Spiritual Care in Advanced Dementia from the Perspective of Health Providers: A Qualitative Systematic Review

Abstract

Background. Worldwide, 47 million people suffer from dementia. Despite recognizing the importance of spirituality within dementia care, it is still unclear how this should be integrated into dementia services. Aim. To explore the perspective of health professionals regarding the spiritual care of people with advanced dementia. Methods. A qualitative systematic review was performed following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines for the study design. The inclusion criteria included original articles published from January 2008 to March 2019, using either qualitative or mixed methods. The quality of the articles included was evaluated using the consolidated criteria for reporting qualitative research, Standards for Reporting Qualitative Research, and the Critical Appraisal Skills Programme. Synthesis of findings was performed using thematic analysis. Results. Twelve studies were included in the review. Seventeen categories were identified, grouped into four themes: (1) the perception of spirituality, including the failure to address the same, (2) the spiritual needs of people with advanced dementia, (3) spiritual needs from health care providers, and (4) addressing spirituality, with the following categories: music, significant activities, among others. Conclusions. Spirituality is not formally addressed in this population, and professionals do not feel confident enough to be able to integrate spirituality in their care. It is necessary to identify and record the spiritual needs of people with advanced dementia, as well as to design specific care programs.

Spiritual Needs of Older Adults Living with Dementia: An Integrative Review

“…Health-related barriers included behavioral expressions and incontinence of PLwDs, which inhibited staff from taking them to religious and spiritual activities. These barriers are not new but are also reported in other spiritual care provision articles [4,21,68,69].…”

“…In addition, caregivers of PLwDs often carry out multiple tasks while caring for their care recipients. Therefore, some essential aspects of care, such as spiritual needs, can be easily overlooked [3] or difficult to identify [4,5], especially in the later stage of dementia.…”

“…Defined by an international consensus conference to coin an agreed-upon definition for spirituality through a Delphi study [15], spirituality is the way in which a person seeks and expresses meaning and purpose and experiences connectedness to the moment, self, others, nature, and the significant or sacred; spirituality is expressed through beliefs, practices, values, and traditions. Persons facing advanced illness have increased spiritual needs requiring spiritual care [4,16], a dimension of palliative care [17]. Spiritual care and support are often reported as the most neglected dimension [18,19].…”

Proficiency and Practices of Nursing Professionals in Meeting Patients’ Spiritual Needs within Palliative Care Services: A Nationwide, Cross-Sectional Study

“…All dimensions of a person must be taken into account in patient care; however, in palliative care patients, spiritual needs often take centre stage [26,27]. Spirituality is expressed in values, beliefs, and traditions and involves the pursuit and expression of meaning and purpose as well as a sense of connectedness to oneself, others, nature, or something that is meaningful or sacred to the individual [28].…”

Spiritual care in the dementia ward during a pandemic

“…In conclusion, I would like to reaffirm that caring for human being’s spiritual lives is important if they are to flourish; this applies to all human beings, whatever their cognitive abilities. A qualitative systematic review conducted in 2021 [ 19 ] concluded that spirituality is still not formally addressed in elderly populations affected by dementia. Professionals still do not feel confident to integrate spirituality into their care.…”