Los Angeles Jewish Home

While health care professionals are proficient in physical and even mental caregiving, few receive training or coaching in how to provide spiritual care. A holistic approach to care and interpersonal relations requires that not only the needs of body and mind are tended to, but the spiritual as well.

How does a health care professional provide spiritual care in a multi-religious or even a setting devoid of religion? The answer is to become aware of spiritual needs rather than focusing on religious requirements. What is the difference? While not everyone may practice a religion, every person has a spirit.

Four specific needs are suggested in an article titled "Spiritual Needs of Patients: Are They Recognized?" (Highfield, Carson. Cancer Nursing 6 1983: 188). These primary human needs are spiritual, but not specifically religious. While many persons fulfill these needs through religious practice, many others do not. But virtually everyone, whether practicing a religious tradition or not, has these same fundamental spiritual needs.

1. The need for meaning and purpose

Everyone needs a reason to get out of bed in the morning. Many of the best dementia care units provide "chores" that residents are responsible for (like watering the flowers or sweeping the room) as a method of lending meaning, motivation, and purpose to the day at hand. People who are aware of no purpose in their lives often become listless, depressed, angry or withdrawn. "Why can't I die? I am no good for anyone anymore!" are familiar laments by people who have lost their sense of meaning.

2. The need to give love

A person needs to give love, not just to receive it. In fact, many depressions develop not because the individual has no one to love them, but because of an inability or lack of opportunity to love others. Instead of having a focus outside of themselves, the focus of these people is directed inward – to a recent health setback, a perceived slight, or the latest ache or pain. All of us have a very real need to be concerned, connected, and involved in something beyond ourselves and our immediate interests.

3. The need to receive love

All people have a need to be loved. Many studies suggest that if infants are not cuddled they do not thrive. The same is true for people of advanced years. Sometimes love is hard for a person to receive out of fear of becoming dependent or indebted to someone else. Yet the need to be loved, and know that we are loved, remains an essential component of our well-being.

4. The need for forgiveness, creativity, and hope

Finally, there is the need for forgiveness, creativity, and hope. Every person needs to feel as though their future is open and holds possibilities. Sometimes, people need to be able to release and forgive the past in order to move on. But every individual needs to feel as though they are a player in the creation of their own future. We all need the hope that tomorrow will be livable and worth living for.

Each one of us is trying in some way to fulfill these spiritual needs through what we do, how we feel, and how we respond to life's twists and turns. If any one or more of these needs are unfulfilled, spiritual distress arises, a distress that is often beyond the purview of physicians and nurses, but makes perfect sense to the spiritual caregiver.

Within every social or caregiving encounter we have with a senior, we have a new opportunity to become aware of and attentive to their spiritual needs – looking not only at the body and mind, but also at the spirit, with an approach that respects the needs of the "whole person."

Rev. Donald Koepke is the director emeritus of the Center for Spirituality and Aging (CSA), a program of California Lutheran Homes and Community Services, headquartered in Southern California. Rev. Koepke has presented many workshops on spirituality and aging. He is also the producer of the DVD, "Caring for Elders: Body, Mind and Spirit," which presents the concepts of the author, psychiatrist and Holocaust survivor, Viktor Frankl, as applied to aging. For further study on spirituality and aging visit the CSA website at http://www.spiritualityandaging.org/.

Labels: Feature Articles, For the Spirit, Koepke, Religion, Spiritual Care