geriatrics
Religion and Spirituality in Older Adults
Role of the Health Care Professionals
Talking to older patients about their religious beliefs and practices helps health care professionals provide care because these beliefs can affect the patients’ mental and physical health. Inquiring about religious issues during a medical visit is appropriate under certain circumstances, including the following: When patients are severely ill, under substantial stress, or near death and ask or suggest that a health care professional talk about religious issues When patients tell a health care professional that they are religious and that religion helps them cope with illness When religious needs are evident and may be affecting patients’ health or health behaviors Older adults often have distinct spiritual needs that may overlap with but are not the same as psychologic needs. Ascertaining a patient’s spiritual needs can help mobilize the necessary resources (eg, spiritual counseling or support groups, participation in religious activities, social contacts from members of a religious community). Taking a spiritual history shows older patients that the health care professional is willing to discuss spiritual topics. The professional may ask patients whether their spiritual beliefs are an important part of their life, how these beliefs influence the way they take care of themselves, whether they are a part of a religious or spiritual community, and how they would like the health care professional to handle their spiritual needs. Alternatively, a health care professional may ask patients to describe their most important coping mechanism. If the response is not a religious one, patients may be asked whether religious or spiritual resources are of any help. If the response is no, patients may be sensitively asked about barriers to those activities (eg, transportation problems, hearing difficulties, lack of financial resources, depression, lack of motivation, unresolved conflicts) to determine whether the reason is circumstances or their choice. However, health care professionals should not force or suggest religious beliefs or opinions on patients or intrude if patients do not want help. Many clergy members provide counseling services to older adults at home and in the hospital, often free of charge. Many older patients prefer such counseling to that from a mental health care professional because they are more satisfied with the results and because they believe such counseling does not have the stigma that mental health care does. However, many clergy members in the community do not have extensive training in mental health counseling and may not recognize when older patients need professional mental health care. In contrast, many hospital clergy have extensive training in the mental, social, and spiritual needs of older people. Thus, including hospital clergy as part of the health care team can be helpful. They can often bridge the gap between hospital care and care in the community by communicating with clergy in the community. For example, when a patient is discharged from the hospital, the hospital clergy may call the patient’s clergy so that support teams in the patient’s religious community can be mobilized to help during the patient’s convalescence (eg, by providing housekeeping services, meals, or transportation, by visiting the patient or caregiver). Patients seek medical care for health-related reasons, not religious ones. However, health care professionals should not discourage a patient’s religious involvement as long as it does not interfere with necessary medical care because such involvement may contribute to good health. People who are actively involved in religious groups, particularly those in major religious traditions, tend to be healthier. If patients are not already involved in religious activities, suggesting such activities requires sensitivity. However, health care professionals may suggest that patients consider religious activities if patients seem receptive and may benefit from such activities, which can provide social contact, reduce alienation and isolation, and increase a sense of belonging, of meaning, and of life purpose. These activities may also help older people focus on positive activities rather than on their own problems. However, some activities are appropriate only for more religious patients. 