pallia spiritual and cultural considerations

February 8, 2012

M. Bunao

Spiritual & cultural considerations

1. Spirituality- our relationships with ourselves , others nature and the transcendent

2. Religion- an organization that has a set of rites, rules, practices, values, & beliefs that prescribe how individuals should live their lives & respond to God

3. Spiritual care- allowing our humanity to touch another’s by providing presence, deep listening & compassion

4. Compassion- the ability to be empathetically present to another while he or she is suffering and is trying to find meaning

5. Existential- relating to human existence and experience

Chronically cool families- a parent to parent support group for families dealing with chronic illness

Questions requiring chaplain referral:

What have I done to deserve this?

I pray but I’m still sick

I used to believe in God, but now I’m not so sure

How will my family get along without me?

What did my life mean?

I’m scared

Spiritual interventions

- Compassionate presence & listening deeply- Bearing witness- Compassion at work

Spiritual care questions:

Are you scared?

What makes life worth living?

Is there anything you haven’t done that you need to do?

What do you hope for?

What are you most afraid of?

Is there anything worse than death?

What are you most proud of in your life?

Do you have regrets?

Spiritual needs in death & bereavement

- 3 most important things to remember when providing spiritual care for those who are immediately dying

o Don’t waito Intently watch & listeno Trust your instincts

Spirituality as meaning: what gives you meaning in life?

Culture competence- unconscious tendency to assume that one’s own worldview is superior that of others

- Assessing the pt. And family’s beliefs about illness and treatments

- Conveying respect, such as saying: I am unfamiliar with your culture. Please help me understand why you think you got sick & what you think will make you better

- Soliciting the pt & family as teachers & guides regarding cultural practices

- Asking about the pt’s personal preferences & avoiding expectations from any individual to represent his or her whole culture

- Respecting cultural differences regarding personal space & tones, such as requesting “Whom do I ask for permission to examine you?”, “May I touch you here?”

- Determining needs & desires regarding health related information, such as asking, “When I have information to tell you, how much detail do you want to know & to whom do I give it?”

- Noting and offering the use of complementary & integrative health care practices

- Incorporating the pt’s cultural healing practices into the plan of care

- Responding to resistance from the pt & family about the recommended treatment plan with understanding

- Negotiation & compromise- Being sensitive

Useful cultural assessment questions:

- How do you describe your condition?- How have you treated your condition?- Who else, if anyone, do you want to know

about your condition?- Who is responsible for your health care

decisions?- Are you spiritual or religious?- Where were you born & raised?- What do you want to know about your medical

condition/illness?- Who else, if anyone, should we talk to about

your condition, treatment options, and the disease process?

- Who are important people in your community?- What do you fear most about your condition,

and its treatment?- Are there any important rituals?