Spirituality and end-of-life experiences: Meeting the spiritual needs of the dying

2021 ◽  
pp. 413-434
Author(s):  
Peter Fenwick ◽  
Bruno Paz Mosqueiro
Keyword(s):  
End Of Life ◽  
Spiritual Care ◽  
Life Experience ◽  
Scientific Evidence ◽  
Spiritual Needs ◽  
Spiritual Experiences ◽  
Life Care ◽  
Practical Guidance ◽  
To Receive

Most patients in palliative care report that it is very important to receive health care that is respectful, compassionate, and culturally sensitive to their spiritual needs. Providing spiritual care to people approaching the end of life and understanding that their mental and spiritual experiences constitutes a key aspect to providing a more effective treatment and quality of life at this moment. End-of-life experience (ELE) provide comfort, and represents a source of spirituality and meaning to the dying. Spiritual experiences also give hope, meaning, and strength to family members and healthcare professionals dealing with terminal conditions and suffering. This chapter reviews the scientific evidence about ELEs and discusses the potential clinical implications of these experiences to healthcare practice. Different patients’ vignettes are presented to illustrate and provide practical guidance to understanding and addressing ELE and spiritual care in end-of-life care settings.

Quality of end-of-life care for veterans with metastatic cancer and advanced chronic kidney disease.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18281-e18281
Author(s):  
Shakira Jeanene Grant ◽  
Claire A Richards ◽  
Nicholas Burwick ◽  
Paul L Hebert ◽  
Ann A O'Hare
Keyword(s):  
Chronic Kidney Disease ◽  
End Of Life ◽  
End Of Life Care ◽  
Metastatic Cancer ◽  
Veterans Affairs ◽  
Life Care ◽  
Advanced Chronic Kidney Disease ◽  
Bereaved Family ◽  
To Receive

e18281 Background: Patients with cancer receive less aggressive interventions and higher quality end-of-life care than those with advanced chronic kidney disease (ACKD). However, the relationship between ACKD and cancer and patterns and quality of end-of-life care is poorly understood. Methods: Among a retrospective cohort of all patients with ACKD (estimated glomerular filtration rate < 20 mL/min/1.73m2) who died in Veterans Affairs facilities between 2009-2015 ( N = 9993), we compared dialysis treatment patterns, end-of-life care and family rated quality of care among those who did and did not have a diagnosis of metastatic cancer during the year before death. Data sources included Veterans Affairs clinical and administrative data, Medicare claims, and the United States Renal Data System registry. Family ratings of end-of-life care were based on responses to the Bereaved Family Survey (BFS). We fit logistic regression models and converted the coefficients to predicted probabilities Results: Overall, 1,237(12.4%) patients had a diagnostic code for metastatic cancer during the year before death. These patients were less likely than other patients to have been treated with dialysis before death. In analyses adjusted for patient characteristics and dialysis receipt, patients with metastatic cancer were less likely than other patients to receive intensive procedures (predicted probability: 18.2% vs. 36.2%) and to be admitted to the intensive care unit (ICU) within 30 days of death (30.7% vs. 50.1 %), or die in the ICU (16.2% vs. 33%). These patients were also more likely to receive a palliative care consultation within 90 days of death (46.6% vs. 37%) and to have hospice services at the time of death (55.3% vs. 33.4 %). Family-rated overall quality of care was higher for those with metastatic cancer (59.6% vs. 54.1%). Family members of patients with metastatic cancer also provided more favorable ratings for five individual BFS items including provider listening, informational, emotional support before death and pain control. All comparisons were statistically significant (i.e., P < 0.05). Conclusions: Within a national cohort of US Veterans with ACKD, the presence of metastatic cancer was associated with less dialysis utilization, less intensive medical care, and significantly higher bereaved family ratings of end-of-life care.

Crossing the River Styx: the power of music, spirituality and religion at the end of life

2019 ◽  
Vol 11 (4) ◽  
pp. 226
Author(s):  
Barbara Salas
Keyword(s):  
End Of Life ◽  
Spiritual Care ◽  
End Of Life Care ◽  
Terminal Illness ◽  
Spiritual Experience ◽  
Life Care ◽  
Quest For Meaning ◽  
Spirituality And Religion ◽  
The Individual

Dying from a terminal illness involves a period of transition throughout which the person deals with multiple losses, including the loss of one’s own life. The awareness of death makes the individual confront spiritual questions that touch the very nature of existence, and music can help intensify that spiritual experience bringing new meaning to the end of life. The reasons why spirituality, religion and music can facilitate the existential quest for meaning and provide an overall improvement of the quality of life at the end of life will be explored, aiming to suggest that a humanist approach to end-of-life care in which alleviation of suffering and consideration of the specific needsof the patient including spiritual care and therapy with music would be desirable to help patients during the dying process.

scholarly journals Provision of Spiritual Care to Patients With Advanced Cancer: Associations With Medical Care and Quality of Life Near Death

