Rebecca Brown is a 35 year old mother with a gynecological cancer and currently undergoing treatment for a year now. However, her medical condition is not improving and causing alarm to her physicians and family. She is now at the end-of-life care by nurses and doctors in a hospital. In addressing her special needs, the hospital placed Rebecca under Hospice Care. Hospice care treats the person rather than the disease; it highlights quality rather than length of life. It provides family-centered care involving the patient and family in making decisions. (ACS, 2007, ¶2).
It is a philosophy that enables patients to spend their remaining days with dignity surrounded by their loved ones. Hospice treatment creates an environment where the patient is listened to and that the people around him are ready to share his concerns. One of the elements of this innovative medication is spiritual care. Evidence shows that patient facing serious illness would shift attention from biomedical to spiritual sources for answer and comfort. At this stage, they would ask spiritual questions and reflect the meaning of life. Dying patients generally voiced out their fear of uncontrolled pain, concern of being a financial burden to the family, anxiety of what happens after death, and worry of not being able to fix some unfinished business. Realizing all these necessities, hospitals are now integrating spiritual care services for early intervention.
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Spiritual Care tries to answer a patient’s quest for the meaning and purpose of life, his feelings of isolation, and his interconnectedness with himself, to others and to God. It fulfills specific needs of the patient to give him strength when facing death and uncertainties. In meeting the spiritual needs of Mrs. Brown, we have shown her compassion by being attentive to her fears, hopes, pain, and dreams. We treated her as a whole person including her physical, emotional, social, and spiritual dimensions. Providing spiritual care can help Mrs. Brown cope up with her inabilities and feel close to God giving her optimism.
With this support, Mrs. Brown can make sense out of her illness, acknowledge that death is near, and maintain a positive outlook. More often we grant her wish for a priest who is readily available to help in counseling and answering spiritual questions. We maintain our trustworthiness and kindness with Mrs. Brown at the same time give her inspirations by helping her understand what it means to live. We have enriched our knowledge with the Catholic faith to comprehend her spiritual needs.
As a result, we have permitted Mrs. Brown to visit the chapel inside the hospital whenever she wants to, let her friends and loved ones pray with her inside her room, and attend Sunday masses where she can receive communion. In addition, she reads the Bible before sleeping at night; write her spiritual journal, and at times request for religious movies. We continue to care for her even though there is no more curative therapy available.
Spiritual assessment is essential so that medical staff may understand the religious practices of patients and be able to respect their beliefs and not impose their own religion. In this way, physicians can formulate proper strategies to enhance positive response from the patients during diagnosis and treatment. In assessing Mrs. Brown, we simply asked her a series of open-ended questions relating to her Catholic faith and the practices or rituals that are important to her.
Our informal interview would revolve around the topics like death and the afterlife, her prayer life (what does she pray for), does her faith give her hope, does she feel abandoned by God, does she find comfort in her belief amidst her illness, the need to be forgiven, was she a member of religious organization within the community, what gives meaning and purpose to her life, and her personal beliefs. The information we gathered helped us determine the kind of spiritual care service we would give her.
Results and Benefits.
In its 1996 meeting, 90% of the American Academy of Family Physicians declared that the spiritual beliefs of patients are helpful in their medical treatment. Several studies and surveys have already shown the many benefits of spirituality in healing. The National Institute for Healthcare Research reported that those who regularly attend religious activities live longer. According to the 1998 Research in Spirituality and Health Coping, prayer is the number one non-drug method in managing pain. These findings can now be seen in Mrs. Brown’s case. After giving her spiritual care, Mrs.
Brown showed signs of reduced anxiety, depression, and distress. She does not feel lonely anymore as she is constantly surrounded by her family and caring nurses. She adjusted well to follow-up treatment of her cancer and has now the confidence of enjoying life. In addition, she somehow improved her physical condition exhibiting high levels of self-respect and less worries about her health. She also demonstrated stronger coping mechanisms and personal values giving her quality of life that she now enjoys. After going through all sorts of counseling, Mrs. Brown is now capable of forgiving and be forgiven.
This feeling, she said, resolved all her guilt and restored her good relationships with those she had disagreements in the past. Because of her faith, Mrs. Brown is now ready to face her final day and is very much prepared to the uncertainties she may encounter. She has already accepted her fate wherever it may lead her to. Her seven children and loving husband are likewise prepared for the event that they may not see her again. Her love grew stronger each passing day and felt the presence of God in her bedside. Despite in the worst situation, she feels good about herself.
(ACS) American Cancer Society, Inc. (2007). What Is Hospice Care? Making Treatment Decisions. Retrieved January 28, 2007, from http://www.cancer.org/docroot/ETO/content/ETO_2_5X_What_Is_Hospice_Care.asp?sitearea=ETO
Gilbert, R. B. (2001). Health Care & Spirituality: Listening, Assessing, Caring (Death, Value and Meaning). Baywood Publishing Company, New York. ISBN-10: 0895032503
University of Virginia. (2006). The Benefits of Spiritual Care Provided by Professional Chaplains. Health System. Chaplaincy Services and Pastoral Education. Retrieved January 28, 2007, from http://www.healthsystem.virginia.edu/internet/chaplaincy/whitepapersection4.pdf
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