Person-Centred Care and Spirituality

Person-Centred Care and Spirituality

I was very struck by an advertisement in a recent Sunday newspaper for a care home which said that ‘because we have taken the time to get to know Jim we know how passionate he is about football and what an important part this played in his life since his father first wrapped him up in a thick green and blue woolly scarf’.

What this advertisement is telling us is how important it is for us to understand an individual; what is it that makes us individual and that we need to have a greater understanding of what has contributed to a person’s life -  whether it is food we like or what time you want to get up in the morning. What are the fundamental needs that have taken us through our life, guided us and built our strengths?

In discussing, implementing and understanding person-centred care it is vital that the spiritual dimension is included.   Some of you might be thinking ‘oh dear is she going to talk about religion’ and I quite frequently get the response of ‘I don’t do God’. I am not talking about religion except in as far as it matters to the individual older person and it is not about what I believe but about what their needs are and how we should respond.  It is the importance of paying attention to what matters to somebody.

Tom Kitwood emphasised that each person should be valued as an individual; understanding the values that were the mainstay of their lives and what had influenced their lives so that we see the person for what they are; as a whole person who's got a history; built an identity and who has lived and experienced a whole range of things.

Person centred care is founded on the ethic that all human beings are of absolute value and worthy of respect no matter what their disability

But spirituality is about the intangible elements that matter - values, relationship and critically, meaning and purpose.  What is it that makes us get up in the morning;

what is it that made anybody in this room want to get up this morning to come to this conference;   what is it that enables us to get through the day.  This is what we what we need to know and understand.

The World Health Organisation is very clear that if you're looking at holistic health and well-being of an individual you have to think of body, mind, and spirit.  We often talk about a spirited person or what lifts the spirit and it is these particular elements that we've developed in our lives that make the difference.

Many writers have spoken about meaning and purpose and Nietzsche said ‘he who has a why to live can bear almost any how they are living’.  We need to ascertain what the ‘why’ is for individuals and I don’t mean we blunder around asking ‘why do you still want to be alive’ but through their memories begin to tease out the factors that have built up the why and what gives us meaning and purpose now.  

Many carers are providing spiritual care but not realising it.  It is not about an additional task but a way of weaving it in and realising individual needs. 

Maureen O’Neill

Director

March 2016

National Care Standards

National Care Standards

Faith in Older People (FiOP) has for some time been urging the Scottish Government to strengthen the existing National Care Standard which relates to the spiritual lives of older people receiving care.  In November last year the Scottish Government issued a consultation paper taking forward some of its initial proposals.

Although we have supported the emphasis on human rights and the stress on the needs of the individual we expressed our concern that the questions did not enable a deep or comprehensive understanding of the issues or how the ideas would be implemented in practice.  We expressed a number of concerns and these can be viewed on the FiOP website.

This month the Review Team which includes the Care Inspectorate, Healthcare Improvement Scotland and the Scottish Government produced an update and this has been posted on the FiOP website as well.

FiOP wants to see a strong but simple approach to standards which are easily understood and appreciated by staff in the care they provide and that older people and their relatives and friends are clear as to what they can expect.  Therefore, we have urged that the language being used is clear; there must be a realism about the standards which should be meaningful to the individual and be the basis of empowering the older person in decision making, choice and participation.

For us the spiritual dimension which holds the identity of the individual is integral to person-centred care.  It is essential to listen to what has governed and influenced a person’s life so that they hold on to what matters to them and from which they can draw strength and build resilience.

The National Care Standards must form part of the bigger policy landscape so that we join the dots and create a coherent framework for the care of older people.

Maureen O’Neill

Director

Inclusion

Inclusion

FiOP is striving to ensure that ‘inclusion’ is integral to all our work.  What we mean by inclusion is ensuring that physical, spiritual and relationship aspects of our lives are taken into account;  that we don’t lose those important connections with the lives we have lived until we find it difficult physically and or cognitively to continue in the same way.

These aspects of our lives are as important to us wherever we live – home, care home or continuing care in the NHS.  We want to develop a stronger understanding of the importance of how our spiritual lives can help to build our resilience to change whether this is through faith, music, creativity or the outside world.  The gifts that older people bring must be acknowledged by our faith community or by care providers outwith the family.

We need to lay particular emphasis on the ‘wide ranging attitudes and practices which focus on the search for meaning in human lives, particularly in terms of relationships, values and the arts.  It is concerned with quality of life, especially in areas that have not been closed off by technology and science.  Spirituality may, or may not, be open to ideas of transcendence and to the possibility of the divine’ (Ferguson, 2011: xxix).

FiOP has incorporated this approach in its current work as we have considered the importance of ‘the outside world’ (Workshop with Professor Mary Marshall); ‘Listening’ (Workshop with Rev Jenny Williams); Music – Singing and Dementia (Workshop with Diana Kerr).  Our ‘Dementia Friendly Faith Communities’ is encompassing all these aspects as we develop a comprehensive and affirming approach open to all denominations and faiths.  This is echoed in our joint work with the NHS Chaplaincy on identifying ways of supporting spiritual care in continuing care units. 

All our work is undertaken in a collaborative way and we would welcome ideas and views about different pieces of work.  Please do contact Maureen O’Neill, FiOP Director: director@fiop.org.uk if you would like to put on an event or would like more information about any of our work.  Our aim is to be both consultative and inclusive.

Maureen O’Neill

1^st February 2016