2010 ◽  
Vol 28 (3) ◽  
pp. 445-452 ◽  
Author(s):  
Tracy Anne Balboni ◽  
Mary Elizabeth Paulk ◽  
Michael J. Balboni ◽  
Andrea C. Phelps ◽  
Elizabeth Trice Loggers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pastoral Care ◽  
Medical Care ◽  
Religious Coping ◽  
Spiritual Care ◽  
Spiritual Needs ◽  
Medical Team ◽  
Aggressive Care ◽  
To Receive

Purpose To determine whether spiritual care from the medical team impacts medical care received and quality of life (QoL) at the end of life (EoL) and to examine these relationships according to patient religious coping. Patients and Methods Prospective, multisite study of patients with advanced cancer from September 2002 through August 2008. We interviewed 343 patients at baseline and observed them (median, 116 days) until death. Spiritual care was defined by patient-rated support of spiritual needs by the medical team and receipt of pastoral care services. The Brief Religious Coping Scale (RCOPE) assessed positive religious coping. EoL outcomes included patient QoL and receipt of hospice and any aggressive care (eg, resuscitation). Analyses were adjusted for potential confounders and repeated according to median-split religious coping. Results Patients whose spiritual needs were largely or completely supported by the medical team received more hospice care in comparison with those not supported (adjusted odds ratio [AOR] = 3.53; 95% CI, 1.53 to 8.12, P = .003). High religious coping patients whose spiritual needs were largely or completely supported were more likely to receive hospice (AOR = 4.93; 95% CI, 1.64 to 14.80; P = .004) and less likely to receive aggressive care (AOR = 0.18; 95% CI, 0.04 to 0.79; P = .02) in comparison with those not supported. Spiritual support from the medical team and pastoral care visits were associated with higher QOL scores near death (20.0 [95% CI, 18.9 to 21.1] v 17.3 [95% CI, 15.9 to 18.8], P = .007; and 20.4 [95% CI, 19.2 to 21.1] v 17.7 [95% CI, 16.5 to 18.9], P = .003, respectively). Conclusion Support of terminally ill patients' spiritual needs by the medical team is associated with greater hospice utilization and, among high religious copers, less aggressive care at EoL. Spiritual care is associated with better patient QoL near death.

Empowering Residents and Families for Care Decisions at End of Life

2017 ◽  
Author(s):  
Eva L. Barnett ◽  
Susan Reese
Keyword(s):  
Nursing Students ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Experience ◽  
Life Care ◽  
Term Care ◽  
Health Crisis ◽  
Centered Care

Emphasis on client‐centred care is the philosophy for most health care institutions. Long‐term care nursing homes have adopted this philosophy as well, with added emphasis on quality End‐of‐Life Care. Medical advancements have made End‐of‐Life care more complex and individuals and families are often asked to make crucial care decisions in the midst of crisis for their loved ones that may not be in accordance with the actual wishes of their loved ones.  Fairmount Nursing Home in Glenburnie has been a leader in their expertise in client centered care. This setting provided a welcoming environment for two of the Queen’s 4 th year nursing students to complete a practicum in Community Health Promotion. Our goal was to increase quality of care at End‐of‐Life by stimulating conversations around advanced decision‐ making. The focus was on expanding the knowledge of residents and their families and Substitute Decision Makers and thereby prompting thoughts about discussion before acute illness or crisis. A social assessment and literature search revealed that everyone has “a story to tell” about a personal End‐of‐Life experience. Through the development of a toolkit, reminders in the Fairmount monthly newsletter to advise readers of resources, and a presentation of information and resources at“Family Night”, we intended to encourage earlier important and focused conversations between residents, families and staff. We found that the information we presented promoted both discussion and questions regarding End‐of‐ Life. Strategic work must continue in order to assist people of all ages and stages of life to talk about their values and wishes before a health crisis intervenes and the opportunity for thoughtful choice is lost.

End-of-Life Care in Non-Cancer Illnesses

2012 ◽  
Vol 5 (6) ◽  
pp. 351-359 ◽  
Author(s):  
Hayley Cousins ◽  
Richard Cassell ◽  
P.-J. Morey
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Specialist Palliative Care ◽  
Patients With Cancer ◽  
Disease Trajectory ◽  
Practical Guidance

End-of-life care is that which is provided to patients experiencing a progressive final decline in their lives, usually with a prognosis of less than a year. End-of-life care in non-cancer illness may be challenging for GPs because of the uncertainty about disease trajectory. Patients with non-cancer illness often experience similar symptoms to patients with cancer but for longer hence with a greater impact on quality of life. Only a minority of such patients need specialist palliative care input so the generalist needs to be confident in assessing, treating and supporting patients and families. This article offers suggestions to overcome the challenges along with practical guidance on managing symptoms in the most common non-cancer illnesses.

