Integration of spiritual care into palliative care service delivery models

Abstract

Addressing spirituality within serious illness is a core dimension of palliative care delivery. However, spiritual care frequently lacks integration within the care of patients and families facing serious illness. This chapter discusses the integration of spiritual care into palliative care delivery. Requisite to this integration is a clear understanding of definitions and palliative care guidelines informing spiritual care provision. Furthermore, integration is informed and motivated by a large body of evidence showing how spiritual and religious factors frequently play salient roles in serious illness and influence palliative care outcomes. The integration of spiritual care into palliative care practice relies on a generalist–specialist model, within which all members of the interdisciplinary palliative care team are responsible for spiritual care provision. Non-spiritual care specialist members of the palliative care team are responsible for generalist spiritual care delivery, including taking spiritual histories and screening for spiritual needs. The care team also includes spiritual care specialists, typically board-certified chaplains, who provide in-depth spiritual care delivery to patients and families and aid the care team in understanding the spiritual and religious dimensions of care. Additionally, data regarding tested spiritual care interventions are discussed as potential tools palliative care teams can employ to improve patient care and outcomes. Finally, the integration of spiritual care into palliative care teams presents both opportunities and challenges that must be considered as efforts needed to foster more seamless spiritual care delivery within palliative care.

Spiritual Care as a Core Component of Palliative Nursing

“…A unique generalist–specialist spiritual care model has been proposed, where all palliative care providers serve as spiritual care generalists 7. In this model, palliative care team members have a responsibility to recognize their limits and refer patients to specialist spiritual care team members when needed, typically board-certified chaplains 7.…”

“…A unique generalist–specialist spiritual care model has been proposed, where all palliative care providers serve as spiritual care generalists 7. In this model, palliative care team members have a responsibility to recognize their limits and refer patients to specialist spiritual care team members when needed, typically board-certified chaplains 7. Specific generalist spiritual care competencies have been proposed based on the 2009 Spiritual Care Consensus Conference19 and the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care 6.…”

“…Every nurse is tasked with being a spiritual care generalist-providing comfort and care to support the spiritual life and well-being of patients. 6 Although evidence supports addressing spirituality as part of holistic palliative care nursing, [6][7][8] we need to be watchful that spiritual care doesn't become another item on our to-do list, but rather is practiced as an embodied way of being, that is, as a part of our daily life and our moment-to-moment nursing activities.…”

“…7 In this model, palliative care team members have a responsibility to recognize their limits and refer patients to specialist spiritual care team members when needed, typically board-certified chaplains. 7 Specific generalist spiritual care competencies have been proposed based on the 2009 Spiritual Care Consensus Conference 19 and the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care. 6 These competencies, compiled by Beaussant and colleagues, 7 Notably, the NCHPC guidelines also highlight the importance of nurses tending to our sense of spirituality as part of our professional role, 8 acknowledging the reality that self-care and self-knowledge are necessary when providing authentic, high-quality palliative nursing care.…”

“…Specific generalist spiritual care competencies have been proposed based on the 2009 Spiritual Care Consensus Conference19 and the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care 6. These competencies, compiled by Beaussant and colleagues,7 include the following:…”