Saturday, October 13, 2018

Spiritual Rituals within the Long-Term Care Community


Author:   D. Eargle, Ph.D., M.Ed.   2018

Spiritual Rituals within the Long-Term Care Community


“wanting to finish my living…”

 Many Chaplains and Spiritual Care Practitioners offer their belief that long-term care facilities should be in the business of helping elder residents finish-their-living, while also creating a strong community presence.  They go further in arguing that spiritual care must be an integral part of the facility’s service programs, with spiritual assessment and care planning being as essential as nutrition, physical therapy, and nursing care plans. 

 Familiar religious rituals should be anticipated and regularly scheduled throughout the year.  All residents, regardless of their health status, should be encouraged to play meaningful roles in spiritual practice. 

While it is beyond the scope of this blog, I wish to share several methods effectively used by practitioners in their spiritual practice with long-term care residents.

Forgiveness, Guided Reminiscence, and Life Review

“seeking forgiveness…”

An important question posed to Pastoral Counselors and Spiritual Care Providers: “What is the biggest need motivating older adults to seek spiritual guidance?”  Resoundingly, the answer went something like this… healing old wounds of troubled relationships, resentments, anger, regrets, forgiving Self, forgiving Others. (Ramsey, 2008).

On an interesting side note: as a scientific field of research, forgiveness has had a brief history.  Since the 1980s, however, it has become a major topic in medicine, psychology, and theology.

According to Ramsey, a family therapist, all forgiveness work includes a life story.  Moving forward in life is perhaps best facilitated for struggling older adults when a spiritual guide helps the person search for exceptions, imagine new and more hopeful endings, and begin to assume more flexible, empowering roles rather than the passive suffering of victimhood (Ramsey, 2008).

Reminiscence & Life Review:

Depending upon the individual, guided reminiscence may take different forms and serve various adaptive functions, e.g., recalling the “good old days,” reinforcing one’s positive self-image & abilities, and entertaining others via story telling.  Some reminiscing, however, may serve the purpose of a life review, often in preparation for death.  Pressing topics typically include resolving issues of the past, seeking forgiveness, leaving a legacy, and completing one’s “unfinished business.”

Ramsey counsels Spiritual Care Providers to help elders use this life review as an impetus to evaluate, make peace with, and give thanks for what has been.  She goes further in encouraging elders to become spiritual mentors to young adults, a life stage that is also often filled with struggles, conflicts, fears, and lack of meaning (Ramsey, 2008).

Fr. Oberle, a Spiritual Care Director, offers a definition of forgiveness that I find especially meaningful:
“Forgiveness is the giving up of all hope of a better past” (Oberle, 2002, p. 7).

  By acknowledging that the past cannot be changed, forgiveness focuses on the future.  This process can be particularly important for elders nearing the end of life. 


Spiritual Legacies, Autobiographies, Ethical Wills,
Life Stories, Journals, and Story Telling

As noted throughout the thanatology research, most older adults have a willingness and a need to speak openly about death.  In fact, elders express a greater openness to such discussions than do younger generations.  Most practitioners are also in agreement that leaving a spiritual legacy is vital for elders nearing the close of life.  In addressing their own mortality, many questions surface:

  Will I be remembered?    How Will I be remembered?
Did my life matter?
In what ways can I contribute to something of lasting value?

Spiritual autobiographies and ethical wills are two examples of avenues for contributing something of spiritual substance to others.  According to Richards, the importance of life stories for all generations can be affirmed in the context of the story of a Higher Power, religious beliefs, and personally important values.  Others find that keeping a written or taped journal, formally or informally, plays a central role in their legacies and can also be experienced as a stress management tool (Richards, 2008).

Reflection Question

Many view our Internet Age as providing additional ways in which older adults can document and share their stories and legacies.  Do you feel our advanced Computer Technologies will impact the ways in which we provide spiritual care in the future?

In Closing…

The following quote has meaning for me, so I want to share with you….

Aging is a moral and spiritual frontier because its unknowns, blessings, terrors, and mysteries cannot be successfully crossed without humility and self-knowledge; without love and compassion; without acceptance of physical decline and mortality; and a sense of the sacred (Cole & Winkler, 1994, p. 5)
Resources
Aging & Spiritual Rituals
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Address, R. (2005).  Creating Sacred Scenarios:  Opportunities for New Rituals.  In Religion, Spirituality, and Aging.  Binghamton, NY:  The Haworth Press.

Black, K., & Elkins, H. (2005).  Wising Up:  Ritual Resources for Women of Faith in their Journey of Aging.  Cleveland: Pilgrim Press.

Cavanaugh, J., & Blanchard-Fields, F.  (2014).  Adult development and aging (7th ed.).   Belmont, CA: Thompson Wadsworth.

Cole, T., & Winkler, M.  (1994).  The Oxford book of aging: Reflections on the journey of life.  New York: Oxford University Press.

Griffin, R.  (2005).  Caregiving and our inner elder: Insights from a spiritual master.  In H. R. Moody (ed.) Religion, Spirituality, and Aging.  Binghamton, NY: Haworth Press.

Hooyman, N., & Kiyak, H.  (2018).  Social gerontology: A multidisciplinary perspective (10th ed.).  Boston: Allyn and Bacon.

Moody, H. R.  (2005).  Knowledge, practice, and hope.  In Religion, spirituality, and aging.  Binghamton, NY:  Haworth Press.

Moody, H.R. (2010).  Aging: Concepts & Controversaries (6th ed).  Thousand Oaks, CA: Pine Forge Press/Sage Publications. 

Nelson-Becker, H., Nakashima, M., & Canda, E. (2012).  Spiritual Assessment in Aging: A Framework for Clinicians.  Journal of Gerontological Social Work, 48, 331-347.

Oberle, J.  (Fall 2002).  Forgiveness: A spiritual value that fosters physical, psychological and spiritual health.  In Newsletter of the Forum on Religion, Spirituality and Aging. 14(3), 7.

Ramsey, J.  (Summer 2008).  Forgiveness and healing in later life.  Generations, 32(2), 51-54.

Richards, M. (Summer 2008). Spiritual Challenges and Hope in Sharing Care.  Generations. 32(2), 68-69.


Blog Author:
Dr. Donnelle Eargle  
deargle@sjcme.edu 

With a background in geriatric rehabilitation psychology, Dr. Eargle teaches gerontology-related courses at Saint Joseph’s College.  Standish, Maine.

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