Spiritual Care: Recognizing Spiritual Needs of Older Adults

SUMMARY

This paper explores aspects of spiritual needs and assessment, while emphasizing the importance of aged care providers being spiritually self-aware. The context of this exploration is meaning in life, spirituality and quality of life as experienced by older adults. Depression and dementia are frequently seen among older adults in residential aged care with resultant lowered quality of life. Pastoral and spiritual care may be used effectively to help alleviate depression and support older people who have dementia. However, to be able to provide appropriate spiritual care, spiritual needs should be assessed. Ways of assessing spiritual needs are suggested.     

A Palliative Approach to Spirituality in Residential Aged Care

SUMMARY

This paper describes how a palliative approach to care is relevant in the context of residential aged care, with specific focus on the spiritual needs of residents. Three issues are described that make attention to spirituality in residential aged care particularly challenging: effects of cognitive changes, potential threats to dignity, and uncertainties about how to provide bereavement support to the range of people who experience loss in this care context. Reflections on how residential aged care staff might better assess the spiritual needs of residents are offered with suggestions from the literature about how to sensitively respond to these needs.     

Mental Health and Spirituality in Later Life: Pastoral Approaches

SUMMARY

This chapter proposes a perspective on providing pastoral care for people at risk of, or who have mental health problems in later life. Two major areas of mental health, depression and dementia are explored, examining their impact on older people and strategies to identify risk in depression, and signs indicating need for pastoral intervention in depression and/or dementia. The work from two studies that examine issues for meaning of people, the first for older people living independently and the second in residential care, form the basis of the material presented in this chapter. It is maintained that pastoral interventions may greatly improve quality of life for these people, their families and carers.¹     

Listening for Safe Places: Networks of Playing and Chalcedon in Disaster Pastoral Care

Disaster pastoral care operates in diverse contexts, which may challenge clergy responders in ecclesiological meaning‐making of their practices of care. This article argues that pastoral care may be imagined as part of a larger “network” of caring acts understood as a collective, multiple care practice. Such practice reflects deep‐rooted movements described in psychoanalytical theory as playing, and the christological idea of communication of properties. Therein, spiritual “safe places” can be seen to emerge, even in the midst of traumatic events.     

Depression and Spirituality in Australian Aged Care Homes

SUMMARY

A national survey of Australian aged care homes has found that between 40% and 60% of high care residents and 25% to 51 % of low care residents are depressed, depending on the method used to assess depression. While this survey did not specifically include items on spirituality, an analysis based the Geriatric Depression Scale question “Do you feel that your life is empty?” provides some insights into the type of person who may benefit from spiritual help.

The view is expressed that those committed to the provision of spiritual care must be more assertive in making the positive contribution to the reduction in depression that empirical research carried out over the last thirty years suggests is possible. The basic step of identifying those who are ready to talk about spiritual matters and who are depressed is offered as a starting point and some ways of doing this are described.     

Virtual Empathy? Anxieties and Connections Teaching and Learning Pastoral Care Online

Is it possible to teach pastoral care online? McGarrah Sharp and Morris describe their process of transforming a residential on‐campus pastoral care course into the first online offering of the course at their seminary. They begin by describing a series of pedagogical choices made with the intent of facilitating dynamic movement between peer‐to‐peer, small group, and whole class discussions throughout the semester. Before and during the course, anxieties arose at many levels of instruction for the professor, teaching assistant, and students. Anecdotes and examples from the online course show how the online course design and facilitation was able to name and respond to anxieties as part of integrating pastoral care course content and practice – a key learning goal for the course. The authors are persuaded that online pedagogy can help identify how anxieties create space for developing empathy as much, if not more than, a traditional on‐campus format.     

Understanding the Ageing Process: A Developmental Perspective of the Psychosocial and Spiritual Dimensions

SUMMARY

This chapter describes a perspective of psychosocial and spiritual development in the later years of life. It outlines a study of nurses conducted in six nursing homes using pre and post workshop tests to identify changes in nurses' assignment of a list of behaviours as psychosocial or spiritual. Use of SPSS found significant changes between the pre and post tests. Pre workshop tests only identified items as spiritual if they included the word God, or Bible. Results from this study highlight the potential role for nurses in aged care to provide spiritual care as part of holistic care. It also highlights the fact that many nurses feel ill prepared for this role.     

