Spiritual Issues in Palliative Care

Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, and to the significant or sacred. Spirituality fulfills specific needs: Meaning to life, illness, crises, and death Sense of security for present and future Guides daily habits Elicits acceptance or rejection of other people Provides psychosocial support in a group of like-minded people Strength when facing lifes crises Healing strength and support

Spiritual Issues as Diagnosis Spiritual or Religious concerns are thought to be so integral to persons being that caution has been raised about labeling spirituality as pathology, as this is an aspect of a human being and not a disorder. Religion may have negative effects on health and spirituality in general may result in distress, pain, or suffering. In this context, we would argue that spiritual or existential issues may in some circumstances be classified as diagnosis, in those cases where patients are experiencing distress or where belief may be impacting adversely. Spiritual Issues include the following:

Despair and Hopelessness Lack of meaning and purpose Grief and loss Anger Abandonment by God or others

Isolation Reconciliation Concerns about relationship with deity Conflicted or challenged beliefs

Each of these spiritual issues may present as part of a persons life not as causing distress or not even affecting the illness with which the patient presents.

Example: 1. Patient may be experience demoralization, finding no meaning or purpose in their lives. -this may be experienced as part of a transition in life such as a divorce, illness, or a mild-life crisis. 2. A patient may simply be questioning meaning of life as a reflective process. ` - this would be identified as a spiritual issues that may or may not affecting the presenting medical or health problem. 3. A patient may experience deep suffering and distress from lack of meaning in life. -it is suggested that in times when meaningless produces pain, suffering or distress, it should be identified as a diagnosis and treated as a symptom equal to physical pain. 4. Forgiveness or reconciliation might be understood as a spiritual or religious practice, but in certain contexts the inability to forgive might impact the illness or the person in such way as to cause severe distress or suffering or even be a contributing cause of clinical depression.

It is important that we will be able to differentiate the full spectrum of how spirituality presents in patients lives in the context of their illness and how it presents in the clinical environment.

SPIRITUAL ISSUES IN PALLIATIVE CARE (ELECTIVE 1) SUBMITTED BY: JEREMY G. TELLAIN BSN3-1 SUBMITTED TO: MELANIE DY, R.N., M.A.N.

CLINICAL INSTRUCTOR