Spiritual care needed in every part of aged care for CALD residents
Meaningful ageing is at the heart of quality of life for all Australians wherever they live, whatever their background, birthplace, language and life story, and spirituality is integral to care - whoever is providing and receiving it.
All older people have spiritual needs regardless of faith, beliefs and religion. Unmet spiritual needs may manifest themselves in a range of ways such as depression, anxiety, hopelessness, challenging behaviours and ongoing dissatisfaction.
Both Meaningful Ageing Australia, formerly Pastoral and Spiritual Care of Older Persons (PASCOP), and Spiritual Health Victoria work to assist those who care for older persons, to understand and satisfy these needs.
In 2015 they obtained funding from the Department of Health to develop spiritual care guidelines that were applicable for residential care and home care packages to provide spiritual and support to older people and their families and representatives.
The consultation processes confirmed that that spiritual care is often conflated with religious and pastoral care. This has caused some staff and older people to avoid spirituality altogether, leaving spiritual needs unmet, especially if the older person is from a culturally or linguistically diverse (CALD) background.
The project team saw the need for inclusive language that focuses on meaning, purpose and connectedness as well as overall resilience. However, there are no guidelines developed or used in Australia or internationally regarding best practice in spiritual care specifically for older people.
Consultation included interviews with older people/representatives, focus groups with staff, and industry-wide surveys.
The Guidelines were then piloted in 21 aged care locations across Australia in metropolitan, rural, regional and remote areas, and included small and large organisations and those with a focus on aboriginal, CALD, mental health and GLBTI older people.
“Spirituality and religion are important aspects of everyday life for many older people from CALD backgrounds” the Guidelines state.
“Older people from CALD backgrounds in Australia are not a homogeneous group. They encounter different outcomes based on individual experiences and backgrounds.
“This diversity means that understanding and meeting the needs of Australia’s older people from CALD backgrounds is highly complex, and needs to be informed by research and evidence.
“Research into older people from CALD backgrounds highlights that many have higher levels of disadvantage and other risk factors than older Anglo-Australians, and that these factors may affect their ageing experience in Australia.
“The life course of migrants from CALD backgrounds, including migration circumstances, and the extent to which cultural traditions are maintained, play a role in health and wellbeing for older people from CALD backgrounds.
“Language and cultural issues emerged as a common source of difficulty. The literature identified that older people of refugee backgrounds are particularly vulnerable to physical and mental health issues.
“There is a need for a paradigm shift from religion and spirituality being incorporated mainly at the end of life/palliative care, to being included at all stages of care.
The resulting National Guidelines for Spiritual Care in Aged Care will encourage spiritual care to be provided by a wide range of people including staff, family/representatives, volunteers and health professionals in a way that is meaningful to the person. The way forward shown in the Guidelines is that, rather than being the sole responsibility of the spiritual and pastoral care practitioners, spiritual care can be provided by everyone caring for the older person, and everyone can contribute in some way to addressing the spiritual needs of the individual.
At the heart of the Guidelines are five domains of spiritual care:
1. Organisational leadership and alignment:
Embedding and practising spiritual care at all levels through the organisation;
2. Relationships and connectedness:
Providing care in the context of mutual, respectful and genuine relationships;
3. Identifying and meeting spiritual needs:
Recognising choices, preferences and needs of older people to be identified, documented and shared by the care team;
4. Ethical context of spiritual care:
Ethical framework to ensure spiritual care is offered in a way that respects and upholds the rights of older people; and
5. Enabling spiritual expression:
Individualised activities and interventions to encourage the finding of meaning, purpose, connectedness and hope.
The project supports the World Health Organisation’s view that spirituality is inextricably linked to quality of life and is founded on the principle that spiritual need is intrinsic to humanity and that spiritual care should be universally accessible to all older people in a way that is meaningful to their beliefs, culture and situation.
The new Guidelines will be completed in July 2016 and checklists and assessment templates will be available to download from Meaningful Ageing Australia’s website at: www.meaningfulageing.org.au
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