Non-Speech Based Pastoral Care: A Pastoral Care Program for Aged Care Residents with Little or No Ability to Speak

SUMMARY

Pastoral care depends on the ability to communicate, most commonly through the medium of speech. The aged person who has suffered illness or accident that has adversely affected their speech, is in great need of pastoral care. Yet chaplains and pastoral carers can feel helpless in the face of such a significant deficit and may not know what to do. At Tregenza Avenue Aged Care Service, the Chaplaincy service has developed helpful individual programs for non-speech based pastoral care. Using visual and tactile symbols, pictures, touch, and music, we have been able to minister to people with a variety of speech problems, with promising results.     

A Survey Report of Nursing Home Ministry and Perceived Needs with Implications for Pastoral Care

ABSTRACT

The last 40 years of growth in the development of pastoral care to the sick appears to have virtually bypassed persons in nursing homes. A study within 13 nursing homes in one city revealed that spiritual ministry within those institutions was generally limited to a series of 9 to 13 worship services per month, attended by approximately 20 percent of the patients/residents. Some patients receive an occasional personal visit by a pastor. The staff perceive that pastoral ministry as good, but inadequate, and expressed their views on that which is needed within their institutions and challenge the clergy with specific suggestions for pastoral care for nursing home patients/residents, their families, and staff.     

Referrals to chaplains: The role of religion and spirituality in healthcare settings

Given the increasing importance of understanding how healthcare workers interact with the principal person designated to meet patients’ spiritual needs— the chaplain— the current study provides an inter-disciplinary perspective of the role of chaplains (and spirituality) in patients’ emotional, physical, and spiritual health. The study surveyed a randomly selected national sample of hospital directors in four disciplines: medicine (n?=?278), nursing (n?=?230), social services (n?=?229), and pastoral care (n?=?470). Participants rated the importance of referring patients to chaplains for four different areas: pain/depression, anxiety/anger, treatment issues, and loss/death/meaning. Results revealed significant differences in referral patterns for type of hospital, professional discipline, the hospital's religious affiliation, and self-reported spirituality. Results are discussed in relation to historical views of spirituality and religion within the different disciplines.     

Spiritual Dark Night and Psychological Depression: Some Comparisons and Considerations

The author contends that spiritual dark night and some forms of psychological depression share commonalties yet have distinctly different features that call for different responses from caregivers. The author presents comparisons between the 2 phenomena; highlights differences between them to offer counselors guidelines for making informed responses to their clients' issues; and compares professional preparation for spiritual directors, pastoral counselors, and traditional counselors. The article focuses on effective caregiver responses to dark night challenges that may be misperceived as manifestations of depression and stresses the importance of counselors and spiritual directors knowing their limits of expertise.     

Wisdom in Pastoral Care and Counseling: What Does it Entail?

The purpose of this article is to suggest richer potential meanings of spiritual wisdom and theological reflection in response to a critical reading of Pamela Cooper-White's book, Shared wisdom: Use of the self in pastoral care and counseling.     

Pastoral care and AIDS: Assessing the stress and satisfaction from caring for persons with AIDS

Members from religious communities in New York City (17 men, 8 women) who volunteer pastoral care to persons with AIDS completed and returned through the mail the (AIDS) Caregiver Scale and the Attitudes toward AIDS Scale. Results indicated that satisfaction from providing care was related to pastoral training, an understanding of the spiritual nature of death, and a positive attitude toward persons with AIDS. Self-reported stress from providing care was inversely related to pastoral training to deal with death. The pastoral volunteers also reported greater satisfaction and lower stress from caregiving than volunteer buddies from upstate New York.     

Representing the Good: Pastoral Care in a Secular Age

In ‘a secular age’ (Taylor 2007), pastoral care is no longer exclusively associated with specific religious traditions and communities. Pastoral caregivers who work in secular institutions provide care to religious and nonreligious people alike, and in several Western societies the term pastoral care is used in relation to nonreligious (humanist) care. In secular contexts, the term ‘pastoral care’ is often replaced by the term ‘spiritual care.’ Spiritual care, however, is provided by various professionals, so pastoral caregivers face the challenge of developing adequate and convincing language to explain what is distinctive about their work. In this article, the authors turn to philosophical language in order to develop a conceptual understanding of pastoral care that does not depend on the specific worldview—religious or nonreligious—of either pastoral caregivers or receivers of pastoral care. Using the work of Taylor (1989, 2007) and Murdoch (1970), we explain pastoral care as engaging with people’s attempts to orient in ‘moral space’ and the distinctive quality of pastoral care as ‘representing the Good.’ Murdoch associates ‘the Good’ with a secular idea of transcendence that is both a movement beyond the ego and an engagement with the reality of human vulnerability, suffering, and evil. We argue that pastoral caregivers who ‘represent the Good’ have the task not only of supporting the existential and spiritual processes of individuals but also of promoting dialogue and social justice and of critiquing dehumanizing practices in the organizations in which they work and in society at large.     

