Addressing the Spiritual Needs of People Aging with Dementia And/Or
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Volume 33 Number 2 Spring 2018 Case Study Addressing the Spiritual so is providing spiritual care. Yet worship; that is, scratching the sur- often this component of holistic face. Needs of People Aging care is neglected. with Dementia and/or According to the 2014 Pew Lifelong Disabilities “Indeed, in today’s care system, the Research Center Religious Land- physical needs of patients are obvi- scape Study, about 72 % of people by Kathy Fogg Berry, MRE, MS, ously recognized; that after all is over 75 consider their faith to be why they are in the system. If the very important to them. The Certificate in Aging Studies right personnel are available, and if Alzheimer’s Association’s 2017 time permits, a patient’s psychoso- Alzheimer’s Disease Facts and Fig- Educational Objectives cial needs can also be addressed. ures Report states that one-third of But all too often their spiritual people over 85 have Alzheimer’s 1. Present the need for spiritual care needs are not recognized or consid- disease, and nearly one half have as part of holistic care for people ered legitimate targets for interven- some form of dementia. So, at a living with dementia and/or lifelong tion; certainly these needs are not time when they may need their faith disabilities. frequently acknowledged, recog- to help them cope with dementia 2. Distinguish the difference nized and dealt with by medical and other major life transitions, between spirituality and religion. professionals” (Sapp, 1999). elders are often unable to initiate 3. Discuss how to assess the spiritu- and sustain faith practices and spiri- al needs of people living with A visit to a new doctor’s office usu- tual disciplines that bring them dementia and/or lifelong disabili- ally begins with questions about peace, comfort, a feeling of close- ties. medical status, past and present. ness to God. This is also true for 4. Show through case study exam- Similarly, a visit to a new psychia- people aging with lifelong disabili- ples specific ways to address the trist or social worker begins with ties, who may not have the physi- spiritual needs of people living with questions about mental and social cal, cognitive, or communication dementia and/or lifelong disabili- health and history. Spiritual health abilities to initiate, ask for or sus- ties. and well-being are rarely, if ever, tain faith practices essential to their assessed. Such an assessment can well-being. Family and profession- Introduction provide valuable insight into a per- al caregivers often do not assess son’s total health or disease. Yet, spiritual needs or assist with vital Just as caring for the physical and rarely is more spiritual/religious religious and spiritual practices emotional needs of people aging information gleaned by those caring which could enhance quality of life with dementia and lifelong disabili- for elders than someone’s faith for those they’re caring for. ties is essential for their well-being, affiliation and perhaps place of Inside This Issue: VCoA Editorial, 6 Ruth Anne Young Award, 11 Museum Dementia Events, 15 DARS Editorial, 7 Age Wave Student Scholars, 11 VCU Road Scholar, 16 Alzheimer’s Training, 9 Legislative Breakfast Recap, 12 VCoA Brand Refresh, 17 ARDRAF Final Reports, 10 Sugar is Everywhere, 14 Calendar of Events, 18 The Federal Government mandates conduct (Post and Whitehouse, join in with organized activities or that skilled nursing facilities must 1999). Fischer, in her book Winter rituals, and they will probably fol- promote each resident’s quality of Grace (1998), says that spirituality low the teachings or philosophies life (42 CFR §483.15). Yet, spiri- doesn’t mean just one compartment either of a living spiritual leader or tual/religious care in long term, of life, but the deepest dimension of of an important religious figure assisted living, and nursing care all of life; spiritual life is not a stat- such as Jesus, Moses or Buddha. facilities is often relegated to volun- ic state but movement, growth, and Religion is, therefore, often based teers who provide generic worship process. on the past, while spirituality tends services, religious music programs, to be more about individual devel- or friendly visits. While these pro- Comparing spirituality to religion opment in the present.” grams might be quite valuable, they on its website, www.reComparison. do not address the unique spiritual com says: “Spirituality is about Sam Harris, neuroscientist, philoso- needs of everyone and cannot meet finding one's own path, which may pher, best-selling author, and self- the challenging needs of residents require the assistance of religious proclaimed atheist, claims, “Spiritu- for day-to-day spiritual support practices or spiritual leaders, but ality must be distinguished from through life’s transitions. which can also be achieved alone religion because people of every or through