Spirituality and palliative care
There is perhaps no other area of health care
where spirituality takes on greater significance
than in end of life care. The pioneers of hospice
care, such as Dame Cicely Saunders,
emphasised the importance of identifying and
addressing spiritual needs and concepts such as
total pain, and acknowledging the relevance of
the spiritual domain to suffering and healing
(Milligan and Potts 2009). Furthermore, the
World Health Organization (2011) suggests
that palliative care ‘integrates the psychological
and spiritual aspects of patient care’.
Few people anticipate the effect of a
terminal diagnosis on spiritual wellbeing.
Some people may go through life without
contemplating seriously the meaning or
purpose of life. Similarly, there are individuals
who may not anticipate the effect of a terminal
diagnosis on spiritual wellbeing. When the
individual realises that life is suddenly limited,
any illusion of security that previously existed
may be shattered. This is what Coyle (2004)
refers to as the ‘existential slap’. Many people
will be able to mobilise strategies that enable
them to adapt to and cope with this new
challenge to their wellbeing (Ando et al 2008).
Indeed, for some people, that realisation of
their own mortality can lead to positive
outcomes, including personal growth and
transformation (Wayman and Gaydos 2005,
Arnold 2011). However, for others, the result
can be acute existential despair, loss of
spiritual integrity, loss of a sense of meaning
and purpose in life and increased suffering
(Narayanasamy 2007).
The spiritual ramifications of a diagnosis
of life-limiting illness can be evident in the
questions people ask healthcare professionals.
Some of these questions are listed in Box 1.
Complete time out activity