Spirituality, sexuality and caring for the carer in palliative care

Question 1

Spiritual care is part of everyone’s

culture

Answer 1

 Integrating spiritual care into palliative care can have huge benefits for
patients and their families.
 This integration has been shown to improve quality of life, decrease
anxiety, reduce end of life despair and anxiety and depression, and have
decreased stay in hospital.
 Religious struggle, on the other hand, can have a negative impact on
wellbeing and even mortality.

Question 2

emphasised the link between existential

distress and physical pain (she described it as “Total Pain” )

Answer 2

cecil saunders

Question 3

What is spirituality?

Answer 3

 There is no clear definition of spirituality.
 It derives from the word “spiritus” meaning “breath”
 The aspect of humanity that refers to the way individuals seek and
express meaning and purpose in life (Dame Cecily Saunders)
 The way we experience the connectedness to the moment, to self, to
others, to nature and to what is significant and/or sacred.
 It is the essence of a person.
S

Question 4

What is spirituality? for a person

Answer 4

 It is different for every person.
 It is different for the same person at different times in their lives.
 It has cultural connotations.
 Spirituality is NOT the same as religion.
 Religion may be the means by which spirituality is expressed.
 A search for transcendent meaning.

Question 5

At the end of life, where do people

find meaning in life?

Answer 5

 A search for a higher meaning beyond suffering.
 Some people look for this meaning in the divine, others in music, arts,
family, science
 Meaning is closely related to a person’s values, beliefs, sense of life’s
purpose, sense of beauty, sense of companionship.
 Meaning is about relationships: with people, with nature, with a
superior being.
 Having meaning in life is related to an acceptance of death and
dying

Question 6

Who needs spirituality in palliative care?

Answer 6

 The patient.
 The nurses
 The doctors.
 The hospitality staff
 The catering staff.
 The family

Question 7

Do the patients want us to discuss their

spiritual needs?

Answer 7

 In one study, 91% of cancer patients had identifiable spiritual needs and
most of them wanted to talk about these needs to their health care
workers.
 So, yes, they do!
 However, patients find it difficult to express their spiritual needs and don’t
use the word “spirituality”.
 Spirituality is defined in terms of the meaning they obtain from life
 It is often expressed through life-stories

Question 8

Do we provide good spiritual care to our

patients?

Answer 8

“There is a distinct lack of confidence in approaching and discussing
spiritual needs with patients.”
BUT….we provide emotional care, we give them laughter and joy, we
provide them with what is important to them, but do we TALK to them
about their spiritual needs.

Question 9

Manifestations of spiritual distress

Answer 9

 Intractable physical pain
 Anger
 Anxiety and depression
 Disintegration of relationships, e.g. with others and God
 Feeling punished or abandoned by God
 Loss of faith
 Feelings of loss of control over life
 Seeking further treatment in the absence of benefit
 Desire for hastened death, hopelessness and suicidal ideation
 Feeling isolated
 Fear at the prospect of dying

Question 10

the perceived barriers to providing good

spiritual care to our patients.

Answer 10

 Lack of time on the part of healthcare professionals to listen to and get to
know patients and develop relationships with them.
 Lack of recognition of spiritual needs by healthcare professionals.
 Lack of training in listening skills, awareness of individual needs and
different cultural beliefs
 Lack of willingness on the part of health professionals to ask about spiritual
beliefs.
 Concern about religious and cultural appropriateness.
 Feelings of discomfort and fear.
 Not being able to identify patients who have spiritual needs

Question 11

What can we say to our patients to provide

spiritual care?

Answer 11

 Where do you gain strength and support from?
 Who or what provides you with meaning and purpose?
 Can you tell me what is important to you at this time?
 What gets you through the day?
 Do you have a faith or belief that supports you?

Question 12

HOPE

spirituality

Answer 12

 H: Sources of hope, meaning, comfort.
 O: Organised religion.
 P: Personal spirituality/practices.
 E: Effects on medical and end of life issues

Question 13

Therapeutic use of self

Answer 13

 This is one of the major components of psychosocial care of the palliative
patient and their families.
 In therapeutic use of self, the nurse uses aspects of his/her personality,
experiences, values and feelings to establish a relationship with the patient.
 This needs self-awareness on the side of the nurse about what his/her
values, feelings are.