Spirituality provides “a context in which people can make sense of their lives, and feel whole, hopeful and peaceful even in the midst of life’s most serious challenges”. Spirituality is not only about religion, It can also mean things that give people purpose in life.
Spirituality is particularly important for patients of life-threatening illnesses. Spiritual well-being is related to psychosocial adjustment to cancer and cancer-related complications.
Spiritual needs are different for each person, and are common among all people despite religious beliefs. Even an unreligious person may be grappling with some of these concerns. Although many do rethink the purpose of their lives, others may not be interested in spirituality.
Examples of spiritual needs:
Spiritual needs differ during different stages in life and can be satisfied by different ways.
People near the end of life may have spiritual needs as compelling as their physical and emotional concerns. They may want to find meaning of their lives and settle the unsettled. The dying person could feel relieved after resolving the unsettled with friends and families. Many people may find peace and strength through religion. Praying, talking about the religious community they belong to, reading religious texts or listening to religious music may bring peace and comfort.
Families and friends can share memories to find peace together. Though unconscious, the ill might still be able to hear. Words of love will never be too late to be spoken.
Caring for people with terminal illness is demanding work. It makes peoploe start to rethink lives as they are witnessing the progress of one.
Therefore, it is also important to invest time into looking after one’s own spiritual wellbeing. Spending time with family and friends, following religious activities to calm the mind, such as mediation or reading and physical activity, are proven ways of spiritual self-care. In times of struggle, it is always helpful to speak to a counsellor, psychologist or a religious figure.
Spiritual distress, also called spiritual pain or suffering, can occur if patients or their families lose meaning or hope in their life. This distress can cause profound effects both physically and mentally.
You may want to start by inviting them to express their feelings. Sometimes it is difficult to discuss spirituality with patients. However, you can always consider using this tool, HOPE, to open the conversation.
Spiritual support
Every family is unique in their spirituality, religion, culture, beliefs and values. Whatever one wishes for the patient’s care, consulting a healthcare team is always a solution. Being aware of different needs, health professionals should be able to help find solutions. Referrals to spiritual care workers can also be offered.
Spiritual care workers are trained professionals who help people work through their feelings spiritually. They are key members of the palliative care team. They can help arrange visits from religious figures such as ministers, priests, rabbis and imams, while educating and supporting others in caring roles by providing culturally sensitive spiritual care. If the patient is religious, possible interventions could include:
If the patient is not religious, possible spiritual interventions might include:
Culture support
Cultural needs differ among people with different backgrounds and education levels. If certain cultural needs are to be fulfilled, it is important to let the palliative care team know. Cultural practices may encompass aspects such as the diet, personal hygiene, clothing, along with special holidays and celebrations.
It is recommended that a professional interpreter be requested regarding important information, if the patient or their family has difficulty understanding English, Mandarin or Cantonese.
The National Council for Palliative Care: Spiritual support
American Society of Clinical Oncology (ASCO): Spiritual support when you have cancer
Canadian Cancer Society: Spirituality
Marie Curie, UK: Providing spiritual care
Special thanks to Dr. Wendy Wing-Lok Chan, Department of Clinical Oncology, the University of Hong Kong, and Dr. Fiona Mei-Ying Lim, Department of Clinical Oncology, Princess Margaret Hospital for authoring and editing this article.
Last updated on 1 Nov 2021.
