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Most healthcare professionals receive little to no training on spiritual care, and patients may see their own faith concerns as irrelevant to their clinical health. In hospice, however, spiritual care is a key part of our patient-centric care model.

At VITAS Healthcare, an interdisciplinary approach to care addresses patients’ clinical, psychosocial, and spiritual needs, offering an improved experience for patient and family.
 
Recognizing spiritual pain
Just as the physiological symptoms associated with advanced illness vary according to specific pathology, the spiritual pain of dying will manifest differently depending on a patient’s personal beliefs, life experiences, and their own ability to grapple with questions that may not have knowable answers.
 
Unlike physical pain, which can be mapped to a nervous response, spiritual pain manifests in the mind and soul, typically in the form of an unwelcome and persistent thought or fear. Across all faiths and even among individuals who eschew spirituality, certain concerns are common to the end-of-life experience:
• “Why am I dying?”
• “What will death be like? Is there something on the other side?”
• “Will my loved ones be OK without me?”
• “Can I be forgiven for my deeds? Is there time to reconcile my personal conflicts?”
• “Have I been faithful/religious enough?”
• “Has my life had meaning and worth?”
 
These questions are undoubtedly daunting and not necessarily unique to terminal patients: Seriously ill individuals with less definite prognoses may face variants of these concerns. Providing good spiritual care does not mean giving answers; mostly, it means listening, learning, and being present.
 
Helping patients find their truth
Every VITAS hospice team features a chaplain trained in pastoral care to help patients and their loved ones address spiritual issues at the end of life. Hospice chaplains’ faith need not necessarily match that of their patients; spiritual care does not require encyclopedic knowledge of a particular theology.
 
Instead, chaplains help patients find comfort in their own spiritual truth. They sit with patients and their families, listen to their fears and understand their needs, and encourage them to express themselves. They invite questions, facilitate discussions, and always ensure the patient knows they are being heard.
 
Sometimes, that means sharing periods of silence with patients as they work out their thoughts or feelings. For others, it might involve a poem, prayer, or a simple reflection on good times. When a patient requests a faith-specific ritual or reading from their preferred holy text, chaplains can arrange for that—but a chaplain never imposes his or her own beliefs or ideology on a patient.
 
To provide effective spiritual care, one must think like a counselor, not a cleric. While chaplains are trained in specific pastoral care approaches, any patient-facing professional can listen attentively and empathically without judgement, when a patient brings forth issues related to faith or spirituality.
 
Spirituality in bereavement support
In hospice, the need for spiritual care extends beyond the patient’s death. Bereavement support often features a spiritual component, helping survivors grapple with many of the same questions their loved one once held, but from a different perspective.
• Why did my loved one get sick and die?
• Are they at peace?
• Did I do enough to prevent their illness or death?
• I have regrets about what did or did not happen in our relationship.
 
Grief is an intensely personal experience and rarely abides by ideals pertaining to its “appropriate” duration or form of expression. Hospice professionals see grief as a natural and healthy response to loss; the support we offer the bereaved aims to help them process it before it develops into “complicated grief,” a more consuming and behaviorally arresting form of bereavement.
 
At VITAS, we offer grief and bereavement support to patients’ loved ones for at least 13 months after a death. This may involve one-on-one phone, video, or in-person visits, support groups, memorial events, and referral to any needed community resources, all provided by trained bereavement specialists.
 
Because the holiday season can exacerbate a grief response as the mourner attempts to cope without their loved one, VITAS is offering a free holiday bereavement memorial event via Zoom on December 12. Register at VITAS.com/Events.
 
VITAS also offers ongoing remote support groups. If you or your patients could benefit from some extra support this holiday season—or any time of the year—learn more and sign up at VITAS.com/SupportGroups.