Provision of Spiritual Care - The Greater Western Sydney Region - Case Study Example

PROVISION OF SPIRITUAL CARE IN A DIVERSE CONTEXT Name: Course: Tutor: Date: INTRODUCTION The Greater Western Sydney region is a culturally diverse population where meeting spiritual palliative care needs of this population pose a number of challenges. Spiritual discussion between health provider and patient has always been looked as odd but time has changed and it is now being incorporated in the healthcare systems. With the changing trends in Palliative care programs patient’s spiritual needs have become central to these programs. Hospice and Palliative care Palliative care programs are known for the provision of comfortable environments especially for dying or terminally ill patients. The main purpose of such programs is to provide as well as improve quality of life with the main focus on care rather than cure. Through these programs patients are usually palliated in the comfort of their individual homes, a hospice setting aged care facility or the acute hospital sector. Moreover, Palliative care programs tends to provide patients with proper emotional as well as psychological care especially to patients who are able to continue with their treatment It is seen as a central program to cancer patients and other end illness. Hospice also known as rest home is a program of supportive and palliative services that are coordinated and provided in the home and inpatient settings which caters to the social, psychological, spiritual and physical care of dying individuals and their families (Ingersoll 2004). These services are usually provided by a medically directed interdisciplinary team composed of volunteers and professionals. Hospice is charged with the sole responsibility of providing support and care for individuals in the last phases of incurable disease so that they can be able to live their last part of their lives as comfortable and fully as possible (Coberly 2002). Hospice is also important as it recognizes dying as part of the natural process of living and pays closer attention to the maintenance of quality of remaining life (Matzo & Sherman 2009) Culture allows various groups to function smoothly in the society hence refers to shared values and beliefs, common communication rules of behaviors and laws. Culture and spirituality therefore are considered to be the most important factors which structures human experience values, behaviors and illness patterns (Holland & Hogg 2001). As a system of shared symbols and beliefs culture tends to support an individual’s sense of security, integrity and belonging on how to conduct life as well as approach deaths. Diverse cultures therefore possess challenges to palliative care nurses when dealing with a culturally diverse population like that one of Western Sydney in Australia. Spiritual care for a culturally diverse population The Greater Western Sydney region is a culturally diverse population where meeting palliative care needs of this population pose a number of challenges. One of these frequent challenges faced by nurses is that of provision of spiritual care in such a diverse content. Spiritual care has always gone hand in hand with healthcare where it has been observed that the spiritual needs of the dying concerns professional counsellors for 2 main reasons (Coberly 2002). To begin with long term care of the dying and bereavement is a representation of stressful and spiritually provocative situations for both the dying and their caregivers (Byock 1997). On the other hand due to the expected rise on rate of mortality in Greater Western Sydney and other parts of the world in the next 50 years majority of individuals will experience these spiritually challenging as well as emotionally difficult situations (Lama 2002). Providing spiritual care for a culturally diverse population can seem quite challenging as the care givers are expected to provide individual care to the dying persons and cater to their personal needs that include their beliefs and culture (Coberly 2002). To begin with, implementing a framework that can help assess diverse patients’ spiritual needs as well as how to successful meet these needs is important in dealing with cultural diverse population. Different people interpret spirituality to mean different things. To some its faith while to other is what they attach meaning to about life and death. Illness disrupts ones sense of meaning and erodes values and faith. Identifying spiritual needs and meeting the needs of those individuals play a great role in restoring the lost meaning. The goal of meeting the spiritual needs during palliative care programs to terminally ill patient is to help keep the patient pain free and ‘sane’ until death arrives. While coming up with such a framework the first thing to understand is that patients are unique and experience the disease differently. When a person knows he is dying he/she loses meaning of life and fears of the unknown settle in their mind (McGrath, 2000).The meaning of life therefore, has to be found in other ways and this is where spiritual nourishment comes in. Failure to address the spiritual needs of a patient may distort the physical condition. Before you can meet these needs it is good to understand the values and beliefs of that patient since every person has a natural belief towards spirituality. As we listen and observe patient we bridge the gap between the patient and provider (Ya-Ling, 2008). Hope is important and makes a difference in patient’s life with renal failure or cancer patients as it determines how they live their remaining life. The healthcare providers affect a patient hope with whatever they do or say. This means that any health care process should incorporate a model that gives their patient hope. They should aim to sustain hope even during prognosis discussions though it a challenge. This does not mean that the provider should withhold information in fact information about their illness and interventions to be provided concern them more than medical care (Ya-Ling, 2008). So the first thing should be informing the patient about what they are suffering from. Discuss what is known about the disease and the curative measures? Such patients want to know that someone care about what is happening in their lives in turn they feel loved. Inform them that anyone can get the disease so as to eliminate any guilt feeling and in turn this will promote peace. Letting the patient know there are others who suffered from the disease and got healed gives them courage to face their condition. Whatever the patient belief is providing them with materials of people who add value to their faith so that they can believe in future life. Increasing caregiver confidence, alleviating anxiety, increasing quality of life for dying individuals and providing comfort and personal contact is another way of meeting diverse cultural challenges in Western Sydney which nurses and other health care professionals should do (Matzo & Sherman 2009). It also incorporates providing culturally sensitive care, promoting informed decisions congruent with spiritual values of the dying person and promoting meaning, hope and significance (Kanitsaki,2009) Providing culturally sensitive care is respectfully inquiring about the dying person’s belief system, past spiritual experiences and current spiritual