Case study:

24 July 2008

Addressing the spiritual needs of individuals nearing the end of life in St Michael's Hospice, Hereford

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Key points

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St Michael’s Hospice in Hereford has developed a spiritual needs assessment tool after discovering that the concerns of those nearing the end of life are not always being catered for.

Staff can be inclined to skirt around people’s spiritual needs because of the supposed close association with religion, not recognising that all individuals may have spiritual needs of one sort or another.

These may relate to issues such as regret about what has happened in the past and whether life now has meaning, value and purpose.

With this in mind the hospice decided to produce an assessment tool, based on other similar tools and their own experience, which includes open questions about support systems and beliefs and how they may have been changed or challenged because of their illness.

The tool covers three main areas – issues of sense, meaning and purpose; individual practice; and spiritual or religious connections.

They include questions such as:

When life is hard how have you kept going?

Is there anyone or anything that has helped you keep going?; and

How are you coping with what’s happening to you?

Once the beliefs, concerns or worries have been identified, support is offered – to both the individual and carers where appropriate.

Trained volunteers in the spiritual care team provide this support throughout the patient’s journey, if appropriate.

It can include assistance with funeral arrangements, working through questions of belief and supporting families as they come to terms with loss.

To help overcome staff concerns, information is available which lays out clearly the rituals around death and ensures these are respected.

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