Systematic Review for the Quality of End-of-Life Care for Patients With Dementia in the Hospital Setting

2018 ◽  
Vol 35 (12) ◽  
pp. 1572-1583 ◽  
Author(s):  
Felicity Moon ◽  
Fiona McDermott ◽  
David Kissane
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Health Care Professionals ◽  
End Of Life Care ◽  
Hospital Setting ◽  
Psychosocial Care ◽  
Life Care ◽  
Hospital Patients ◽  
To Receive

Background: Patients with dementia may receive suboptimal end-of-life care in hospital settings reflecting broader debate around the palliative status of dementia syndromes. Objectives: To synthesize literature describing the quality of end-of-life care for patients with dementia dying in hospital. Methods: An integrative review assessed the quality of 26 articles concerning medical, nursing, and psychosocial care of patients with dementia dying in hospital settings. Results: Literature reflects a growing awareness of the need to consider a palliative approach to end-of-life care for patients with dementia in hospital. Patients with dementia are less likely to receive aggressive care at the end of life, but provision of palliative care interventions is inconsistent. Health-care professionals highlighted the need for greater education around identification and management of problematic symptoms at the end of life. Engagement of family caregivers is essential in optimizing end-of-life care, and further research is required to ascertain their experiences around decision-making. Conclusion: Although patients with dementia appear to receive less aggressive treatment at the end of life, the provision of palliative care and symptom management may be inadequate.

The Whites

2018 ◽  
Author(s):  
David Wendell Moller
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
End Of Life ◽  
Life Experience ◽  
The Body ◽  
Illness Experience ◽  
Spiritual Needs ◽  
Human Spirit ◽  
Healing Power

The story of Annie declares the dignity and grace of the human spirit in the midst of extensive suffering. It shows how social support heals throughout the illness experience. Her narrative is an example of the healing power of spirituality throughout dying. From her end-of-life experience, we learn that dying is far less about matters of the body than it is about matters of the person. We also discern that when a person is well attended throughout the dying process—her emotional, social, and spiritual needs being fulfilled—her suffering is eased and she is deeply comforted. Exploration of the dimensions of quality of life (QOL) help us to plan care which addresses all dimensions of QOL.

scholarly journals Comparison of Prospective and Retrospective Indicators of the Quality of End-of-Life Cancer Care

2008 ◽  
Vol 26 (35) ◽  
pp. 5671-5678 ◽  
Author(s):  
Soko Setoguchi ◽  
Craig C. Earle ◽  
Robert Glynn ◽  
Margaret Stedman ◽  
Jennifer M. Polinski ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Acute Care Hospital ◽  
Teaching Hospitals ◽  
Care Hospital ◽  
Life Care ◽  
Cancer Registry Data ◽  
Long Acting ◽  
To Receive

Purpose To compare prospectively and retrospectively defined benchmarks for the quality of end-of-life care, including a novel indicator for the use of opiate analgesia. Methods Linked claims and cancer registry data from 1994 to 2003 for New Jersey and Pennsylvania were used to examine prospective and retrospective benchmarks for seniors with breast, colorectal, lung, or prostate cancer who participated in state pharmaceutical benefit programs. Results Use of opiates, particularly long-acting opiates, was low in both the prospective and retrospective cohorts (9.1% and 10.1%, respectively), which supported the underuse of palliative care at the end-of-life. Although hospice was used more commonly in the retrospective versus prospective cohort, admission to hospice within 3 days of death was similar in both cohorts (28.8% v 26.4%), as was the rate of death in an acute care hospital. Retrospective and prospective measures identified similar physician and hospital patterns of end-of-life care. In multivariate models, a visit with an oncologist was positively associated with the use of chemotherapy, opiates, and hospice. Patients who were cared for by oncologists in small group practices were more likely to receive chemotherapy (retrospective only) and less likely to receive hospice (both) than those in large groups. Compared with patients who were cared for in teaching hospitals, those in other hospitals were more likely to receive chemotherapy (both) and to have toxicity (prospective) but were less likely to receive opiates (both) and hospice (retrospective). Conclusion Retrospective and prospective measures, including a new measure of the use of opiate analgesia, identify some similar physician and hospital patterns of end-of-life care.

Recent Progress in Chaplaincy-Related Research

2017 ◽  
Vol 71 (3) ◽  
pp. 163-175 ◽  
Author(s):  
George Fitchett
Keyword(s):  
End Of Life ◽  
Patient Outcomes ◽  
Patient Experience ◽  
Spiritual Care ◽  
End Of Life Care ◽  
Recent Progress ◽  
Spiritual Needs ◽  
Life Care ◽  
Related Research ◽  
The Impact

In light of the continued growth of chaplaincy-related research this paper presents an overview of important findings. The review summarizes research in six broad areas: what chaplains do; the importance of religion and spiritual care to patients and families; the impact of chaplains’ spiritual care on the patient experience; the impact of chaplain care on other patient outcomes; spiritual needs and chaplain care in palliative and end of life care; and chaplain care for staff colleagues. It concludes with a description of several innovative and important new studies of chaplain care and notes areas for future investigation.

Sign in / Sign up

Export Citation Format

Share Document