needs with is necessary especially when dealing with a culturally diverse population such as the Greater Western Sydney (Lama 2002). Some of the culturally sensitive approaches to providing spiritual care by caregivers include personal spiritual development, thoughtful investigation of the patient’s religious traditions, values inherited from ancestors and cultural history as well as spiritual memories for instance memories of conversion experiences (Matzo & Sherman 2009). Taking into account the manner in which the patient’s personal spirituality may be different from their cultural history or traditional religious expectations is important in assisting the dying person achieve reconciliation and a sense of peace with their upbringing (Coberly 2002). Having patients talk about life in spiritual terms makes them have an understanding of what is taking place currently and what they would like to happen in future is also another way of dealing with diverse population (Byock 1997). According to the concept of a psychologically healthy death it is important for the active participation of patients to communicate their needs in the course of their awaiting death (Lama 2002). A good example is where the dying person is aware of a need for confession or forgiveness thus prompting caregivers to arrange for a consultation with the patient’s spiritual leaders such as a priest, rabbi, imam or pastor, depending on their spiritual and cultural backgrounds as a way of providing a culturally appropriate ritual within the patient’s religious tradition (Coberly 2002).. Recent research studies conducted on the subject matter have revealed that caregivers can help minimize anxiety experienced by dying patients by helping them state their spiritual fears as well as concerns through provision of opportunities to speak about them without shame and extension of validation and support (Koenig 2003). Counsellors and caregivers in Greater Western Sydney have learned to provide a means of coming into terms with spiritual concerns through methods such as poetry, religious rituals especially since it is a culturally diverse population, progressive desensitization, guided imagery and breathing exercises which have so far proved effective and comforting to the patients (Coberly 2002). Anything else perceived by the patient as effective in the alleviation of anxiety may also be taken into consideration as being part of the clinical encounter. Nurses charged with the responsibility of providing palliative and spiritual care to dying persons and their families should provide comfort and personal contact as a means of establishing a safe environment in which the patients can consider spiritual aspects of the dying process (Matzo & Sherman 2009). Under circumstances such as that of a culturally diverse population, it is of vital importance that caregivers spend quality time with their patients and communicate with them while allowing them to share their spirituality, memories, values, story and meanings (Byock 1997). This validating, accepting personal contact provided to the dying persons may be unique among the patient’s circle of caregivers (Weisman 1993). Bearing witness as it were to a patient’s situation has been observed to have profound spiritual implications since the patient becomes aware of the fact that the caregiver is acting as a container for their experience and that the caregivers may carry those experiences into a future where the patient will not be included (Coberly 2002). Through a number of studies conducted recently the nurses and care givers of palliative and spiritual care in Greater Western Sydney which happens to be culturally diverse have realized that processing the meaning of one’s death in a purposefully spiritual manner allows the patient to gain a sense of personal significance as to how they belong to a larger human story whether in one’s immediate family or the larger community (Matzo & Sherman 2009). Nurses and caregivers can assess spiritual needs of the dying persons using open-minded conversations, personal narratives and individualized checklists (Young & Koopsen 2006). Elevating the patient’s experience over routine is one of the best practices in as far as provision of spiritual care is concerned. This entails appropriate attention to multicultural concerns for instance the patient’s cultural values which is necessary in a culturally diverse population such as the Greater Western Sydney, family traditions, important religious rituals that may include creation of memorial altars, anointing with oil, confession and fasting (Koenig 2003). Conclusion In conclusion we can say as long as heath care systems primary aim is to cure or manage the physical pain, they should also treat patients as human who have spiritual needs. And that this spiritual aspect of healing is as important as the medical aspect and in fact if administered successfully great success can be achieved. They should understand that terminally ill patients need spiritual nourishments aimed at regaining courage, hope, faith, peace and love. As way of dealing with diverse cultural differences it necessary to understand the beliefs of the patient and their family about the treatment of the disease as well as the outcome of that treatment. The treatment plan should be in relation patient’s spiritual needs hence it should be accepted by the patient as well as their family members and the health care team.Death and dying are subject matters that tend to provoke anxiety for anyone especially families that are related to the dying individuals. It is therefore important for the families of such patients to be educated on ways of enhancing a more comfortable and peaceful environment in which the patient can spend his/her last moments. Both patients and caregivers also need ongoing education as regards what is to be expected in the dying process. REFERENCES Byock, I.R. (1997). The Prospect for Growth at the End of Life. New York: Putnam/Riverhead. Coberly, M. (2002). Sacred Passage: How to Provide Fearless, Compassionate Care for the Dying. Boston: Shambala. Holland K, & Hogg C (2001). Cultural Awareness in Nursing and Health Care. London, UK: Arnold Ingersoll, R.E. (1994). Spirituality, Religion and Counselling: Dimensions and Relationships. Counselling and Values, 38(2). Pp. 98 – 111. Kanitsaki, O (2009). Palliative care and cultural diversity. In: Parker JM, Aranda S, eds. Palliative Care Explorations and Challenges. Sydney, NSW: MacLennan & Petty Pty Limited Koenig, H. (2003). Spirituality in Patient Care: Why, How, When, and What. Philadelphia, P.A.: Templeton Foundation Press. Lama, D. (2002). Spiritual Advice on Dying and Living a Better Life. New York: Atria Books. Matzo, M., and Sherman, D.W. (2009). Palliative Care Nursing: Quality Care to the End of Life. 3rd Edition. New York, N.Y.: Springer Publishing Company. McGrath, C L (2000). Issues influencing the provision of palliative care services to remote aboriginal communities in the northern territory. Australian Rural Health Journal. Australia: MacLennan & Petty Pty Limited Ya-Ling, H (2008).Accommodating the Diverse Cultural Needs of Cancer Patients and Their Families in Palliative Care. Australia: Nursing Society and Brisbane Regional Group Young, C., and Koopsen, C. (2006). Spirituality, Health & Healing. Sudbury, M.A.: Jones & Bartlett Learning. Read More