INTRODUCTION TO

SPIRITUAL CARE

Rev Heather Leppard

 AIMS OF THIS SESSION

• To explore together our understanding of spirituality,

religion and belief
• To reflect on how we can offer Spiritual Care to patients
• To provide you with information and guidance for caring
for patients from a variety of different religious and cultural
backgrounds
• To be aware of Chaplaincy services in the NHS
 WHY DOES SPIRITUAL CARE MATTER?

‘Cultural, spiritual and religious beliefs and practices can impact on health behaviours and
practices, health outcomes, use of and access to healthcare, and decision-making regarding
medical treatment.’
- Culture, spirituality and religion: migrant health guide
https://www.gov.uk/guidance/culture-spirituality-and-religion

‘Research suggests that attention to the religious and cultural needs of patients and
service users can contribute to their wellbeing and, for instance, reduce their length of
stay in hospital. Religion and belief are therefore important considerations for all patients
and staff.’
- Religion or belief: A practical guide for the NHS 2009
SPIRITUALITY & RELIGION
 Discussion

What does the word ‘Spirituality’ mean to you?

 Central features of spirituality

1. Meaning (finding purpose, making sense of life)

2. Value (related to beliefs, truths, worth)
3. Transcendence (dimension beyond self)
4. Connecting (self, others, God, environment)
5. Becoming (reflection, experience, discovering who we are)

1. (based on Martsolf and Mickley, 1998)

 DISCUSSION

What is the difference between spirituality and

religion?
How do they link to each other?
 RELIGION IN THE UK

The 9 world faith groups that comprise the Healthcare

Chaplaincy Faith and Belief Group are:

Bahai Muslim Jewish

Buddhist Hindu Pagan
Christian Jain Sikh

The British Humanist Association attend as observers.

SPIRITUAL CARE
 SPIRITUAL CARE

Spiritual care is care provided in the context of illness which

addresses the expressed spiritual, pastoral and religious
needs of patients, staff and service users.

It is important to note that people who do not hold a

particular religious affiliation may still require pastoral
support in times of crisis.

Nhs Chaplaincy Guidelines 2015 (accessed April 2023)

https://www.england.nhs.uk/wp-content/uploads/2015/03/nhs-chaplaincy-guidelines-2015.pdf
 SPIRITUAL CARE

“It means being open to help in whatever way we can in a

dying person’s search for meaning in their lives, for their
most important inner values, and as they look beyond
themselves for what they see as true. I think that is the
spiritual area, the spiritual need… That is what we are about:
to find meaning and self-worth.Very essentially, listen to your
patients. They will tell you what they need.”
Dame Cicely Saunders, founder of St Christopher’s Hospice
in London and pioneer of the modern hospice movement
 SPIRITUAL CARE

Nhs Chaplaincy Guidelines 2015 (accessed April 2023)

https://www.england.nhs.uk/wp-content/uploads/2015/03/nhs-chaplaincy-guidelines-2015.pdf
 SPIRITUAL CARE

“Spirituality I take to be concerned with those qualities of

the human spirit - such as love and compassion, patience,
tolerance, forgiveness, contentment, a sense of responsibility,
a sense of harmony - which bring happiness to both self and
others.”
Dalai Lama
 SPIRITUAL CARE

“In one sense, I don’t think there is such a thing as spiritual

care. There is just care of whole persons... I begin by
listening. If you are able and prepared and can listen, people
will show you their spirituality.”
Dr. Ira Byock, palliative care physician and author of Dying
Well
 WHO’S RESPONSIBLE?

Medical staff are usually focused on the interventions that

they are trained in, and often pressed for time but they do
have a responsibility to address patients’ needs holistically.

Chaplains are the experts, but anyone involved in a patient’s

care can ask pertinent questions and offer the gift of
presence and supportive listening.

