Spiritual-Care-Position-Statement.pdf - Palliative Care Australia

Spiritual-Care-Position-Statement.pdf

Spirituality is the way we seek and express meaning and purpose; the way

we experience our connection to the moment, self, others, our world and

the significant or sacred. Spiritual care occurs in a compassionate

relationship. It responds to our search for meaning, self-worth, and our need

to express ourselves to a sensitive listener.

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Palliative Care Australia and Meaningful Ageing Australia affirm that:

 Spiritual care is an integral part of palliative care.

 A palliative approach includes spiritual assessment, and the involvement

of appropriately trained staff.

 There are gaps in understanding about spirituality and spiritual care

across the community, including amongst aged care staff and

organisational leaders.

 Further education and specific funding is needed, for spiritual care

practitioners to function as part of the team in the palliative approach.

 Religious and spiritual beliefs can affect decision-making about

treatment, medicine and self-care as well as expectations of, and

relationships, with health and aged care service providers.

 Individualised spirituality-based interventions can lead to lower

depression scores and reduced anxiety.

 Cross-disciplinary palliative care is required to address psychosocial and

spiritual needs at end-of-life in long-term care settings.

Palliative Care Australia and Meaningful Ageing Australia call for:

 All aged care organisations to recognise the importance of spirituality

and spiritual care for people, particularly those receiving end-of-life and

palliative care, and respond appropriately to these needs.

 Aged care funding models to include specialised spiritual care support.

 Aged care workforce development to recognise spiritual need,

particularly for those receiving end-of-life and palliative care, and

improve capability to provide basic spiritual care.

 Consistent spiritual screening and assessment of all people in aged care,

particularly at the point of commencing end-of-life and palliative care.

 Australian aged care standards to reflect the importance of meaning,

purpose and connectedness for people receiving aged care, as described

in the National Guidelines for Spiritual Care in Aged Care.

The Palliative Approach and the National Guidelines for Spiritual Care in Aged Care

More than ten years ago the Australian Government identified a particular need for people with a life-limiting

illness or who are dying as a consequence of the ageing process to receive palliative care in residential aged

care. The government later released the Guidelines for a Palliative Approach in Residential Aged Care2 which

acknowledged the importance of palliative care for people in community based and residential aged care as

they enter the final phase of life.

These guidelines describe the palliative approach and call for an integrated and holistic approach to spiritual

care in palliative care for older people. The guidelines emphasise that for both residential and community based

care the primary goal of a palliative approach is to improve the person’s level of physical comfort and function,

and to address their psychological, spiritual and social needs.

Building on the government’s commitment, Meaningful Ageing Australia developed the National Guidelines for

Spiritual Care in Aged Care3 which specify that “spiritual care is an essential component of palliative and end of

life care” and that “understanding the older person’s spiritual needs is essential to be able to provide spiritual

care that is appropriate for each individual”. To support this, screening by staff who have had training in spiritual

care is recommended, followed by more in-depth care by a spiritual care practitioner or other suitably qualified

member of the care team as required.

The importance of spirituality and spiritual care4

Religious and spiritual practices and beliefs may impact the way people understand diagnoses, illness, health,

loss and recovery, their strategies for coping with illness and resilience, resources and sense of support;

enhance pain management, improve outcomes following surgery, and reduce the chance of substance abuse.

Numerous studies demonstrate the role of spiritual support in overall wellbeing including health outcomes such

as increased hope, greater longevity, coping skills, health-related quality of life, and less anxiety, depression and

suicide. Further, self-reported spirituality is a strong predictor of adjustment to ageing and following spiritual

care interventions, reports from nursing staff noted that clients seem relaxed, peaceful, grateful, and calm -

states believed to aid healing and recuperation or peaceful death.

Medical support with a focus on spiritual care and specialised spiritual care visits is associated with higher

quality of life scores near death. People can be better supported to prepare for their final months and weeks of

life through reflecting on their life and its contribution, exploring unresolved issues, reinforcing their worth and

having their preferences recorded and respected.

Spirituality and grief4

Families and staff form a vital part of the older person’s palliative care team. For families spiritual care activities

are associated with increased overall family satisfaction. Sensitive spiritual support for families in the time

leading up to end-of-life and immediately after their loved one has died is essential. Without this in place,

normal grief processes are in danger of being de-railed.

Another key finding during the development of the National Guidelines for Spiritual Care in Aged Care was the

importance of spiritual support for staff. In order for staff to be fully available and present to the people in their

care, they need to be given the opportunity to acknowledge their experiences of being a carer, and allowed to

develop and access their own spiritual resources.

Despite the significance of spirituality within end-of-life and palliative care, there is currently no funding

specifically for spiritual care, and the availability of spiritual care in aged care is left to the discretion of the care

provider. Palliative Care Australia and Meaningful Ageing Australia would like to see the universal acceptance of

the importance of spiritual care in aged care, and particularly for those receiving end-of-life care, their families,

carers and staff.

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Palliative Care Australia

(PCA) is the national peak

body for palliative care in

Australia. PCA provides

leadership on palliative care

policy and community

engagement. Working closely

with consumers, its Member

Organisations and the

palliative care and broader

health workforce, PCA aims

to improve the quality of life

and death for people with a

life-limiting illness, their

families and carers.

Meaningful Ageing Australia

is the national peak body for

spiritual care and ageing.

Meaningful Ageing

Australia’s mission is to

enable access to high quality

pastoral and spiritual care for

all older people in Australia.

We do this by creating high

quality, practical resources;

and advocacy.

02 6232 0700 | pcainc@palliativecare.org.au | palliativecare.org.au

 03 8387 2616 | admin@meaningfulage.org.au | meaningfulageing.org.au