| Spirituality can also be described as a vigorous | | | | but the emotionally sensitive indicators that were |
| process of looking within oneself to reflect on | | | | paramount, were the ability to be listened to and |
| your own life and at the same time turning | | | | be cared for with love and trust. |
| outward to seek what is actually beyond what is | | | | Yet to be able to just listen with intent and show |
| being experience on a daily basis. For many | | | | unconditional love and care is often the hardest |
| people, spirituality is found in religion but for others | | | | aspect of providing end-of-life care. |
| spirituality can be found in nature, art or music. | | | | Once one grasps the concepts and skills to |
| There are also those who will reflect on spirituality | | | | listening with intent they develop a better |
| as being what occurs in everyday life through | | | | understanding of what the person is really saying. |
| their association with friends and family. | | | | The spiritual aspect of terminal care becomes a |
| For anyone facing an end to their physical life, | | | | journey which is then more emotionally satisfying |
| religion and spirituality are two causes of deep | | | | and healing for all concerned. |
| apprehension and pain. Sometimes these two | | | | Spiritual pain can be the result of a past |
| subjects may never have even been previously | | | | experience that has been filed away in their |
| considered, let alone talked openly about. The | | | | subconscious mind. Perhaps it was an experience |
| sudden sharp focus on either or both of them, | | | | that totally traumatized them and may have for a |
| are not only reasons for apprehension and pain in | | | | period of time, left them in a state of |
| the person facing end of life, but also for the | | | | helplessness, and now with their death looming |
| caregiver and other family members. | | | | this past memory resurfaces and becomes the |
| In discussing this area of care it is difficult to | | | | center of their being; it is how they are viewing |
| separate spirituality in the terms relating to carers | | | | their life, once again in a state of devastation and |
| and that which relates to the person who is | | | | hopelessness. This is often expressed by the |
| coming to the end of their physical life, so the | | | | person continually saying thing like - 'Why?' or |
| two need to be intertwined. | | | | 'Why me?' or 'I am lost and lonely.' They feel that |
| Religion and spirituality are often blended together, | | | | their life is devoid of all hope and if they used a |
| but they are in fact not the same and it is | | | | religious term it probably would be "dark night of |
| possible to have either a secular spirituality or a | | | | the soul". As with any pain, spiritual pain does |
| religious spirituality. | | | | present with known symptoms. A fear of dying is |
| Spirituality and spiritual care are acknowledged as | | | | very widespread and deep and the following |
| central topics when professional carers are | | | | seven fears represent the major symptoms of |
| responsible in the delivery of a high quality end of | | | | spiritual pain: |
| life care. Spirituality, however, is difficult to define | | | | Fear of the dying process "what will it be like?" |
| and many health care professionals themselves | | | | Will it be painful? |
| feel ill at ease in their attempts to provide spiritual | | | | Fear of loss of control "will I be dependent on |
| care for those who are dying and/or bereaved. | | | | others? Will I be unable to care for myself? |
| These challenges seem to emerge out of a | | | | Fear of loss of loved ones "How will they manage |
| number of issues concerning the diverse meanings | | | | without me? |
| of spirituality in a culturally diverse society, as well | | | | Fear of others reaction to them "How will people |
| as the complexities of our current day, | | | | cope with seeing me like this? |
| contemporary health-care delivery systems. Even | | | | Fear of isolation "Will people stop coming to see |
| those health-care providers who are the most | | | | me? |
| sensitive to including all aspects of spiritual care in | | | | Fear of the unknown "what happens after you |
| their caring role are often very daunted by the | | | | die? |
| thought of engaging such a vague or ill-defined | | | | Fear that life will have been meaningless. |
| expression of need. | | | | By being aware and responding appropriately to |
| Over recent years many studies have been | | | | what these questions represent, caregivers can |
| conducted into aspects of spiritual care in both | | | | reduce the person's fear and alleviate their spiritual |
| the home and health facility setting and a study | | | | pain. |
| that was conducted by KE Steinhauser, NA | | | | Spiritual pain does not require a dose of |
| Christakis, EC Clipp (and others) considered | | | | pharmaceutical medication, it requires all those |
| several factors that were pointed out to be highly | | | | delivering care to be able to let go of their ideas, |
| important at the end of life by patients, family, | | | | roles and agendas, to listen intently, to provide |
| physicians and other care providers. This study | | | | encouragement and to acknowledge as |
| was reported on in the Journal of American | | | | necessary. Put simply those experiencing this pain |
| Medical Association in 2000, and indicated that | | | | require their carers to listen with their heart. |
| both the person dying and their families | | | | By listening with your heart, there is no need to |
| considered spiritual care to be important. The | | | | respond, the love and feeling are passed through |
| range of expectations expressed and the desire | | | | your looks and your touch, their spiritual pain is |
| for spiritual care was found to be very expansive, | | | | only healed from within. |