A practical approach to supporting spirituality in care
What does it mean to forget, to lose words, thoughts, images of our lives, not recognise the people we love and who love us? Is a pathway towards the end of our lives embedded within us via faith or nature? How do we truly support a culturally diverse and inclusive spiritual health for people living with a dementia.
Humanity and the link between spirituality and our core spirit is one well explored. It is linked to our soul and the nurturing of it. Our Soul, that part of us that observes quietly behind what we do, think, believe, and feel. For each of us, our Soul is where unconditional love, unending forgivingness, compassion, harmony, peace, and joy reside. This has to be the foundation of our approach and application of spirituality in care. We are Spiritual Beings having a human experience.
“We are, not metaphorically but in very truth, a Divine work of art, something that is in the making, and therefore something with which we have a certain character that is ever changing and ever present”.
C S Lewis
What is spirituality?
Spirituality is an evolving concept. There are two extremes to the definition of spirituality; both approaches acknowledge a search for meaning. For some people, divine presence is central; for others, spirituality is inner life, personal belief and focussing on self. Regardless, both beliefs are important in understanding the core spirit within each of us.
Spirituality is a complex array when we consider:
- Spirituality as part of a religious belief: A particular spirituality is a specific system of beliefs, virtues, ideals and principles which form a particular way to approach God, and therefore, all life in general.
- Spirituality as a secular concept: Spirituality are those ideas, practices and commitments that nurture, sustain and shape the fabric of human lives, whether as individuals or communities.
- Spirituality as a metaphor for absence: By raising the importance of meaning, purpose, hope, love or relatedness issues when living with dementia and other problems linked with ageing, the language of spirituality identifies gaps and ideological differences often creating conflict. This in itself can reinforce our spirituality as an expression of absence or inadequacies.
- Spirituality as a search for meaning: Spirituality recognises the human need for ultimate meaning in life, whether this is fulfilled through a relationship with God or other expressions that reaffirm our beliefs, values and feeds our soul/core spirit.
- Spirituality as life being lived: Spirituality refers to the deepest values and meanings by which people seek to live… it implies some kind of vision of the human spirit and of what will assist it to achieve full potential.
“Do not be fooled by its commonplace appearance. Like so many things, it is not what’s outside, but what’s inside that counts” – Aladdin
Supporting Spirituality | How it looks, sounds and feels?
Not one approach can satisfy this need yet, it is essential to nurture the soul and spirit of all of us. Supporting spirituality for people living with a dementia is challenging, intertwined with culture, diversity, story and our core spirit, there is not one size that fits all.
Spirituality needs nurturing by:
- Using the senses
- Rituals and iconography
- Understanding spirituality is not religion
- Recognising our spirituality changes
- Understanding stages of dementia impact our experience of spirituality
Practical approaches to support a diverse spiritual experience
The creative arts
The arts – music, dance, painting, drawing, poetry, writing, sculpting, theatre, craft, embroidery, flower arranging – take us away from everyday routine and fulfil the spiritual need for creative expression.
Example activities might be:
- Listening, moving or dancing to music
- artistic expression
- Writing simple poems together or making up stories
- Singing, reminiscing through songs
- Stories being shared
These can be built around creative interests the person has enjoyed in the past.
The wonders of nature
Many people respond to and feel spiritually fulfilled by nature. They love the great outdoors, smelling the aroma of blossoms, hearing bird calls, working with the soil, seeing and touching various things that are linked to the experience of nature.
Other wonders of nature activities might include:
- Watching and listening to birds
- Looking at a sunset or the stars
- Garden activity
- Walking or sitting outside
- Doing nature themed crafts such as flower pressing, gardening
- Growing plants indoors
- Connection with animals
What you choose to do will depend on the person’s capabilities – but supporting the senses through nature can be very meaningful.
Friends, family and community
Retaining feelings of connection with friends, family and the community is an important part of a spiritual life. These are the people who share similar traditions, beliefs and values.
Examples are:
- Doing simple one-to-one activities with available family members such as flower arranging, enjoying listening to music, looking at old photographs of family celebrations, singing along to favourite songs, etc.
- Celebrating different special times such as Easter, birthdays, anniversaries, grandchildren passing exams, the arrival of spring, etc.
- Many opportunities can be created for two or more family members to get together and in which your loved one can take part and which encourages communication.
Invite the person’s friends and acquaintances to some occasions or organise the event especially with them in mind.
Faith based activities
Support from the faith community is important for religious expression. The faith community may have volunteers who visit those who are homebound and carry out the rituals.
Other things you could organise may include:
- Watching a religious service, rituals or occasion on TV or the internet
- Visiting the place of worship when the building is quiet and just sitting silently in contemplation
- Listening to religious recordings
- Reading or listening to faith readings
- Making sure the person has religious or cultural items near to hand where they can see and touch them
Sensitive and compassionate care that includes those elements of spirituality which have meaning and significance to your loved one is essential in maintaining their well-being. Even if you might not share their beliefs they have the right to the comfort of them. Ensuring they are part of daily routines and activities will also make caring for them so much easier and enjoyable.
REFERENCES
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Swinton J and Pattison S (2010) Moving beyond clarity: Towards a thin, vague and useful understanding of spirituality in nursing care, Nursing Philosophy, 11, 226-237
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Lima, S., Teixeira, L., Esteves, R. et al. Spirituality and quality of life in older adults: a path analysis model. BMC Geriatr 20, 259 (2020). https://doi.org/10.1186/s12877-020-01646-0
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Downing, D. C. (2021). The most reluctant convert: CS Lewis’s journey to faith. Wipf and Stock Publishers.