We may be on the other side of the world, but many of the challenges we face in spiritual care in long-term care echo those I hear you discussing in Australia.
Our societies share many similarities, as places of beautiful and sometimes complex diversity, with indigenous people, descendants of settlers from generations past, and recent immigrants sharing this land together.
Our older citizens have lived through our society’s evolving relationship with religion, from a time when most everyone belonged to and went to a Christian church on Sundays, through a time when talk of religion was taboo, and into this current time when we are seeing an increase in religious ‘nones’ alongside an increase in people of faith coming to Canada from other parts of the world. Our context for meaning-making is all over the map.
It was in this context that I recently undertook some research with Canadian baby boomers, to get a sense of what sustains them, in order to inform our provision of spiritual care in long-term care into the future for those most likely to use residential care.
Using narrative research methods, I explored with twelve participants (six men and six women, born between 1946 and 1955 in Canada), what they would describe as their “spiritual resources.”
It was interesting that they each started by talking about the religious experience they received as children, and their relationship with the church. Many talked about supportive community as important, and prayer, in many forms. Music was mentioned, and the joy of making music with others.
About half are still active in a church, while others stopped going for reasons including: changed beliefs, desire for more open-minded conversation, and lack of belonging.
Most would describe themselves as ‘people of faith’, though they meant different things by faith, expressing both beliefs and/or mystical experiences.
But when asked what sustains them, they talked about much more than religion. As I processed what I learned from their stories, I came to define what they were describing as ‘spiritual resources’ as “all those things, internal and external, that address deep human need for such spiritual values as love, hope, peace, and joy.”
Some of their spiritual resources were rooted in their own selves and informed by the self-awareness, self-help, and self-care emphases of their cohort throughout their life course. Independence was valued, along with role models, strong values, and intentional attitude.
Relational resources were also recognized, as they voiced the need for ‘someone’ to accompany them as they grow older, especially as their families are smaller, busier, and more geographically dispersed than in generations past.
Finally, their environment, the ‘space’ around them, was important to their spiritual sustenance. Quiet, beauty, meaningful personal belongings, nature, and the ‘spaciousness’ of time were valued, along with privacy and security, gathering space, and opportunity to get out in the community.
Spiritual need for love, hope, peace, and joy are met within each of these themes of ‘self’, ‘someone’, and ‘space’.
For example, love is experienced in self-acceptance, in relationship with others and perhaps with a higher power, and by being in an environment that is comfortable and filled with reminders of one’s meaningful connections throughout life, a place where you feel you belong.
Hope is often found in beliefs and values that give meaning and purpose to life and equip one to focus on positive possibility. Role models who have exhibited resilience and growth in adversity provide inspiration, and friends who can “hold hope” within known risk of disappointment are encouraging. Being part of a larger community, world, and story that includes younger generations and will continue into the future provides context for hope. And nature, including living, growing things, surprising beauty, and light in darkness, provides a powerful metaphor for regenerative hope.
Peace may be grounded in personal faith or trust. Peace is found through forgiveness and reconciliation in relationship, and confidence in practical and emotional support when needed. Peace thrives in a context of freedom and security, where honesty, questions, and autonomy are welcome and supported. Quiet, nature, and unhurried time all contribute to the experience of peace.
And joy may be found in thoughts that lift one’s spirits, in relationship and engagement with others, laughter and enjoyment. Opportunity to experience and/or express joy can be found in work and play, in music, dance and art, in food, in humour, in beauty, light and colour, in mindfulness of the little things.
In our society, and others like it, where religious diversity is pervasive, it is tempting in healthcare to dismiss spiritual care as too fraught with potential for division and misunderstanding, and too complicated to provide.
I am hopeful that speaking of ‘spiritual resources’ as all those things that address need for love, hope, peace and joy (including, but not limited to, religion) will help spiritual care feel more comfortable and inclusive.
The participants in this study uniformly expressed openness to exploration, learning and diversity in the realm of spirituality. It is my hope that this openness will contribute to more sharing of spiritual resources that will bring comfort and inspiration, counter loneliness and accompany people of all faiths and ‘none’ to seek and find spiritual richness. Using these simple, familiar, but profound words (love, hope, peace, and joy) to centre deep and meaningful conversation can make spiritual care in long-term care more accessible to all.
Jane Kuepfer, RP, MDiv, PhD
Schlegel Specialist in Spirituality & Aging
Conrad Grebel University College