The World Health Organization defines health as being comprised of ‘body, mind and spirit’. The spiritual dimension is often ignored and misunderstood. However, it plays a significant part in our wellbeing as it is what makes us unique, it defines what really matters to us and helps us to build resilience in the face of illness, diminishment and dying.
The Scottish Government published its Spiritual Care Framework and Delivery plan in May 2023, Discovering Meaning, purpose and Hope through Person Centred Wellbeing and Spiritual Care . Faith in Older People (FiOP) has been working to develop a stronger understanding of the importance of the spiritual dimension for about 15 years. It has been a fascinating and illuminating journey and we were delighted to see that the Scottish Government had given it strategic importance and that we could play our part in the Advisory and Education Groups set up.
The emphasis to assist people to understand spiritual is to focus on meaning and purpose in our lives. What makes us tick, motivates us, gives us joy. Many consider spirituality to be only about religion. Historically, they were considered the same but are now acknowledged to be separate although spirituality recognises the importance of faith to some individuals. It is also important to consider that Health and Social Care Standards in Scotland, which are underpinned by a human rights approach, stress the importance of a spiritual dimension.
Donald Macaskill, CEO of Scottish Care gave a very eloquent and thoughtful lecture on these issues the text of which can be found in the FiOP January 2024 Newsletter.
This definition embodies the need to understand what has built a person’s identity and sense of belonging and how can this be nurtured in a changed environment. It emphasises the importance of relationship; having a sense of purpose and meaning to make each day worthwhile whatever diminishment is being faced and why having an opportunity to see more widely than an immediate environment is essential to well-being. This is the basis of compassionate care.
There is perhaps a view that only very specialist, trained, people can deliver spiritual care, such as chaplains. However, in the research undertaken by Faith in Older People with nurses and health and social care workers, they were quite clear that it was ‘everyone’s business’ to pay attention to what matters and to capture those moments when the person they are caring for opens up about their hopes and fears. It is an important time to listen and to be present with them. Whilst some people struggled with the concept of spiritual care, we often found that they were unconsciously providing that spiritual support.
FiOP has a major concern about the education of nurses and health and social care staff and undertook a research project to review the inclusion of spiritual care in the curriculum in Universities and FE colleges. There was very little although we know how important spiritual care is to staff wellbeing and consequently to how people deliver care.
Just as spiritual care is important in the care of individuals, so it is for staff who must be supported when their work embraces end of life care, dying and death. The Scottish Care Report ‘Trees that bend in the wind’ highlights the role played by staff in considering someone’s end of life issues and in triggering those important conversations but that this resource “has to be recognised, nurtured and valued”. A greater understanding of the spiritual dimension can help to increase confidence in these conversations which includes religion but acknowledges that it is so much wider.
“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet” (Remen, RN (2006) Kitchen Table Wisdom, Stories that Heal; Riverhead Trade).
Extract from Spiritual Care Matters (NES 2007)
“A person’s spirituality is not separate from the body, the mind or material reality, for it is their inner life. It is the practice of loving kindness, empathy, and tolerance in daily life. It is a feeling of solidarity with our fellow humans while helping to alleviate their suffering. It brings a sense of peace, harmony, and conviviality with all. It is the essence and significance behind all moral values and virtues such as benevolence, compassion, honesty, sympathy, respect, forgiveness, integrity, loving kindness towards strangers and respect for nature. Spirituality creates and connects these virtues. This is what lies behind moral intuition. It is about knowing and experiencing deep meaning and connection behind apparently random events and processes such as illness and an awareness of human vulnerability”.
Spiritual care is an integral part of good health. It is an element in our human rights and should be incorporated in all relevant policies and practice. It is important that all those who care for us have a good understanding of how it affects individual perspectives and values and needs.
FiOP congratulates VHS on its 20th Anniversary with praise for its exceptional work.
Maureen O’Neill is Director of Faith in Older People and Vice Chair of VHS.