THEOLOGY AND SCIENCE OF MENTAL HEALTH AND WELL‐BEING

The approach to mental health and well‐being taken here illustrates the complementary perspectives approach and assumes that there are useful and intersecting contributions from science (including medicine) and from religion and spirituality. What counts as poor mental well‐being depends on the interaction of relatively objective criteria with culturally contingent value judgments. I then discuss theological perspectives on depression, including a consideration of sources of hope and tolerance of dysphoria, and argue that depression can be part of a spiritual journey. I then look at the relationship between psychosis and religion, including the work of Isabel Clarke, arguing that a spiritual approach to psychosis can complement a medical approach. Finally, I present a pastoral case study illustrating the interface between neurological and spiritual aspects of the sense of presence. A religious perspective can challenge and complement current assumptions about mental health in a potentially fruitful way.     

A Christian for the Christians, a Muslim for the Muslims? Reflections on a Protestant View of Pastoral Care for all Religions

Whereas in the first half of the 20th century, proclamationwas the focal point of pastoral care in Germany, the 1970s witnessedan embracing of the American pastoral care movement. From thenon, pastoral care was increasingly understood as accompanyingpatients whilst adopting the spiritual dimension. Nowadays,Christian chaplains are encountering an increasing number ofpatients from different religious communities. Various modelshave been proposed to help Protestant chaplains find an authenticform of pastoral care suitable for all religions. Until a clearposition is assumed with regard to Christianity's demands ofabsolutism, however, none of these approaches can be satisfactory.     

Layers of engagement: Staff perceptions of spiritual care in residential aged care

ABSTRACT

Addressing the spiritual care needs of residents living in aged-care facilities should be an important dimension of quality care. We conducted semi-structured interviews with residential aged-care staff (including caregivers, nurses, managers, and chaplains) in New Zealand to explore how spiritual care is understood and operationalized. Many participants appeared to equate spiritual care with holistic care that respects the whole person. Participants discussed five types of spiritual care engagement requiring different skills, knowledge, and personal commitment, including information gathering, facilitation, companionship, end-of-life care, and counseling. Our findings suggest that the spiritual care that was offered by our participants, clergy and non-clergy alike, was predominantly informal and unplanned.     

Spiritual Need Five: Providing Quality Pastoral Care as a Congregation

SUMMARY

Critical to the needs of older adults is the care and nurturing of the feelings and emotions that often offer context for the human spirit. Grounded in the history of pastoral care, this chapter explores an approach to pastoral care that is reflective of the author's study and experience in the parish.     

Therapeutic turn

This paper offers a systematic and critical exploration of contemporary theology of pastoral care in the Evangelical Lutheran Church of Finland in light of the history of the practice of care-giving and Western cultural change. Currently, pastoral care is characterized by a therapeutic approach that aims to offer sincere help for earthly suffering and to promote the good things that the individual chooses to reach for. This has been drastically different than historical models from Luther to the early twentieth century that were spiritual and paternalistic in nature. The therapeutic turn connects to the therapeutic culture that has set self-actualization as a central idea determining Western cultural ethos. The therapeutic approach calls into question how the spiritual task of the church is carried out. The prevailing pastoral-psychological theology of pastoral care proves to be problematic. The spiritual task of pastoral care should be based on the basic Lutheran theology of God as objective and not conditioned upon the human mind. Yet, the therapeutic aim should still be maintained as the basic approach of care.     

Managed Care and Pastoral Counseling: An Opportunity for Spiritual Growth

Managed care has forced changes on pastoral care. Among these changes are increased demand for and volume of clients. An appropriate response to this demand is for pastoral counselors to adopt a more short-term oriented treatment approach. While this approach has historically been at odds with the pastoral counseling movement, the authors argue that a combination of the therapies of Albert Adler and Albert Ellis provides a framework for addressing the needs of clients. Social Work at the