Monday 31 August 2015

Why is going outside so crucial for older people and people with dementia?



Why is going outside so crucial for older people and people with dementia?

Professor Mary Marshall will be giving a seminar on the ‘Outside World and Wellbeing’ on 29th September at 2.00 in the Scottish Storytelling Centre, Royal Mile, Edinburgh


There are lots of serious mental and physical health benefits of going outside. Here are a few:-


  • 20 minutes outside in the sun will give us our daily dose of vitamin D which is so essential for bones and muscles (and it looks as if Vitamin D is implicated in dementia too)
  • going outside lowers blood pressure, we get exercise outside which is essential for all of us and helps keep dementia at bay
  • going outside is good for our mental health especially if it involves looking at or being alongside nature


One of the benefits is our spiritual wellbeing; which will be different for each of us but equally important.

This is all blindingly obvious – we all need to be outside and probably cannot contemplate being permanently stuck inside or depending on someone else to take us.

Yet this is the predicament of hundreds of older people in care homes, hospitals and even at home.

So why is this?  It must be due to a lot of factors.  If we depend on staff to take us out – they are often too busy and they often do not understand why it is so important.  The weather is also unpredictable: it can be raining or about to rain or has just rained.  The building may not provide easy access to outside and the outside spaces may not be well designed.  Hospices understand how crucial nature is for most people at the end of life and they always have lovely grounds and wide doors so beds can be wheeled out.   There may not be a toilet nearby so people get anxious about getting there quickly if they need to.  Another reason is that some of our outside spaces are not appealing to us – we all have very different backgrounds and different preferences for outside spaces.  People, who have always lived in remote rural areas for example, feel the need to look at fields or at the sea, rather than a rose garden.

Mary Marshall
August 2015

Monday 17 August 2015

Spiritual Care Matters



Spiritual Care Matters

I have recently taken the opportunity to re-read ‘Spiritual Care Matters’ which was produced by NHS Education in 2009.  It clearly sets out a vision for meeting the spiritual care needs of patients but the values and approach are just as applicable to people in residential care or receiving care at home.  It is a really helpful resource for people trying to understand the breadth of spirituality and how it is interpreted by each of us individually.

Faith in Older People is fortunate to have Chris Levison, who was the Programme Director for Healthcare Chaplaincy and Spiritual Care in NHS Education at the time, on its Board.  I found the following extract from the document to be a strong grounding in putting spiritual care in context.
“Many find themselves between the religious certainties of a bygone age and the cold rationality of the opposite extreme.  They have values and beliefs but they do not find it easy to say exactly where they belong. 

“Spirituality is a slippery word these days involving anything from monasticism to wind chimes, but I’ve never been able to resist a little tinkering under the bonnet of the soul.  No longer convinced by the religious absolutes of my childhood, I nevertheless hankered after something to replace them, a working credo with which to engage life” (Nick Thorpe (2006) ‘Adrift in Caledonia: Boat Hitching for the Unenlightened’. Little Brown UK)

Spiritual care in its broad and inclusive sense can perhaps help give us a workable credo, as we acknowledge the importance of responding to spiritual need of all kinds in the health (social) care environment.  Spiritual care is that care which recognises and responds to the needs of the human spirit when faced with trauma, ill health or sadness and can include the need or meaning, self worth, to express oneself, for faith support, perhaps for rites or prayer or sacrament, or simply for a sensitive listener.  Spiritual care begins with encouraging human contact in compassionate relationship, and moves in whatever direction need requires”.

Perhaps we need to recognise and understand what feeds our own spirit in order to support others.
(Spiritual Care Matters: An introductory resource for all NHS Scotland Staff: (2009) NHS Education for Scotland:  www.nes.scot.nhs.uk )

Maureen O’Neill
August 2015

Monday 3 August 2015

What matters to you about the future of palliative and end of life care in Scotland?



What matters to you about the future of palliative and end of life care in Scotland?

I attended a recent workshop to discuss these issues which was organised by the Palliative and End of Life Care National Advisory Group.  The participants came from a range of organisations – NHS practitioners, voluntary sector, government and care homes.

We discussed five key questions:

·         What have been the key achievements in the delivery of palliative and end of life care in Scotland since the publication of Living and Dying Well in 2008?

·         What do you see as being the main priorities and objectives to improve palliative and end of life care in Scotland over the next 5 years and beyond?

·         What are the most significant challenges to delivering improvements in a)access; b) quality of palliative and end of life care in Scotland in the future?

·         How can we support these improvements a)in access; b) in quality of care

·         What matters to you if time were to become short?  

A number of the themes which emerged have been echoed in discussion which FiOP has enabled including:

·         Having the ‘conversation’ and being confident in talking about death and dying

·         Destigmatise death, dying and bereavement

·         Culture specific responses

·         Ensuring that spiritual care is available and that this is understood

·         Must be person-centred and enabling the individual to be in as much control as possible

·         Flexible approach allowing individual choices

·         Compassion

These themes are consistently discussed and acknowledged as being critically important so why is it so difficult to embed them in practice not just in relation to end of life care but all care?

Edinburgh Roadshow Summary Report

Maureen O’Neill
July 2015