iPall: Learn Palliative Care
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Spirituality in Palliative Care

In this chapter we explore the role of spirituality in palliative care.  I have been inspired by my chaplain and psychology colleagues, as well as by some physicians who have been delving into this arena through various forms of reflection rounds and Schwartz presentations.

CAPC (Center to Advance Palliative Care) defines Spirituality as: The transcendent dimension of a person's life.  May be described in terms of inspiration, meaning, and/or value.  An organized religion may be part of an individual's spiritual experience.

Loss of meaning, existential suffering, fear of afterlife can add to patient's despair.  Spiritual resilience, identification with meaning, shifting sense of purpose, often religion can help patients transcend their suffering as well.  Part of our role as palliative care clinicians is to identify suffering in this realm and know how to help - whether directly, or by tapping the shoulder of one of our colleagues.  Part of our role is also to understand some basic tenets of different religious traditions, especially with how they apply to decision-making, identification of suffering, enhanced communication, cultural identity

The goals of the chapter:
  1. Review the definitions and the evaluation of spirituality and spiritual suffering;
  2. Reflect on the role that spirituality may play in self-care of clinicians in the field of hospice & palliative care.

Articles

  • Religious Coping and Use of Intensive Life-Prolonging Care Near Death in Patients With Advanced Cancer JAMA. 2009;301(11):1140-1147. doi:10.1001/jama.2009.341. (Open Access)
  • Multidisciplinary training program for spiritual care in palliative care from Australia - http://www.palliativecare.org.au/Default.aspx?tabid=1743
  • Spirituality at the End of Life – from Growthhouse: http://www.growthhouse.org/spirit/
  • Improving the Quality of Spiritual Care as a Dimension of Palliative Care: The Report of the Consensus Conference – Puchalski et. al. JPM Volume 12, Number 10, 2009 DOI: 10.1089=jpm.2009.014 http://www.growthhouse.org/spirit/files/spiritual_care_consensus_report.pdf
  • Matters of Spirituality at the End of LIfe in the Pediatric Intensive Care Unit. Mary Robinson et al. Pediatrics. Volume 118, No 3, Sept 2006. pp e719-729. dpi: 10.1542/peds.2005-2298 http://www.pediatricsdigest.mobi/content/118/3/e719.short 

Recommended reading from Tom Sheehan, UMass Memorial Chaplain:

  • Different health care reform: doctors trained to deal with patients about faith (Opinion, Christian Science Monitor Jan 5, 2010) 
  • A resource describing professional chaplaincy as it is currently understaood by the tandem chaplain certifying bodies: The National Association of Catholic Chaplains, and the Association for Professional Chaplains. (Just left click twice on the image to move to the next slide.)  (.swf if a flash video; may prompt you to add a flash player to your computer. - carrie)
  • Chaplains Are More Than What Chaplains Do. (Rev. Stephen Ryan, OSM, National Association of Catholic Chaplains website) 
  • Do You Want To See The Chaplain? (Joan E. Carlson, National Association of Catholic Chaplains website)This is an excellent summary article about an appropriate assessment of needs for chaplaincy in a hospital setting,which is not in use at UMMMC, which still asks the incoming patients, "Do you want to see a chaplain?" It gives a sense of how we could improve our ministry both as chaplains and as spiritually-minded clinicians. 

Books

The Soul of Medicine: Spiritual Perspectives and Clinical Practice by John R Peteet & Michael N D'Ambra Amazon link  Powells link 

Podcasts, links and blogs on spirituality and palliative care

Healthcare Chaplaincy Network "Caring for the Human Spirit"
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A fabulous online blog and resource about spirituality, meaning, purpose, and on being human.
  • Contemplating Mortality - Interview with Ira Byock (Krista Tippett On Being)

A Presence in the Wild - Interview with Kate Braestrup, Chaplain to the Game Wardens in Maine (Krista Tippett On Being)
Approaching Prayer - Interview with Anoushka Shankkar, Stephen Mitchell, and Robderta Bondi  (Krista Tippett On Being) 
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