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I am working towards my degree in Psychology to complement my prior degree in Biology with the goal of being certified as an End of Life Doula. I will function as the primary non-medical support person for the patient in whatever they, and their family or support system, need. This will encompass emotional, physical, social support or what other help they need during the dying process.
In light of my future plans I have selected to discuss the Spiritual dimension.
From my prior experiences with Hospice over the last 25 years I have seen where people who are in the dying process no longer care much about Finance, Occupation or Intellectual dimensions. Even their Environmental, Social, Physical and Emotional interests move out of the foreground of their thoughts. Not to say that they don’t, at some point during their Hospice stay, seek to put their affairs in order, have final conversations or amends as they feel proper. But, the majority of people become more focused on the spiritual in whatever way they understand that as part of their preparations to transition from this existence.
Spirituality can be seen as the most intimate of the dimensions. When people are children they often are aware of whatever spiritual discipline their primary caregivers observe. As we become adolescents it is natural to explore other ways of thinking and belief as a way to test for ourselves what resonates with us personally. This can cause issues in families for whom the observance of a specific belief system is seen as something just to be accepted and not questioned at all. An individual’s journey along the Spiritual dimension can cause them emotional or mental distress, aside from the stress of falling out with their family unit, when what they had been taught through out childhood and adolescence is no longer a belief system they can say with integrity as an adult that they can support. For many this change is how they express their beliefs can also cause Social isolation if their former community is not willing to allow a different viewpoint to co-exist. However, I believe that having a belief system of faith, spirit or consciousness is important as part of the overall well being for each person. By taking time to thoughfully read, discuss and meditate upon relevant writings, spending time with others who have adopted your new faith years earlier and can be mentors, and finally by allowing yourself to be gentle with your home environment in not forcing them to accept this change in an instant – then a person can define for themselves what they believe.
When we look back on world history there are countless examples of how faiths and belief systems have wreaked havoc, and brought positive change, to societies and peoples. Change is not always a negative thing – Scientific advances, Social awareness along with Art, Music and Literature all evolve and grow within a variety of changes. Often simultaneously. And it is not always fair or just as we understand those concepts in today’s mindset, but they all have molded the world we currently know and reside in.
I know that for myself, when I feel spiritually grounded and in harmony with my community, and connected to my purpose while living in a way that does not compromise my beliefs or ethics – then I am a much happer person. More at peace and feel able to give to others from a place of plentry. Giving to others is very difficult when you feel your spititual tank is running on fumes. This feeling calm and centeredness is what I hope will make me an effective EOL Doula and advocate for my patients. When Hospice first became an optiuon in the United States, the dying process had been commandeered by the Medical profession which seemed to view death as an insult to doctors personally. As if the death of a patient under any circumstances was a personal smear on their character and abilities – even those patients for whom there were no treatment options, only pallative care.
Andreas Walker’s 2017 article highlights how these views have begun to change. Granted, the change has been more embraced in Europe where Hospice began, but it is moving into the awareness of American doctors, especially those who work with terminal and life-threatening disease states. The article not only states clearly that spiritual support does not have to be linked to a religion but can be viewed, as I stated earlier, as an overall belief system in what a person’s purpose in this life is, how they fit within the overall context of country, planet, universe and their beliefs about what occurs after the physical body stops functioning. Medical personnel do not necessarily need to pray with a patient or their family, although if this is acceptable to all parties it is an option. Supporting the Hospice patient’s Spiritual well-being is to acknowledge their beliefs, honor their wishes for care and intervention within that belief as long as ethics or laws are not violated, and sometimes just be in each other’s precense for a while.
During interviews with various Hospice personnel the researchers found that there are as varied an understanding of Spiritual well-being as there were participants. Even among those who identified with a specific belief system in common, such as Buddism, there were nuances in how they defined it. What they did have in common was a common goal of helping a patient overcome any fear they may have about the dying process, and to understand and accept what was happening to their physical body. They concluded that by ignoring this dimension of a person, their passing could be more distressing for everyone involved.
SOURCES
Eight Dimensions of Wellness | SAMHSA - Substance Abuse and Mental Health Services Administration. (2017). Samhsa.gov. Retrieved 6 November 2017, from https://www.samhsa.gov/wellness-initiative/eight-dimensions-wellness
Walker, A., Breitsameter, C. (25 Apr 2017). The Provision of Spiritual Care in Hospices: A Study in Four Hospices in North Rhine-Westphalia. Journal of Religion and Health. 56(6): 2237-2250. doi: 10.1007/s10943-017-0396-y
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