The Centers for Medicare and Medicaid Services (CMS) require spiritual counseling / services be available to the patient and their family. This service is of utmost importance for those dealing with the stress of a terminal prognosis, related conditions, and ultimately, death. Thinking and speaking about death is often hard and uncomfortable. A spiritual assessment is completed as part of the initial comprehensive assessment within 5 days of electing to receive the hospice benefit. Spirituality is often confused with a religious affiliation. A spiritual assessment goes beyond asking a person’s religious preference. Open conversations with the patient and family are necessary to determine what they need and what they want.  Spiritual support is provided according to patient and family preferences, values, beliefs and needs. Quality Hospice Care’s chaplain collaborates with members of the Interdisciplinary Team (IDT) to develop a plan of care specific to the individual patient and family. This plan of care is re-evaluated and updated, if needed, at least every 15 days. Spiritual care is unique to each patient. Quality Hospice Care offers each patient the opportunity to receive whatever spiritual support or comfort they desire as they approach end-of-life.  Our goal is for our patients and their families to know that they are not alone. Someone is nearby to listen to their thoughts and worries.

The Spiritual Care Assessment is at the core of planning the spiritual care for the patient and family. Identifying the supportive assistance is vital to planning the care. The patient’s supportive assistance frequently includes family, friends, community organizations and religious organizations. Spiritual strengths are also identified. These strengths often include:

  • involvement in religious groups
  • acceptance of prognosis
  • personal faith experience
  • sense of purpose in life
  • available spiritual support

Spiritual issues are also identified. Issues that are commonly found are:

  • concern with death/dying
  • spiritual questioning
  • shame/guilt/unfinished business
  • feeling of abandonment/isolation/withdrawal/depression/anger
  • perception of illness as punishment

Once the spiritual strengths and issues are identified the focus becomes on interventions. These often include visits with the patient to:

  • build a relationship of trust and support/provide a safe space
  • provide ritual service
  • read/pray with patient
  • enable life review/mending relationships
  • allow the patient to express their feelings and openly communicate their feelings
  • allow the patient to feel more connected to the religious/spiritual community

As I was writing this month’s blog I went back and re-read the first blog of “Did You Know” posted in July 2023 regarding the history of hospice. It was then that I realized spirituality has been a part of hospice since its beginning. Many experts believe the first hospices were started to provide refuge to weary travelers that were searching for spiritual renewal as they travelled to and from the Holy Land. These travelers often became ill on their journey and needed a refuge to receive care and often a place to die.

I want to thank you for reading Quality Hospice Care’s “Did You Know” blogs. Next month I plan to write about our Bereavement Program which begins at the death of a hospice patient.