While the role of a chaplain is to provide spiritual care for those seeking a religious spirituality, there is an increasing move in our society towards a spirituality that is not religious.
For an increasing number of our patients – and their families and support networks – institutional religion does not play a significant part in their lives. They may, however, profess a spiritual view of their own being and a spiritual element to their personal beliefs.
While recognizing and serving those in our care who hold to and practice a religious spirituality, a spirituality that is otherwise defined may present more of a challenge to our holistic care.
Person-centered care for all
My role at St Giles was created and defined by managers at the hospice who saw the need for a transition and development in the service to encompass people of all religious faiths, as well as those with a non-religious spiritual orientation and those for who spiritual needs simply translate as a need for compassionate companionship.
The difference between them may be seen as a matter of life choice, understanding or views of faith, but are, in my view, all of equal importance.
At the hospice, spiritual care exists to meet the deepest emotional and existential needs of all our patients and their families – without exception.
Strangely, such a plan to serve everyone equally does work in practice because, in the first instance, our response to patients’ spiritual care is person-centered. Our goal is simple: the wellbeing of our friends throughout their hospice journey.
In spiritual care in the palliative context, there is no aim to convert or convince of the need to change. Our one desire is for the patient and their families to see inner peace as a resource to ease their journey and add to their times of freedom from pain.
One area in which spirituality is seen as possibly being directly relevant to our patients’ care, whoever they are, is in the area of ‘total pain’.
Dame Cicely Saunders first introduced the idea of total pain, which encompasses psychological, social, emotional and spiritual components as well as physical symptoms.
When a patient has pain that should be directly controlled through a well-managed prescription of palliative drugs, they may still experience pain that confounds our clinicians. It can appear that there is no rational cause for the continued pain after their administration of pain relief.
Engaging with the psychology of the patient and with the benefits of mindful meditation, in addition to clinical care, is opening up an increasingly cooperative relationship between disciplines, to seek to give the patients resources to enable them to manage this ‘total pain’.
The recognition that the inner mental focus and discipline required for meditative practice does not depend on a religious mindset is helpful for both professionals and patients alike. It is, in itself, an engagement with the human being aimed at alleviating worry or anxiety and allowing the patient to free themselves from the progression of thoughts that lead to heightened sensitive states of mind.
If the mind is at peace then there can be a measured impact on the patient’s ability to receive the benefits of other treatments and therapies. In co-operating within the holistic focus of care, we may see a direct benefit to the patient in their relief from pain.
Even when the clinical interventions and psychological support are wholly effective, applying attention to the inner life cannot hurt or confuse when it is focused simply on achieving the greatest peace of mind and palliative outcomes.