Spirituality/Medicine Interface Project

Spirituality and Care at the End of Life

Authors: Keith G. Meador, MD, ThM, MPH

Abstract

The role of spirituality in healthcare is an active and ongoing conversation with varied perspectives represented within the medical community. Whatever perspective one might bring to the conversation regarding spirituality and medicine in general, the particular relevance of spirituality for many patients at the end of life compels us to a focused consideration of this issue. Many persons who might otherwise have ambivalence regarding the place of spirituality in their lives have a heightened sense of concern regarding spiritual concerns when faced with a life–limiting illness. Idler and colleagues note the importance of religion in the lives of frail elderly in a community sample of elders.1 While allowing for a decline in religious service attendance secondary to poorer health, the importance of religion and the significance of religious coping persisted into the later months of life. The importance of spirituality and religion for elderly frail and dying persons in the community challenges healthcare providers to include sensitivity to the spiritual lives of their seriously ill patients in the clinical care context.

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References

1. Idler EL, Kasl SV, Hays JC. Patterns of religious practice and belief in the last year of life. J Gerontol B Psychol Sci Soc Sci 2001;56:S326–S334.
 
2. Steinhauser KE, Voils CI, Clipp EC, et al. “Are you at peace?”: one item to probe spiritual concerns at the end of life. Arch Intern Med 2006;166:101–105.
 
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5. Hanson LC, Tulsky JA, Danis M. Can clinical interventions change care at the end of life? Ann Intern Med 1997;126:381–388.