The Spiritual Dimension of Caring: Applying a Model for Spiritual Tasks of Ageing

SUMMARY

This chapter describes a spiritual dimension of ageing using themes and a model for spiritual tasks of ageing, developed as a part of doctoral studies that examined spirituality amongst a group of independent-living older adults in Canberra and NSW. This model has been tested further and the model was confirmed through in-depth interviews of residents of nursing homes in the ACT. The first study identified six major spiritual themes from participant interviews. These were: ultimate meaning in life for each person, the way they responded to meaning, self-sufficiency versus despair, moving from provisional to final life meanings, relationship versus isolation in ageing and hope versus despair.     

The Defiant Power of the Human Spirit: Mental Health in Later Life

SUMMARY

This paper sets forth a wholistic perspective on the aging process, that clearly acknowledges the struggles and tensions between both the positive and decremental aspects of aging encountered in this journey. It speaks eloquently of the overarching tapestry of our lives balanced against the precariousness and brevity of life's experience. It speaks of challenges of later life that are experienced as physical decrements progress. Against these are balanced the need for rituals and transcendent symbols to enable the person to move into the spiritual and find meaning in the journey. In presenting this picture of aging, Kimble moves beyond the biomedical paradigm and applying Frankl's material he clearly demonstrates the defiant power and potential of the human spirit in adjusting to and moving through and beyond suffering.     

Logotherapy and Pastoral Counseling

SUMMARY

An intensive study of Frankl's logotherapy reveals its timely relevance for pastoral counseling. The paradigm of logotherapy recognizes the spiritual dimension as the inclusive and encompassing dimension for comprehending and integrating human phenomena. Its hermeneutical phenomenological analysis introduces an understanding of personhood which affirms one's capacity to find meaning in life, indeed, even in suffering and dying. It is this unique spiritual capacity which conveys a renewed awareness of self worth and human dignity and assists persons in understanding themselves as fashioned in the image of God. Logotherapy provides a helpful counseling theory for pastors and laity engaged in older adult ministry.     

Ageing and Isolation: Is the Issue Social Isolation or Is It Lack of Meaning in Lige?

SUMMARY

Social and spiritual isolation are growing issues for an ageing society that promotes the ideals of autonomy and high levels of individuation amongst its citizens. This chapter explores the issues of social and spiritual isolation for older adults and ways of addressing these issues both now and in the future. The need for intimacy with God and with others is illustrated using material from in-depth interviews with older adults who live independently and others who are residents of aged care facilities.     

Ageing Health Care and the Spiritual Imperative: A View from Scotland

SUMMARY

This paper, given as a keynote presentation at the third international conference on Ageing and Spirituality 2004 in Adelaide, Australia, offers a perspective on ageing that makes central and fundamental the spiritual journey. Ageing is not confined to the old. We are all ageing all the time and whilst the imperative of ego integration (Erikson, 1986, 1982) is more pressing in old age, the march of time makes no exceptions. The paper starts with a consideration of the Scottish context and the current interest in Scotland in spirituality and health. Borrowing from the human developmental ideas of Frankl, Jung, Erikson, and Klein, the paper takes the view that we are all spiritual beings, and we are all trying to be successful, integrated reconciled and mature individuals. Ageing and spirituality is relevant to every individual. Successful ageing is fundamentally concerned with the successful self. The spiritual journey is bound up with the search for meaning. Ageing is part of the task of being human and it involves decline and loss. The spiritual journey–search for meaning–is unique to each one of us. The spiritual journey is made evident in the search for the ultimate destination of giving up self, transcending self. Remembrance and routine are methods by which the ageing and the spiritual journey can be facilitated. A successful ageing, according to this perspective, is therefore one that embraces and self-consciously embarks upon a spiritual journey. To take it further–the spiritual journey is bound up with ageing–and further still–ageing is a spiritual journey (Bianchi, 1984). The primary task of ageing is spiritual development. Spiritual development is helped by an appropriate societal context in which ageing as spiritual journey can flourish. This has implications for health and social care services.     

Theological Attentiveness to A Universe from Nothing: A Review Essay

Abstract

This article explores the need for a theological attentiveness to recent discoveries in the scientific world, and the corresponding debates between theologians and scientists. Specifically the article discusses the writings of Lawrence M. Krauss about a universe from nothing in five scientific claims, and the need for caution by believers in God, not to infer a creation story from the scientific view of the Big Bang theory. The progressive understanding of the spiritual dimension of human nature is just as important as the progressive understanding of the scientific nature of the universe. Krauss seems not to share a faith in theological matters which is not a reason on his part to belittle it. The progressive understanding of the spiritual dimension of human nature is just as important as the progressive understanding of the scientific nature of the universe.     

