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Opinion: Guidelines put spiritual care in focus

Nurses are at the frontlines in residential aged care and in caring for older people in their own homes. The ANMF states that there were more than 13,000 registered nurses and 11,000 enrolled nurses working in residential aged care in 2012.

While the trend is that the nursing proportion of the aged-care workforce is decreasing, nurses remain dominant in senior and care manager roles, and their fewer numbers has meant more responsibility for them in maintaining the clinical standards of aged-care settings.

While our quality of aged care is among the highest in the world, until now, Australia has had no national guidelines on spiritual care within this sector. Spiritual care is not just for religious people or clergy. Spiritual care is giving older people access to care that allows them to maintain purpose and meaning in their lives at any stage, whether through a connection with god or another being, or with meaningful people or things around them.

There are many ways to define spirituality. One definition is that spirituality is what lies at the core of a person, the essential dimension that brings meaning to their life. Spirituality goes beyond notions of religious practice to something about what gives the individual a reason to keep living.

Improvement Matters, The National Ageing Research Institute (NARI), Spiritual Health Victoria, and Meaningful Ageing Australia (formerly PASCOP) have developed the first Australian Guidelines for Spiritual care of Older Australians living in residential and home care. The project was funded by the Australian Government in 2015.

A set of principles underpins the new guidelines:

  • Principle 1: a whole-of-organisation approach is needed to provide effective care, so spiritual care is reflected in key systems and processes of the organisation.
  • Principle 2: is that human relationships are central to spirituality, and significant relationships need to be supported, whether that is with family, friends, faith community, staff, volunteers, healthcare professionals or god or a higher being.
  • Principle 3: spiritual care is everyone’s business, and while there is a distinct role for spiritual care practitioners such as chaplains or pastoral carers, anyone who has contact with older people needs to have a basic awareness of spirituality and how it affects their role.
  • Principle 4: is that spiritual care is about growth and flourishing, and that it is important to bring meaning, purpose and wholeness to assist older people in flourishing, growing and realising their potential in their final journey of ageing.

Through a process of extensive literature review and consultation with a wide range of stakeholders, including those working in aged care, families and older people themselves, five domains of spiritual care have been identified and included in the new guidelines.

The guidelines support the World Health Organization’s view that spirituality is inextricably linked to quality of life. Nurses can play a crucial role in modelling spiritual care of older people.

Elements of spiritual care can include spiritual assessment, developing trusting relationships, fostering rituals that individuals prefer, facilitating compassion by waiting for an invitation to discuss spiritual matters, giving care that provides a spiritual connection with the person, being attentive and allowing reciprocity in the relationship with the older person. Other elements are prayer, reminiscence, story telling, and mindfulness.

The literature on spiritual care and nurses has emphasised the importance of nurses incorporating spirituality and spiritual care into their practice. While cutbacks to education and training in organisations may have hindered nurses’ ability to provide spiritual care, there is increasing evidence that this side of care can enhance quality of life, assist with mental health issues such as depression and anxiety, and provide a holistic approach to caring for our increasing ageing population.

The new guidelines will be available for distribution in June and can be accessed here.

A series of free workshops is being offered in 2016 to provide information about the new guidelines on spiritual care in aged care.

Schedule of spiritual care workshops, June

Date Location Venue
June 20 Perth Bethanie Group
June 21 Adelaide Anglicare SA
June 22 Melbourne BlueCross
June 23 Hobart Freemasons Homes’ of Southern Tasmania
June 24 Brisbane Churches of Christ in Queensland
June 27 Darwin Southern Cross Care (SA/NT)
June 28 Sydney Anglican Retirement Villages
June 29 Canberra Baptistcare


Professor Colleen Doyle is principal research fellow at the National Ageing Research Institute and is also professor of aged care at the Australian Catholic University and Villa Maria Catholic Homes.
Hannah Capon is a research assistant at NARI.
David Jackson is a research assistant at NARI.
Elizabeth Pringle is the director at Improvement Matters.

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