiences presented many challenges to health care providers but were secondary to the numerous beneficial aspects of their work, especially as they related to meaning and purpose. 6,7,9,11,14,32 This study differed from others in its explicit focus on the impact of death and dying on health care providers; its cross-sectional sample of national leaders and frontline professionals in palliative and hospice care; and the inclusion of participants' experiences with death and dying across the trajectory of their lives.…”

“…[6][7][8][9][10][11][12][13][14][15] To address these gaps in the literature, this study explored the impact of death and dying on the lives of key leaders and frontline professionals in palliative and hospice care -individuals who arguably provide society and health care practitioners with the most authoritative discourse on end of life and its effect on life in general. This study was part of a larger ethnographic inquiry on the spirituality of palliative and hospice care professionals in Canada.…”

“…[1][2][3][4][5] A small number of studies discussed the residual impact of end-of-life care within a localized group of health care providers; however, there is limited cross-sectional research explicitly investigating the long-term effect of death and dying on the personal and professional lives of individuals who are exposed to death and dying on a frequent basis. [6][7][8][9][10][11][12][13][14][15] To address these gaps in the literature, this study explored the impact of death and dying on the lives of key leaders and frontline professionals in palliative and hospice care -individuals who arguably provide society and health care practitioners with the most authoritative discourse on end of life and its effect on life in general. This study was part of a larger ethnographic inquiry on the spirituality of palliative and hospice care professionals in Canada.…”

History, Culture and Traditions: The Silent Spaces in the Study of Spirituality at the End of Life

“…This creates major challenges for care givers. The lack of such knowledge has been found as a reason for dissonance between care providers and patients and is often described as a barrier to providing spiritual care [83]. In some instances, it has resulted in highlighting the value of understanding contextual meanings and practices towards when making palliative care more adapted to local cultural context [2,84].…”

Family Relations And Spiritual Response To Palliative Care: A Review Of Literature

“…One of the main characteristic of palliative care is the spiritual caregiving; 67% of people die in hospitals or long-term care facilities without assured access to spiritual care in the USA [5]. Spirituality is a multidimensional state that envelops meaning of life questions; it's a step to deal with your own mortality, linked with religious and non-religious traces.…”