In response to this problem, the Reverend Joep van de Geer and Professor Carlo Leget, supported by policy adviser, Marijke Wulp, initiated the European Association of Palliative Care (EAPC)Taskforce on Spiritual Care to support research and education into this area.
Following their attendance at two consecutive congresses of the EAPC (Budapest in 2007 and Vienna in 2009), Rev van de Geer and Prof Leget saw that there was a huge interest in issues of spirituality in palliative care. However, there were massive challenges to be overcome before consensus and collaboration could be achieved.
“When we went to the EAPC congresses in Budapest and Vienna,” said Rev van de Geer, “we saw that there was a large spiritual care involvement, but that the presentations had no common base. Also, we realised that there were differences in how spiritual care was structured in the different countries in Europe.”
A major issue obstructing the development of spiritual care in palliative care was the difficulty in defining the concept. This was intensified by subtle differences in linguistic connotations of the concepts ‘spirituality’ and ‘spiritual care’ in different European languages.
In the Netherlands, where Rev van de Geer and Prof Leget live and work, the concept of spiritual care is difficult to express linguistically without straying into the esoteric. According to Rev van de Geer: “The challenge was to find a way to define and express the concept in a new, professional way for healthcare providers.”
A key function of the EAPC Taskforce on Spiritual Care is to overcome these linguistic and conceptual barriers so that research and education can be shared between countries. “We thought that we could all benefit from what is developed in different languages. We thought that this could be inspiring to people working in other countries,” said Rev van de Geer.
One of the first successes of theTaskforce was to reach consensus in building on the work of Dr Cristina Puchalski and Dr Betty Ferrell in the USA to arrive at a European working definition of spirituality.
Rev van de Geer explained the need to rework this definition for use in a European context: “We have different structures and cultural contexts in healthcare and society and we felt that we needed a kind of platform to exchange these ideas and to discuss and inspire each other.”
The research, implementation and education subgroups of the Taskforce continue to do good work. Dr Lucy Selman, co-chair of the research sub-group, and Teresa Young recently led a pioneering international survey of palliative care researchers’ and clinicians’ priorities in spiritual care, which provides a foundation for future research in the area.
The education subgroup, led by the Reverend Andrew Goodhead, is focused on bringing together theoretical knowledge and daily clinical practice, as well as connecting chaplains with other members of the multidisciplinary team to support them in providing impeccable spiritual care to their patients.
“Many doctors and nurses realise that this is very important for their patients and their families,” said Rev van de Geer, “but they are not trained to do so. They are very focused on the physical and psychosocial dimensions. But the spiritual care dimension is hard to grasp and often you will find that they feel insecure on this. The chaplains would be very good at this, but they have to discover what are the exact problems and questions from doctors and nurses. So we need to connect these disciplines.”
The education subgroup is also mapping how to educate primary healthcare workers on how to work with the spiritual dimensions of care.
The EAPC Taskforce on Spiritual Care continues to grow. From the original group of seven countries, membership has expanded to include people from all over Europe, Canada, South Africa, Uganda, even Australia, Peru, Argentina and India. The most recent request to connect has come from Singapore.
In the interest of building awareness and recognition of this important but often elusive aspect of palliative care, the implementation subgroup is cooperating with the European Journal of Palliative Care, providing articles from member countries each contributing an update on spiritual care in palliative care in their country.
Follow the work of the Taskforce on the EAPC website.
Selman L, Young T, Vermandere M, Leget C, Stirling I on behalf of the EAPC Spiritual Care Taskforce. Research priorities in spiritual care research EAPC Spiritual Care Taskforce survey: Final results of an international survey of 971 researchers and clinicians. 13th World Congress of the European Association for Palliative Care, Prague 2013. European Journal Palliative Care, Abstract FC 12.4 (p.60).