Spirituality and Aging

Helen Lavretsky


Aging Health. 2010;6(6):749-769. 

In This Article

Spiritual Care by Healthcare Providers

Despite the controversy, the role of religion in healthcare is growing. The guidelines of the Joint Commission on Accreditation of Healthcare Organizations require hospitals to meet the spiritual needs of patients.[131] The 'Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition' (DSM) recognizes religion and spirituality as relevant sources of either emotional distress or support.[132,133] The recently published edition of the DSM-V Research Agenda specifically addressed religious and spiritual issues in psychiatric diagnosis.[134] The medical literature on religion and spirituality has increased by 600% from 1993 to 2002.[135] Some have recommended that physicians take into account the religious and spiritual histories of their patient to better understand their backgrounds and beliefs.[136,137] There has also been a greater emphasis on integrating various religious resources and professionals into patient care, especially when the patient is approaching the end of their life.[137] Some effort is made to train healthcare providers to better understand spiritual practices, listen to a patient's religious concerns and perform clergy-like duties when religious professionals are not available.[138]

Assessment of Spirituality in Clinical Practice

Acknowledging the spiritual lives of patients may involve asking about their spirituality when recording their history during the clinical interview, which may not be appropriate for every patient. Some practitioners suggest four simple questions that might be asked of seriously ill patients:[11]

  • Is faith (religion, spirituality) important to you in this illness?

  • Has faith been important to you at other times in your life?

  • Do you have someone to talk to about religious matters?

  • Would you like to discuss religious matters with someone?

In addition, open-ended questions allow patients to tell healthcare providers about how they view relationships, the meaning of their illness and what type of coping mechanisms have helped them in the past. Patient responses to these questions can yield information about spiritual concerns and practices that may help healthcare providers better understand their patients' worldly perspectives. This understanding can help practitioners determine whether patients' religious and spiritual beliefs, as well as community involvement, can be a useful resource to assist with their coping and healing process.[11]

Obtaining a spiritual history from the patient can be aided by using spiritual history tools, including FICA (Faith, belief, meaning; Importance/Influence in healthcare decision-making; Community; Address/Action in treatment plan),[139] HOPE (Sources of Hope; Organized religion; Personal spirituality; Effect on medical care and end-of-life issues),[140] and SPIRIT (Spiritual beliefs; Personal beliefs; Integration with spiritual community; Rituals; Implications for care and Terminal care).[141,142]


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