New guidelines aim to raise awareness of the psychological and spiritual needs of older people receiving aged care and assist staff in meeting them, write Colleen Doyle, Hannah Capon and Elizabeth Pringle.
While person-centred or relational models of care have become accepted better practice in aged care, attention to psychological and spiritual needs of people receiving care can still be relegated lower priority than meeting physical needs in many care settings.
In an attempt to raise awareness and provide a structural framework for spiritual care, Meaningful Ageing Australia (formerly PASCOP), Improvement Matters, the National Ageing Research Institute (NARI) and Spiritual Health Victoria have developed the first Australian Guidelines for Spiritual Care of Older Australians living in residential and home care. The project was funded by the Australian government in 2015.
The guidelines emphasise that everyone has spiritual needs and that spiritual care is not only relevant to people from religious backgrounds. They are due for release in the second half of 2016, and a set of workshops are being held around Australia during June 2016 for those wishing to get a head start in implementing them.
A set of principles underpin the new guidelines.
Principle 1 is that a whole-of-organisation approach is needed to provide effective care, so spiritual care is reflected in key systems and processes of the organisation.
Principle 2 is that human relationships are central to spirituality, and significant relationships need to be supported, whether that is with family, friends, faith community, staff, volunteers, health care professionals or God or a higher being.
Principle 3 is that spiritual care is everyone’s business, and that while there is a distinct role for spiritual care practitioners such as chaplains or pastoral carers, anyone who has contact with older people needs to have a basic awareness of spirituality and how it affects their role.
Principle 4 is that spiritual care is about growth and flourishing, and that it is important to bring meaning, purpose and wholeness to assist older people to flourish, grow and realise their potential in their final journey of ageing.
These four principles are operationalised into five domains in the guidelines. The five domains are:
- Organisational leadership and alignment. This domain focuses on spiritual care being embedded and practiced at all levels through the organisation;
- Relationships and connectedness. This domain focuses on the importance of providing care in the context of mutual, respectful and genuine relationships;
- Identifying and meeting spiritual needs. This domain focuses on allowing choices, preferences and needs to be identified, documented and shared by the care team;
- Ethical context of spiritual care. This domain focuses on the ethical framework in organisational policies, procedures, processes and practice;
- Enabling spiritual expression. This domain focuses on individualised activities and interventions to encourage the finding of meaning, purpose, connectedness and hope.
The implementation process will vary from one organisation to another depending on the results of their self-assessment. It is envisaged that organisations will conduct a self-assessment to identify any gaps between current practice and the guideline statements.
The next step is then to develop an action plan to bridge those gaps. An implementation plan will include a strategy regarding how changes will occur, transitions, links with other initiatives, barriers, risks and so on. Then the plan would be implemented and monitored and evaluated by assessing progress against the plan and conducting a self-assessment.
Meaningful Ageing Australia will support organisations to implement the guidelines through the development of tools, templates and resources that will be available at their website in 2016. There will also be an interactive forum where those implementing the guidelines can share their challenges and successes. These new supports will help the sector move towards awareness of the importance of meeting spiritual needs of their clients.
Colleen Doyle is principal research fellow and Hannah Capon is research assistant at NARI, and Elizabeth Pringle is director of Improvement Matters.