End-of-Life

Spiritual issues, long neglected in the rush of modern living, may surface as the individual faces the prospect of dying or the inevitablility of dying. A quest for meaning and purpose through life review is often helpful in identifying spiritual needs (Loseth, Moore, Mulder, & Peterson, 2005). Spiritual needs include the need for meaning and purpose in life, the need to receive love, the need to give love, and the need for hope and creativity (Highfield & Cason, 1983). Failure to meet these needs leads to spiritual distress, conceptualized as a "disruption in the life principle that infuses the patient with a variety of characteristics that are both religiously oriented and existentially oriented" (Loseth et al, p. 326).

Case Study

Although Diane Brady is not actively dying, she has now faced disease recurrence. Her fiance is angry. At this time in her disease trajectory, it is appropriate for the nurse to intervene by providing presence, active listening, and continue with ongoing assessment.

Interventions

• Facilitate life review
• Presence
• Relieve suffering--adequate symptom control
• Encourage identification of personal values and goals
• Discuss how the individual maintained integrity (adherence to personal values) and achieved attainment of goals
• Identify need to forgive or be forgiven
• Refer to religious professional
• Pray with patient as appropriate for the individual patient
• Read favorite scriptures to the patient
• Suggest listening to music that enables the patient to "tune in" to spirituality (Halstead & Roscoe, 2002)

Resources

Halstead, M., & Roscoe, S. (2002). Restoring the spirit at the end-of-life: Music as an intervention for oncology nurses. Clinical Journal of Oncology Nursing, 6, 322-6.

Highfield, M., & Cason, C. (1983). Spiritual needs of cancer patients: Are they recognized? Cancer Nursing, 6, 187-192.

Loseth, D., Morre, C., Mulder, J.,  & Peterson, C. (2005). Cultural and spiritual issues. In K. Kuebelr, M. Davis, & C. Moore, (Eds.), Palliative Practices: An Interdisciplinary Approach, pp. 309-334. St. Louis: Elsevier/Mosby.

Halstead, M. (2005)