Spirituality within Dementia Care: Perceptions of Health Professionals

By Bursell, Jennifer; Mayers, Christine A. | British Journal of Occupational Therapy, April 2010 | Go to article overview

Spirituality within Dementia Care: Perceptions of Health Professionals


Bursell, Jennifer, Mayers, Christine A., British Journal of Occupational Therapy


Introduction

It is predicted that by 2051 the number of people with Alzheimer's disease and other dementias will be 1.8 million (Parliamentary Office of Science and Technology 2007). In acknowledging this, the National Institute for Health and Clinical Excellence and the Social Care Institute for Excellence (NICE and SCIE) (2006) published best practice guidelines for dementia care and the National Audit Office (2007) published a report on how dementia services could be improved. These documents highlight that a person's spiritual needs should be recognised, but they do not detail why this should be the case.

Research has, however, established that addressing a person's spiritual needs can have a positive impact on his or her mental health (Koenig 2001, Lawrence and Raji 2005, Mental Health Foundation 2007). Authors such as Goldsmith (2004), Higgins (2005) and Swinton (2008) specifically related this link to people with dementia and advocated for improved spiritual care. Bryden (who has dementia) clearly argued that dementia should not result in a person's spiritual needs being overlooked: 'We can find meaning in our spirituality, and you can connect with us, empower us' (Bryden and MacKinlay 2008, p138). The issue for health professionals is, therefore, how to integrate spiritual care into dementia services (Bell and Troxel 2001, Bephage 2008).

Defining spirituality

There has been much debate as to how the term spirituality is defined (for example, McSherry and Draper 1998, Swinton 2001, Greenstreet 2006). As there is no one definition used for spirituality within the current literature, Mowat (2004) suggested that when planning research in this area, a definition should be chosen that is relevant to the researcher. The present research was being conducted by an occupational therapist, so the definitions within occupational therapy literature were consulted. Johnston and Mayers (2005) completed a full literature review in this area and, following this, proposed a definition:

Spirituality can be defined as the search for meaning and purpose in life, which may or may not be related to a belief in God or some form of higher power. For those with no conception of supernatural belief, spirituality may relate to the notion of a motivating life force, which involves an integration of the dimensions of mind, body and spirit. This personal belief or faith also shapes an individual's perspective on the world and is expressed in the way that he or she lives life. Therefore, spirituality is experienced through connectedness to God/ a higher being; and/or by one's relationship with self, others or nature (Johnston and Mayers 2005, p386).

This definition is very comprehensive and, since its publication, has been used not only in occupational therapy research but also in research regarding spirituality and health professionals in general (Collins 2006). The definition was therefore felt to be the most appropriate for use within this research.

Literature review

Spirituality and mental health

Much literature has been published about spirituality and health care (Cressey and Winbolt-Lewis 2000, Speck et al 2004, Mental Health Foundation 2007). Through the use of various mental and physical health standardised outcome measures, Koenig et al (2004) established that religion and spirituality have a positive effect on the psychological health, and to some extent the physical health, of older people. A previous systematic review had also concluded that despite religion frequently being perceived as having a negative impact on patients with mental health difficulties, it often actually enables patients to have positive experiences in life (Koenig 2001).

Spirituality within dementia care

In considering the specific needs of patients with dementia, Coleman and Mills (2001) argued that people are spiritual beings throughout their lives and that dementia should not hinder 'spiritual expression' (p76). …

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