The Spirituality of Compassion: A Public Health Response to Ageing and End-of-Life Care

SUMMARY

The recent revival of interest in spirituality in later life marks a significant step forward in the person-centred care of ageing people. The benefits will, however, be of limited value if we do not attend to the settings in which spirituality is to be lived. In contemporary society many aged people are located in environments unsympathetic to spiritual belief and practice. Health care settings focus on professionally-assessed physical needs and are dominated by concerns about the cost of services. The national social policies that direct health care services and less directly shape older people's place in contemporary society are strongly influenced by globalised neoliberal economic policies characterised by individualism, competition, and greed. For robust and viable spirituality to develop at the individual level we need compassionate social policies that support interdependence within communities and between nations.     

Step Two: What Do You Want the Older Adult Ministry Program to Accomplish?

SUMMARY

What is the purpose for an older adult ministry within a congregation? It is not a program but a process of spiritual care, spiritual development, and spiritual formation as older adults are confronted with challenges to their spiritual perspectives due to the changes inherent in the process of aging. The experience of aging is a teacher that can be denied only with great peril to the person. Various views of aging as a spiritual journey are shared. The support and guiding of the spiritual perspectives of older adults is the core purpose for an older adult ministry in a congregation. This central purpose must be overtly expressed through the writing of a mission statement for older adult ministry that will be a yardstick not only for evaluating present ministries but also for guiding their future efforts. A simple, easy-to-use method of developing a mission statement is shared.     

Old Age,Finitude and Meaning: Reflections on the Care of Older Adults Based on Logotherapy

Due to the steady increase in the number of older adults among the Brazilian population, the aim of the present article is to reflect on the care provided to the elderly based on Viktor Frankl’s logotherapy as an alternative approach to understanding more deeply what this life stage means. For this purpose, demographic data on the population of older adults are provided, together with distinct views on aging and its relationship to the quality of life. Next, logotherapy, from its conceptions about the relationship of the person to finitude and to the person’s possibilities for existence, is presented as a psychological theory likely to improve the understanding of aging and to represent a possible approach to the care of older adults. Based on an understanding of humans as beings of power and therefore as self-transcendent and endowed with the will to meaning, the possibility of psychology investing in the relationship with alterity as the grounds for interventions targeting older adults is emphasized.     

Psychiatry and religion: a perspective on meaning

ABSTRACT

A Position Statement on Spirituality and Religion in Psychiatry was issued by the World Psychiatric Association in 2016. Among many recommendations, this statement underscores the need for research on both religion and spirituality in psychiatry, especially on their clinical applications. In this contribution we will put light on the issue of meaning and meaning-making, i.e., an important field for every human, Particularly for individuals suffering from severe mental disorders. After an introduction about meaning in its religious/spiritual dimension, we will describe what needs to be studied in order to get a better knowledge as to how patients cope with meaning, and how they process (in terms of meaning-making) the outburst of a severe mental disorder such as schizophrenia.     

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.     

‘And if not now,when?’: Spirituality,psychotherapy, politics

Abstract

Without collapsing distinct discourses into each other, the paper considers the linkages between spirituality, psychotherapy and politics. Changes are taking place in all three areas. Therapists who focus on the spiritual dimension as part of their ordinary work still tend to be marginalized. Similarly, the political dimensions of the client's experience often receive insufficient attention. The author offers an initial sketch of a new ‘anatomy of spirituality’: into social spirituality, democratic spirituality, craft spirituality, profane spirituality and spiritual sociality. He criticizes the practice of ‘safe therapy’, meaning therapy based on an object relations paradigm that represses the (incestuous) sexuality that lies at the heart both of the therapy encounter and the domain of spiritual values. The paper concludes with some thoughts about justice and an account of pertinent grassroots political developments.     

Worlds in Motion: Temporality and Historicality

ABSTRACT

Worlds are always in motion; what kind of movement is at stake? In this essay, I will argue that Heidegger moves beyond Hegel by making the concept of world central to phenomenology. But how do worlds move? As history, Heidegger says; yet his initial attempt to interpret history, in the final sections of Being and Time, is at certain moments hampered by his attempt to ground the historicality of shared world in the temporality of individual Dasein. Derrida then moves beyond Heidegger by addressing paradoxes in our understanding of time and history. This allows Derrida to introduce the ethical dimension of world from the start as we are called to acknowledge that the Other brings their own world and awaits our response. Worlds are both singular and shared; and in any case, they move (and move us).     

