Spiritual care in a secular age

Modern Australia is going through a major reappraisal of what we mean by ‘spiritual’. For…

Modern Australia is going through a major reappraisal of what we mean by ‘spiritual’. For some, spiritual’ is either an illusion, or at best a kind of emotion—awe and wonder at the fact of existence, at beauty in its various forms, and at relationships of love. For others, the universe is upheld by a personal God (or gods) fundamentally not of this natural order, who is ‘spirit’, and who invites a relationship of love with mortal ‘flesh’ enabling us to become spiritual beings. Between these positions are a plethora of approaches where we may participate with something supra-natural, yet not exactly personal, and somehow interpenetrating everything around us.

These distinctions only glimpse the range of people now coming into care. Days of Christian privilege, where a clergy-person roved the halls talking to whomever they chose, are long gone. With the logic of individual rights and informed consent applied more consistently to our lives, a sea-change in spiritual care has followed. In the language of consumer choice, management priorities must attend to the preferences of the cared-for. A proactive awareness of diversity, whose hard-edged expression becomes the forbidding of discourse that could be regarded as ‘proseletysing’, is compounded perhaps by unfortunate experiences with particular clergy who were insensitive, inept, or agenda-driven.

In a risk-averse culture, risk-mitigation around poor spiritual care has comes to seem like a low hanging fruit for beleaguered management. In some settings, one middle manager who is negative about spiritual care may have effective veto over it, leveraging these perceived risks to heighten fears around it. The veto is likely to be effected indirectly, through managerial frustration of spiritual carers, rather than overtly.

The overall effect combines to create chilling effect on all talk of the spiritual that is a hallmark of modern Australian life. The registered nurse who visibly stiffens when a clergy person hovers into view; the nursing assistant who moves faster to finish and get out when someone in their care has a wave of sadness about illness, life, or impending death; the family member in their parent’s room who is hostile to a pastoral visitor’s careful enquiry.

Research evidence shows, though, that older people often grow in their need to discuss meaning in their lives. The changes listed above were a necessary protection upon older people. But when that chilling effect goes too far, older people are simply deprived of access to spiritual care in its proper legitimacy. Just as flourishing older life might include new experiences, new uses of the body and new skills, so also it can include access to new spiritual approaches including reappraisals of existing ideas that may not have served us well.

This chilling effect often arises from staff under-skilled in spirituality, and from management projecting the baggage of their own life experiences. Despite that these staff do so well in caring on other fronts, in the worst cases this chilling may straightforwardly constitute abuse and neglect for people whose felt need is, more highly than any other, that desperation to assuage regret, or find new meaning, or understand their past and future, or to find a way to hope.

Skills and theory training in what people believe; what spiritual changes can be expected for older people; and how to handle searching, distress and the onset of cognitive decline can effectively bridge the gap for carers unused to offering spiritual care. Charles Sturt University, for example, has a graduate program in Ageing and Pastoral Studies showing learners how to create non-intrusive cultures of spiritual care.

These may include opt-in programs such as regular conversation corners about people’s spiritual journey; practices of ‘spiritual reminiscence’; regular study groups in sacred texts; multisensory worship services; and seminars in contemplative practice. The regular use of research-based spiritual care needs inventories for each older person will further assist management to meet the spiritual care requirements of the new aged care standards. A non-intrusive culture of spiritual care can also include access for staff to explore issues, fears and spiritual ‘underskilling’, perhaps through a kiosk where staff anonymously or openly ask questions to receive simple, skilled answers. In addition, memoranda of agreement with spiritual carers (whether paid or volunteer) that expect collaboration, skills at engaging with distress, and competence in offering meaning and hope mean that these carers can be performance-managed appropriately.

Total care needs spiritual care, if being human is inherently to be spiritual. No cultural trends, no amount of chilling and no management gatekeeping will ever eradicate that.

Whatever your faith background or none, we would love to discuss how to upskill you in new ways of thinking and acting constructively in spiritual care.

About the author

Reverend Dr Andrew Cameron is the Director of St Mark’s National Theological Centre. His academic interests are in ethics and theology, and he teaches in the Ageing and Pastoral Studies program with the Charles Sturt University School of Theology.

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