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SPIRITUALITY AND MEDICINE IN END-OF-LIFE CARE

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Spirituality can help find meaning to one's suffering ... Spirituality is about the search for transcendent meaning. ... What gives your life meaning? ... – PowerPoint PPT presentation

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Title: SPIRITUALITY AND MEDICINE IN END-OF-LIFE CARE


1
SPIRITUALITY AND MEDICINE IN END-OF-LIFE CARE
  • Dr. Mike Marschke

2
Historically
  • Religion and medicine were intertwined in most
    cultures throughout time
  • In early Renaissance, though, with the Church
    confronting Galileo, medicine became more
    scientific, with religion posing barriers
  • Presently, 98-99 of Americans have some belief
    in a higher being, though it is lower in
    physicians.
  • Though medicine focuses on science, suffering and
    death are still inevitable. This focus on
    science can turn humans into subjects.
  • Religious practice can make a difference
    studies show better health with religious
    practice, even outside prayer impacting outcomes.

3
Questions of the dying
  • Why did this happen to me?
  • What will happen to me after I die?
  • Why would God allow me to suffer this way?
  • Will I be remembered?
  • Will I be missed?

4
  • Spirituality can help find meaning to ones
    suffering
  • Spirituality can find hope in the midst of despair

5
Physicians role
  • 65-95 of patients would like to address
    spiritual issues with their doctor
  • Less than 10 actually do address it

6
Hope and Healing
  • Hope can change over time hope for cure, hope
    for time, hope for peace
  • Healing involves the whole individual, sense of
    self, along with your surrounding relationships
    a wholeness of the individual
  • Spiritual hope can help people deal with chronic
    and life-threatening illnesses
  • Illness in general can be a very spiritual
    journey for the individual, especially at the end
    of life.

7
Definition of Spirituality for the Assoc. of
Amer. Med. Colleges
  • Spirituality is recognized as a factor that
    contributes to health in many persons. The
    concept of spirituality is found in all cultures
    and societies. It is expressed in an
    individuals search for ultimate meaning through
    participation in religion and/or belief in God,
    family, naturalism, rationalism, humanism, and
    the arts. All of these factors can influence how
    patients and health care professionals perceive
    health and illness and how they interact with one
    another.

8
  • Spirituality is about the search for transcendent
    meaning.
  • Religion is a formal set of beliefs and practices
    of a community that is searching for a
    transcendent meaning in a defined way.

9
Spiritual History
  • F Faith and belief Do you consider yourself
    spiritual? What gives your life meaning?
  • I Importance What importance does your faith
    or belief have in your life? What role do you
    beliefs play in your health?
  • C Community Are you part of a spiritual or
    religious community, and how are they of support
    to you?
  • A Address in Care How would you like me to
    address these issues in your health care?
  • -developed by Dr. Christina Puchalski at GWISH

10
Spiritual History
  • Goal to LISTEN empathetically listen to their
    fears, hopes, beliefs.
  • - Can open up communication about how a person
    wants to die.
  • - Helps bring compassion back to medicine,
    taking care of the whole individual.
  • - Helps to bring dignity to medical care,
    improving patient trust.
  • - Can help to relieve suffering.
  • - Certain religious believes may impact medical
    decisions.

11
Spiritual History- scenarios
  • Mr. T is a 65 year old black gentleman with lung
    cancer, failing chemotherapies. He is in the
    hospital with dyspnea. You want to discuss DNR
    issues with him. After describing what
    resuscitation is, you state that in his
    condition, it is extremely unlikely to succeed.
    You ask him what he thinks about all this.
  • He replies Well, I want you to do what you can.
    I trust that God will decide when its my time.
  • What is your response?

12
Spiritual History- scenarios
  • Ms. B is a 46 yr. old hispanic woman with renal
    failure, partial blindness, and admitted for a
    foot infection from diabetes. She now is needing
    dialysis. On discussing this with her, you ask
    how she is doing?
  • She replies I dont know. I keep wondering why
    all of this is happening to me.
  • What is your reply?

13
Avoid pitfalls
  • Dont try to solve the questions
  • Know your boundaries
  • Dont try to provide premature reassurance

14
Spiritual History - scenario
  • Mr. C. is a 76 yr old white man admitted with a
    severe GI bleed. He passed out on the way to the
    ER and remains unconsious, possibly also having a
    stroke. Initial work-up reveal a low blood
    pressure and a hemoglobin of 6. You prepare to
    transfuse him emergently. His wife sees this and
    steps in saying No way are you giving him a
    blood transfusion. Jehovahs witnesses cannot
    get someone elses blood.
  • What questions do you ask?

15
  • USE
  • YOUR
  • RESOURCES!

16
  • DONT
  • PREACH!

17
  • SEARCHFOR YOUR
  • OWN MEANING
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