Spiritual care and religious practices
Good spiritual care responds to the hopes, concerns and faith of an individual without judgement or imposing any beliefs. Often by effectively meeting spiritual needs a person feels more hopeful, reassured and peaceful. This positive effect also can benefit family and other carers too.
An important part of spiritual care for many includes meeting their religious needs. Responding to religious needs of people will include recognising issues that may be important especially towards the end of life.
Understanding a patient’s spiritual needs is about having compassionate communication and giving those under our care the time to express what is important to them. This will be unique to each patient and may include both religious needs and other requests for personalised supportive care. There are some notes on communication skills and asking the right questions at the end of this chapter.
For specific information about the different religious approaches to end of life care and death: HDFT Spiritual, Religious and Pastoral care policy on the intranet.
The Chaplaincy Team are available 24 hours a day and can be contacted on (55)3045 or via switchboard.
Resources in meeting spiritual and religious needs
A member of the healthcare team dealing directly with the patient or carers is the most important resource as they can identify that someone has spiritual needs to be met. These needs should be recorded and planned for.
The family, friend or carers in attendance with a dying patient may be able to give advice regarding the specific spiritual or religious needs of a patient when that individual is unable to communicate. They may also have needs of their own.
The Chaplaincy Team is based at Harrogate and District NHS Foundation Trust and is available to provide advice, training and direct support where appropriate. They provide a 24/7 on-call service to help support patients, carers and staff. Local faith groups may be able to provide support when the patient already has that supportive connection. The Chaplaincy Team have a directory of contact details for the Harrogate and District.
The Chaplaincy Team are on-call 24 hours a day. Please contact via the hospital switchboard.
Common
themes
in
meeting religious or cultural needs
Modesty & gender issues
Modesty in dress and a requirement to be treated by a healthcare professional of the same sex is important in some religions. Staff should consider these requirements in order to preserve the dignity of the patient.
However, it is not always possible or deasible to provide same sex attendance, particularly without adequate notice.
Supportive community
An essential part of a patient’s religious and spiritual care may involve the support of family and/or their particular community. This is applicable across the different healthcare settings.
A faith leader visiting them may also be important. If appropriate this may be facilitated outside of normal visiting hours with permission from the senior nurse on duty. Chaplaincy can be helpful in a number of ways both for the patient/family and staff either by providing direct care or advice to staff as needed.
Drugs and treatments
For religious reasons some patients may raise issues with prescribed medicines or treatments that involve porcine-based drugs or alcohol-based drugs/treatments.
However, if there is no ready alternative the patient may be happy to take the prescribed medicine as allowances in their religious observance may be made for the sake of their physical health.
Spiritual pain/distress
This may present as:
Fear of death or abandonment - Unresolved anger - spiritual emptiness, hopelessness - unresolved past experiencesconfusion or doubt about beliefs - need for reconciliation, comfort, peace – The why questions: why me? why God? why now? why this? - Feelings of guilt - inability to trust
“The realisation that life is likely to end soon may well stimulate a desire to put things first and to reach out to what is seen as true and valuable – and to give rise to feelings of the unfairness of what is happening, and at much of what has gone on before, and above all a desolate feeling of meaninglessness. Here is, I believe, the essence of ‘spiritual pain’.” - Dame Cicely Saunders
Care after death
Many religions and beliefs include in their teachings views on dying, death and the afterlife. For many religions, life does not end with death.
In the event of a death, staff should consult the patient’s relatives to determine their preferences with regard to preparation of the body and other religious requirements. It is important to remember that early burial is a requirement in some religions.
Seek to understand the family and don’t make assumptions based on what you may know about a religion. The family may practice differently/not practice what their named religion is.
Communication skills around individuals’ spiritual and religious needs
• Vocabulary can be difficult; words do not always have the same meaning for different people.
• Always ask the person about themselves.
• Religious needs are individual to each patient and family.
• Question your own assumptions e.g.: I understand that some people of your faith like to… how about you?
• Choose words and phrases that are comfortable for you.
• Ask open questions where possible.
• Do not be tempted to answer unanswerable questions.
• Learn to live with unanswered questions and respect them.
• How is what you are dealing with affecting you as a person?
• What does all this mean for you?
• You seem thoughtful; tell me what’s going through your mind?
• How does what’s happening to you fit with your expectations of life?
• How do you feel things are going?
• How do you feel you are coping?
• How does this make you feel?
• How important is your faith to this situation?
• How does your faith or religious belief support you or cause difficulties?
• If prayer is part of your life, how well is it supporting you just now?
• How can we help you to continue to practice your faith whilst unwell?
• Suggestions to responding to questions about your own faith or beliefs:
• Tell me what made you ask me that?
• It seems this is an important area for you. Tell me more about it.
• Some questions are unanswerable. I’m interested to know how you feel about it/how would you answer that question?