The Role of Religion and Spirituality in Long Term Care Environment
The Rationale Behind Therapeutic Spiritual Support
Research shows that spirituality is essential to the older adult population and plays a positive role in maintaining health, recovering from or coping with illness, and increasing quality of life 1-2. But the benefits of spiritual support aren’t only for long-term care patients. Spiritual support also increases satisfaction scores, which helps facilities retain existing residents, attract new residents, and receive financial benefits.
The Unmet Need of Residents
Among elderly long-term care residents, only about half of respondents were satisfied with the spiritual care they received. In a recent study from 2020, residents, families, and physicians all highlighted a lack of spiritual support as a major barrier to optimal treatment in long term care facilities. It was noted that existing mental health resources were devoted primarily to dementia and memory care rather than spiritual support critical for people approaching the end of life. Physicians and staff indicated a strong desire to provide spiritual support, but felt hesitant over concerns that they could not appropriately represent multiple faiths. They also cited over-extension and burnout of staff as barriers to providing more spiritual care resources.
These studies show a clear gap between the need for spiritual support in long-term care and the ability of facilities to provide adequate spiritual support to all residents.
What Is Spiritual Support?
Spirituality is loosely defined as an individual dimension dealing with meaning, purpose, values, transcendence, connectedness, and energy. In other words, spirituality encompasses the experiences, beliefs, and practices that connect a person’s sense of self to community and divinity8. Spiritual support involves holistic medicine approaches such as meditation, yoga, and religious activities like prayer and ritual.
Who Provides Spiritual Support?
Residents of long-term care facilities reported receiving spiritual care from several common sources including:
● Family or friends (41%)
● Clergy/chaplains (17%)
● Healthcare providers (29%)
Chaplains are trained professionals who focus on providing spiritual care for individuals in non-religious settings, like the military, prisons, hospitals, and long-term care facilities. Nearly half (48.4%) of elderly-care physicians also provide end-of-life spiritual care to residents. Yet, the most common spiritual care providers in long-term care facilities are not chaplains or medical providers. In many facilities, spiritual care is coordinated by an activity director. In others, no formal spiritual care is provided, and residents rely on friends, family, and volunteers for individual spiritual support.
Time constraints and the variety of individual resident needs make it difficult for facilities staff to prepare spiritual conversations/activities and facilitate them routinely. These challenges have been amplified since the beginning of the COVID-19 pandemic. The need for spiritual support in long-term care facilities has increased. At the same time, the ability of clergy and professional spiritual care providers to be physically present in such facilities and to conduct care has been disrupted. Opportunities to personalize spiritual care using technology like FaithFirst have evolved to fill this need and will remain essential.
What Are the Benefits of Spiritual Support?
Growing older is a universal experience that holds opportunities for growing in confidence and wisdom, but aging also has inherent challenges. Aging adults often face stress, trauma, social disconnection, purposelessness, illness, grief, and loss. Spiritual support is a critical source of resilience for vulnerable older adults as they face life changes like loss, a medical diagnosis, or relocation to a care facility. The necessity of spiritual care is well illustrated by this quote from a long-term care resident:
“My faith helped me survive because I believe God is real. I rely on that belief to get me through. Each time I deal with a major blow, I get better and better at relying on that belief, where I just know it’s going to be okay.”
Spiritual Support in Assisted Living and Memory Care Facilities
In one study, implementing a comprehensive pastoral (spiritual) care program at two retirement communities resulted in increased spiritual awareness and satisfaction for residents. In another study, 62% of residents in a nursing home reported low stress levels after a spiritual care session, compared to only 36% of residents who had a control interaction (not spiritual care).
Spiritual support may be especially important for residents with Alzheimer’s disease who have been shown to rely on teleological explanations and beliefs in a higher power to provide hope and a sense of control in the face of dementia. Participation in spiritual support and religion has even been shown to slow cognitive and behavior decline in dementias.
Spiritual Support at the End of Life
Many organizations in the United States recognize that spiritual support in healthcare is essential, particularly in long-term care and surrounding the end of life. For example, the Medicare Conditions of Participation (CoPs) for hospice care require providers to assess patients’ spiritual needs and offer spiritual support.
A new review in the Journal of the American Medical Association (JAMA) concluded that scientific evidence supports incorporating specialty practitioners and spiritual care into the standard of care for patients with serious illnesses18. In agreement, a survey of the loved ones of residents facing the end of life found that providing spiritual care services regardless of religion or spirituality was a near-universal expectation19.
The top expectations were:
● Comfort and care/emotional support (96%)
● Active listening (96.5%)
● Presence of the spiritual support provider as a reminder of “God’s” presence (93.6%)
● Prayer (96%)
● Scripture reading (69.3%)
● Ritual/anointing of the sick (71.3%)
FaithFirst provides the tools for anyone — including activity coordinators and facility staff, chaplains, volunteers, friends, and family — to meet each of these needs.
FaithFirst: The Ideal Tool for Filling Unmet Spiritual Need
FaithFirst is the largest multi-faith audio & video library providing spiritual and religious support to nurture connection and wellness in healthcare environments. It can help fill the need for spiritual support when chaplains and clergy cannot be present or when a representative of the appropriate faith is not available. The service includes a wide range of audio and visual content, from meditations and music to prayers and sacred texts. It also provides interactive content, including worship opportunities, rituals, education, and spiritual exercises designed to promote healing.
The ever-expanding resources cater to a diversity of beliefs, including Catholic and Protestant Christian faiths, Jewish, Muslim, Buddhist, and Native American traditions, as well as general spirituality. The service provides the tools for staff, chaplains, caregivers, and volunteers to offer spiritual support to individuals and groups in their tradition of choice. The content and programming are created and curated by a team of board-certified chaplains, clergy, academics, and accredited spiritual care providers. Long-term care administrators can feel confident that they are delivering high-quality, vetted content that positively impacts the lives of their residents, staff, and extended families.
Conclusion
Spiritual support helps residents find meaning and purpose and cope with illness, pain, suffering, and death. Furthermore, the FaithFirst offering allows residents to connect to their tradition of choice and to find peace, comfort, acceptance, and community.
Despite the known benefits, spiritual support is often limited in long-term care facilities. Evidence shows that many long-term care residents do not receive spiritual support that meets their needs. The COVID-19 pandemic has hindered the ability of chaplains and other spiritual support providers to work in these facilities. Facilities staff and volunteers are frequently asked to provide spiritual support but are hampered by a lack of time and expertise to prepare and deliver such care.
FaithFirst allows anyone to assess the spiritual needs of residents and plan, schedule, and facilitate proven plug-and-play spiritual care programs — with minimal time investment or experience in spiritual care. The FaithFirst offering provides the tools for family members, caregivers, activity directors, facility staff, and chaplains to spark intentional practices and conversations on an individual or group level, providing much-needed spiritual support to residents anywhere and anytime.