What does spiritual care look like and what does it do?
Read this incident from clinical practice (adapted from Ross, 1997):
"Mrs T was an elderly lady in long term care. She was a tiny bird like creature who had no teeth, had sunken cheeks and never spoke, except to whimper in pain when she had her dressings changed. She was bed bound and had a large pressure sore on her hip which was infected and revealed bone. It required daily dressing and she needed strong pain killers before the dressing could be attempted. She required regular turning and help with feeding (liquidised diet) and drinking. The four walls of the ward and the ceiling were her entire world. She stared into space with a glazed, dull lifeless expression. In my view as an 18 year old care assistant, she had very poor quality of life and was more or less waiting to die.
One day whilst tidying the lockers I came across an old Bible stuffed at the back of her drawer. Clearly it was well used. I considered asking her if she would like me to read a passage to her, but was fearful that I might get into trouble with the ward sister as I was unsure if this was part of my job. I waited until the ward sister was off duty one weekend and plucked up the courage to ask Mrs T if she would like me to read to her from her Bible. The change in her expression was remarkable. Instead of lying sleeping or staring blankly into space, her eyes widened, she strained to raise her head, smiled and tried to mouth the words with me whilst reaching for my hand. Looking back on it, she had a spiritual need".
Reflections
Reflecting on this example of spiritual care, take a blank piece of paper and divide it into two columns. In the first column write down what spiritual care looks like – in other words, what does it involve? What action is taken? Then in the second column write down what spiritual care does. What effects does it have? The following lists are not exhaustive.
What spiritual care looks like:
- picking up a clue
- taking a risk
- engaging with a person
- creating dialogue or permission
- acting or facilitating a religious need
- aiding religious ritual
- touch
- "being with".
What does it do:
- enlivens or 'sparks'
- changes expressions
- interacts with and connects
- affects emotions
- creates reaction
- creates meaning
- gives hope
- reconnects with belief or faith
- creates feelings of being loved and valued.
'Being' with patients and clients
In the previous example attention focused on what action was taken in giving spiritual care by asking the question ‘what does it do?’. However, spiritual care is not just about ‘doing to’ a patient/client; it also involves ‘being with’ them. This means that our attitudes, behaviours and personal qualities will be important and will influence ‘how we are’ with people.
Although the example included a religious element, spiritual care is not just about religious beliefs and practices. It is not about imposing our own beliefs and values on another or about using our position to convert. It is about meeting people at their point of deepest need. It involves treating spiritual needs with the same level of attention as physical needs. Just as you would assess your patients’ physical needs, an initial assessment of their spiritual needs is also important.
You may find questions like these helpful in the assessment:
- Do you have a way of making sense of the things that happen to you?
- What sources of support/help do you look to when life is difficult?
- Would you like to see someone who can help you talk or think through the impact of this illness/life event? (You don’t have to be religious to talk to them).
Spiritual care can then be planned, implemented and evaluated in the same way as physical care (McSherry and Ross, 2010).
References:
- Ross L (1997) Nurses perceptions of spiritual care, Aldershot: Avebury
- McSherry W and Ross L (eds) (2010) Spiritual assessment in healthcare practice, Keswick: M&K Publishing
Move to the next page: What skills are needed in order to give spiritual care?