unconventional means. faith, and of none, have had the If 72% of elders over 75 consider Spirituality is more about an inner same sorts of spiritual experiences” their religious faith to be important, quest than an outward perfor- (2005). then facilities are not doing enough mance, so it can be harder to recog- to maintain or enhance elders’ qual- nize and it can also be much more Everyone is a spiritual being, but ity of life. This is especially true in individual than religion. People not everyone adheres to a particular regard to residents who, due to may achieve spirituality in their religious belief or becomes part of a dementia or lifelong disabilities, own unique way. Some people have religious organization. Whether cannot practice their religion and found a spiritual connection persons living with dementia and/or nurture their spirit without assis- through prayer or meditation, while a lifelong disability live at home tance. Administrators, doctors, others were struck by spirituality with caregivers or in a facility, find- nurses, social workers, recreational while walking, surfing, gardening ing ways to help them explore and therapists and all staff, not just or even working. Typically, spiritu- nurture spirituality is essential to chaplains, should seek to under- ality involves feeling a connection providing quality care, as is stand and address the spirituality of to a higher power or to a larger enabling them to practice their residents. Most facilities caring for reality, or finding a deeper under- faith, if they’ve become part of a elders do not have chaplains on standing of one's own nature. An particular religious group. staff, so this needs to be a part of individual may spend a lot of time everyone’s responsibilities. thinking about spirituality, but with- Identifying and Addressing out being part of a particular reli- Spiritual Needs Spirituality and Religion gion.” Humankind experiences deep needs Although there is no single, broadly Emile Durkheim (1912) maintained for security, trust, reassurance, love, accepted definition of spirituality, that religion involves a unified sys- inclusion, joy, hope, and accep- many agree that it involves the tem of beliefs and practices relative tance, among others spiritual needs. search for meaning to life. Spiritu- to sacred things. This then evolves How each person feels and experi- ality, in contrast to religion, pertains into a moral community called a ences these is as unique as there are to a sense of relatedness to nature, church (community of faith.) The people on the earth. So, spiritual all humanity, and the Transcendent. defining characteristic of a religion care must be person-centered, Although it need not be the case, is that it is an organized form of uniquely addressing the specific spirituality is often contextualized belief, www.reComparison.com needs of each individual in the spe- within a religious tradition, a spe- suggests. “Someone who is part of cific way he needs them addressed. cific system of belief, worship, and a particular religion will usually Conducting a spiritual assessment 2 can help discern each person’s speak to the senses of those who life. They’ve experimented with needs. It is important to ask about have cognitive impairment and can- music, pet and art therapy, and vis- rather than assume needs. A spiri- not comprehend the meaning of iting children, all of whom she also tual assessment should not be done words. This is true for persons liv- rejects. with a clip in hand, but rather over ing with lifelong disabilities, as time through conversation and rela- well. The hospice staff has had some luck tionship. For someone living with providing essential care at times, dementia, it is best to conduct an Depending on the person’s level of assessing physical needs, providing assessment during the early stages. cognition, further conversations medication, and soothing baths, but If the person with dementia or a might explore such questions as: the hospice chaplain has been lifelong disability is unable to com- What religious or spiritual influ- unable to discern her spiritual municate well, then talk with the ences shaped your life? What pre- needs. All anyone knows about person’s family or caregivers to dis- vents you from exploring and nur- Emily’s faith background is her cern past and present spiritual turing her spirit? church’s name, listed in the chart. and/or religious needs and prac- However, since she has lived in the tices. When people lose the ability to nur- facility for 10 years, she’s been ture their spirits and/or practice unable to attend church, and no one A sample Spiritual Assessment Tool their faith in ways that give them can recall a minister visiting in from When Words Fail: Practical purpose, comfort, peace, and a recent years. Ministry to People with Dementia sense of community, part of provid- and their Caregivers (Berry, 2016) ing holistic care is helping them do One day the facility’s social worker asks: those things.