Religious studies and claims of satanic ritual abuse: A rejoinder to Stephen Kent

Care of the dying is likely to be a useful indicator of trends in Christianity, a religion which for centuries has been deeply concerned with the problem of death. The article identifies three approaches to the spiritual dimension in contemporary terminal care—a religious approach, an ecclesiastical approach and an approach that identifies the spiritual as the search for meaning. Though the ecclesiastical approach dominates practice, the ‘meaning’ approach is becoming fashionable and represents a highly individualized, postmodern variety of religion with similarities to the New Age—a surprising conjunction in those hospices with a Christian foundation.     

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.     

Developments in Spiritual Care of the Dying

Care of the dying is likely to be a useful indicator of trends in Christianity, a religion which for centuries has been deeply concerned with the problem of death. The article identifies three approaches to the spiritual dimension in contemporary terminal care—a religious approach, an ecclesiastical approach and an approach that identifies the spiritual as the search for meaning. Though the ecclesiastical approach dominates practice, the ‘meaning’ approach is becoming fashionable and represents a highly individualized, postmodern variety of religion with similarities to the New Age—a surprising conjunction in those hospices with a Christian foundation.     

SOCIAL NEUROSCIENCE AND THEISTIC EVOLUTION: INTERSUBJECTIVITY,LOVE, AND THE SOCIAL SPHERE

After providing a brief overview of social neuroscience in the context of strong embodiment and the cognitive sciences, this paper addresses how perspectives from the field may inform how theological anthropology approaches the origins of human persons‐in‐community. An overview of the Social Brain Hypothesis and of simulation theory reveals a simultaneous potential for receptive/projective processes to facilitate social engagement and the need for intentional spontaneity in the form of a spiritual formation that moves beyond simulation to empathy and love. Finally, elements of a virtue science that draws on Dietrich Bonhoeffer's relational imago Dei are shown to be helpful in framing and motivating theological approaches to human origins.     

Out of the depths

A fundamental approach of theology as practiced within the palliative setting is care for the whole human being, with particular focus on spirituality and the spiritual dimension. Theology and medicine come together in palliative care in which the spiritual aspect is an important component together with the physical, psychological, and social. This article is based on a mixed methods study of spirituality among persons receiving palliative care. Findings revealed the importance of spirituality and its multidimensional elements by which spirituality was perceived as a complex phenomenon relating to religious and non-religious aspects of human life. Theological reflection based on the present findings indicates that a sharp distinction between the concepts of religion and spirituality is not beneficial. It also reveals the significance of the spiritual dimension and that theology has an important role in creating a deeper understanding of this complex part of human existence. Spiritual needs, expressed in various ways, were evident among the participants receiving palliative care. The findings confirm that the theological approach in palliative care, with its focus on the whole human being and emphasis on spirituality and the spiritual dimension, continues to be the hallmark of practicing theology within palliative care.     

Spiritual Integration:

This paper examines the interface between the religious and social service communities surrounding the aging person. Linkages between the two sectors are discussed In terms of: (1) the ersonal or small group level; (2) the local community/local church level; and (3) the institutionalidenominational level. implications of these linkages for supporting the need for spiritual integration among older persons will be discussed.     

A ‘new life’ story or ‘delaying the inevitable’? Exploring older people's narratives during exercise uptake

ObjectivesThe purpose of this study was to examine narratives of ageing in a clinical population embarking on a physical activity/exercise programme, exploring if and how their narratives changed throughout their experiences.DesignThe study employed a longitudinal narrative approach.MethodParticipants were six sedentary individuals aged between 78 and 89 years who were enrolled on an exercise programme for older adults. During the course of the 32-week programme participants took part in multiple interviews focused on their attitudes towards physical activity and their physical self-perceptions and identity. A structural narrative analysis was used to focus on the progression of the plot outlined in each participant's story.ResultsOur results suggested the emergence of two comparative narratives, with each demonstrated in the stories told by three participants. The first narrative is one of decelerated decline, in which the exercise programme is assimilated or fitted into the existing life narrative, but little is made of the personal meaning of being active. In the second narrative, participation in exercise prompted participants to re-story their ageing narratives, changing from initially accepting the decline they associated with an ageing body, to the prospect of gaining some control. While this increased sense of control may intuitively seem positive, participants initially described a number of existential challenges and dilemmas as well as their resolution of these.ConclusionParticipants' emergent stories highlighted that while older adults may perceive exercise positively, their existing narratives of decline may be resistant to change. Where changes do occur, it is important for health professionals to recognize the associated difficulties with gaining increased responsibility for health.