Stephen A. Spates et. al., ‘Exploring Challenges of Hospital Chaplains in Transdisciplinary Teams’. Frontiers in
Communication, 11th December 2020. DOI: https://doi.org/10.3389/fcomm.2020.582626 Retrieved in
November 2022 from: https://www.frontiersin.org/articles/10.3389/fcomm.2020.582626/full
 PROVIDING SPIRITUAL CARE

The best spiritual care is when there is a connection

between two people. It doesn’t matter whether you have had
in depth theological training, it’s about connection, and
making sure the person in front of you feels seen and heard.
 HAVING SPIRITUAL CONVERSATIONS

If you were in hospital today, what kind of spiritual care

would you want?
Would you know how to ask for it?
 HAVING SPIRITUAL CONVERSATIONS

Spiritual conversations often come up once a good rapport has been

formed and the person in front of you trusts that you will listen well to
them.
The cues you might like to pick up on include:
● What gives meaning to their life
● What do they enjoy
● What makes them feel alive
● What community groups are they part of
● Who do they trust to speak to
● What keeps them going in difficult times
 HAVING SPIRITUAL CONVERSATIONS

What would good spiritual care look like?

What would bad spiritual care look like?
Can you think of examples of good or bad spiritual
care?
RELIGIOUS CONSIDERATIONS
 KEY CONSIDERATIONS

• Diet • Visiting Faith Leaders/Clergy

• Modesty • Chaplaincy Support
• Beginning of Life • Naming Systems
• Palliative Care • Hygiene
• End of Life Concerns • Sexuality
• Concerns with Certain • Festivals and Religious
Drugs and Treatments Observance
• Organ/Tissue Donation ‘Religion and Cultural Beliefs’ Blackpool Teaching Hospitals NHS
https://www.bfwh.nhs.uk/wp-content/uploads/2015/07/CORP-GUID-027-
Religious-and-Cultural-Guideline-Aug16.pdf Accessed April 2023
 FESTIVALS AND RELIGIOUS
OBSERVATIONS

‘It is important to recognise that different faiths have

different religious and holy days. These vary from faith to
faith and aren’t always set dates each year. It is important to
be aware of these festivals and holy days by referring to
something like a Faith Calendar or by accessing the BBC
Faith website.’

‘Religion and Cultural Beliefs’ Blackpool Teaching Hospitals NHS

https://www.bfwh.nhs.uk/wp-content/uploads/2015/07/CORP-GUID-027-Religious
-and-Cultural-Guideline-Aug16.pdf Accessed February 2024
 MODESTY

Modesty in dress and a requirement to be treated by a doctor /

nurse of the same sex is also important in some religions. NHS
staff should consider these requirements in order to preserve the
dignity of the patient. However, it is not always possible or feasible
to provide same-sex attendance, particularly without adequate
notice that this might be an issue, and this should be made clear
at the time of making appointments.

‘Religion and Cultural Beliefs’ Blackpool Teaching Hospitals NHS

https://www.bfwh.nhs.uk/wp-content/uploads/2015/07/CORP-GUID-027-Religious
-and-Cultural-Guideline-Aug16.pdf Accessed February 2024
 NAMING SYSTEMS

Ways of naming individuals and families vary around the world therefore:
- Do not presume that someone’s name follows a pattern of First
name- Family Name
- Do not ‘alter’ someone’s name or give a nickname to get round
pronunciation difficulties unless they specifically ask you to do this.
- In some cultures, formality is valued and familiar names are not used
lightly.
- Some names have great personal or cultural significance or value.
- Note that some people have adopted their name to match European
models, but this may not be how relatives know them.
 ASK

“The individual is the expert when

it comes to their culture, religion or spirituality.”
It is important never to make assumptions about another
person’s cultural or religious views or requirements:
PLEASE ASK THEM FIRST.

Religion and Cultural Beliefs’ Blackpool Teaching Hospitals NHS

https://www.bfwh.nhs.uk/wp-content/uploads/2015/07/CORP-GUID-027-Religious-and-Cultu
ral-Guideline-Aug16.pdf Accessed April 2023
CHAPLAINCY
 CHAPLAINCY

From NHS Chaplaincy Guidelines:

“Wherever possible, patients should have access to a

chaplain of their religion or belief to ensure appropriate
pastoral, spiritual or religious care.”
“It is important to note that people who do not hold a
particular religious affiliation may still require pastoral
support in times of crisis.”
NHS England. ‘NHS Chaplaincy Guidelines 2015: Promoting Excellence in Pastoral, Spiritual & Religious
Care’. Retrieved in April 2023 from:
https://www.england.nhs.uk/wp-content/uploads/2015/03/nhs-chaplaincy-guidelines-2015.pdf
 CHAPLAINCY

DISCUSSION

What do you know about Chaplaincy?

 WHO ARE HEALTHCARE CHAPLAINS?

• Accredited by a faith community

• Often formally trained in healthcare chaplaincy (not
always)
• There are some volunteers who are “honorary
chaplains”, but they are required to have equivalent
qualification / accreditation as their staff counterparts

NHS England. ‘NHS Chaplaincy Guidelines 2015: Promoting Excellence in Pastoral, Spiritual & Religious
Care’. Retrieved in April 2023 from:
https://www.england.nhs.uk/wp-content/uploads/2015/03/nhs-chaplaincy-guidelines-2015.pdf
 CHAPLAINS PARTICIPATE IN HEALING

“Healing has to do with opening up the experience of pain,

illness, suffering and loss and enabling people to find
themselves and their communities in the midst of such
experiences. In so doing people can begin to move towards
spiritual health: a type of health that may desire cure, but is
not defined by it.”
● Spiritual health and physical or mental health are
interlinked.
John Swinton and Ewan Kelly, ‘Contextual Issues: Health and Healing’ in Christopher Swift et.
al., A Handbook of Chaplaincy Studies. Routledge, London. 2016.
 SPIRITUAL SUPPORT

Spiritual interventions that make up spiritual support

can come in many forms, such as:
● listening to someone who feels life has lost all
meaning, is expressing doubts about their faith, or
would value space to share their hopes.
● referral to a chaplain or dedicated spiritual care
provider, counsellor, psychologist or therapist, or
where appropriate a spiritual leader in the
community
 I NEED A CHAPLAIN!

For a patient
It may be that they could benefit from speaking with a chaplain. There
may also be certain religious rites in any religion where the patient needs
to see someone from their faith community e.g. in Christianity, Anointing
of the Sick or Emergency Baptism

For yourself
There may be patients whose beliefs and spirituality challenges you,
because it chimes with your experience or unsettles something in you.
Chaplains can help you explore these feelings and reflect on them.
Chaplains are there as much for you as for the patients, so do use them!
 CONSENT

Data concerning religious or philosophical beliefs, are a class of

“special category data.”

Consent to share a patient’s data (including basic information of

name and location in hospital) with the chaplaincy must be freely
given, informed and specific.

Consent should be recorded. Consent may be withdrawn at any

time.

Information Governance: NHS Chaplaincy and Non-Religious Pastoral Support (accessed April 2023)
https://www.england.nhs.uk/wp-content/uploads/2019/03/nhs-chaplaincy-information-governance-guida
nce-march-2019.pdf
 SPIRITUAL DISTRESS

Spiritual distress refers to a person’s “impaired ability to

experience and integrate meaning and purpose in life
through connectedness with self, other, art, music, literature,
nature, and/or power greater than oneself.”

Christina Puchalski and Betty Ferrell, Making Health Care Whole: Integrating Spirituality into
Patient Care. Templeton:Pennsylvania. 2010.
 SPIRITUAL DISTRESS

Existential concerns involve questions of meaning such

as:
● Why is this happening to me?
● What is my purpose?
● What is the meaning of my suffering?
Joy Freeman, ‘Recognising Spiritual Distress’. Blog post published on True North, 22/10/2019.
Last accessed October 2024, from: https://www.nkch.org/blog/recognizing-spiritual-distress
 SPIRITUAL DISTRESS

Not all difficult emotions are spiritual distress.

Culturally we may find ourselves increasingly encouraged to

resist negativity, and to view periods of difficulty as potential
or active illness.

However, all religious traditions I'm aware of have some way

to have a healthy spiritual relationship with sadness and
crisis.
 REFLECTION

• What do you think patients know about the services

available to meet their religious and spiritual needs?

• What barriers might people face to accessing spiritual

care?

• How can you help them?

 KEY DOCUMENTS

• Government UK: Culture, spirituality and religion: migrant health guide

https://www.gov.uk/guidance/culture-spirituality-and-religion
• A Concise Guide to the Customs of Religious Culture and Practice:
https://www.yorkhospitals.nhs.uk/seecmsfile/?id=597

• NHS England, 2023. ‘NHS Chaplaincy - guidelines for NHS manages on

pastoral, spiritual and religious care’.
https://www.england.nhs.uk/long-read/nhs-chaplaincy-guidelines-for-nhs-manag
ers-on-pastoral-spiritual-and-religious-care/