Life Review in Pastoral Counseling: Background and Efficacy for Use with the Terminally III

2003 ◽  
Vol 57 (3) ◽  
pp. 281-292 ◽  
Author(s):  
Robert G. LeFavi ◽  
Marcia H. Wessels
Keyword(s):  
Older Adults ◽  
Pastoral Counseling ◽  
Life Story ◽  
Terminally Ill ◽  
Well Being ◽  
Life Review ◽  
Systematic Theology ◽  
Spiritual Needs ◽  
Traumatic Death ◽  
Spiritual Assessment

Research continues to confirm that sharing one's life story through the process of life review enhances psychological well-being and increases life satisfaction. Although researchers have outlined techniques and activities that may be used in life review with older adults, little work has focused on the use of life review methods with terminally ill patients. Additionally, researchers have suggested that life review can take on the form of a spiritual assessment; and that such spiritually oriented life reviews may enhance a sense of meaning and foster reconciliation as one approaches dying. In this article, the authors provide a brief review of the research on and the practice of life review. Further, by merging concepts of life review with systematic theology, they offer a sample instrument—using the example of one faith framework—with which pastoral caregivers can better approach the spiritual needs of patients and facilitate a less traumatic death in the terminally ill.

Themes of Gerotranscendence in Narrative Identity Within Structured Life Review

GeroPsych ◽  
2020 ◽  
Vol 33 (2) ◽  
pp. 77-84
Author(s):  
Sharlene L. Jeffers ◽  
Ricco Hill ◽  
Miriam F. Krumholz ◽  
Cynthia Winston-Proctor
Keyword(s):  
Older Adults ◽  
Narrative Identity ◽  
Developmental Stages ◽  
Life Story ◽  
Late Life ◽  
Well Being ◽  
Life Review ◽  
Late Life Depression ◽  
Clinical Narrative ◽  
The Life Course

Abstract. Narrative identity is a person’s internalized and evolving life story. It provides a person with some degree of unity and purpose over the life course. It is shaped by the themes, plots, and images available within an individual’s culture. Research in narrative gerontology finds that positive themes within narrative identity in late life are sparse because of a pervading “narrative of decline,” which may contribute to prevalence of late life depression. Structured Life Review (SLR) is an effective intervention to manage depressive symptoms in older adults. It relies on clinician-guided storytelling and themes drawn from Erikson’s developmental stages to foster positive narrative identity. In this theoretical review, the authors explore gerotranscendence-related themes to inform narrative identity through SLR, the goal being to advance the argument that gerotranscendence can adaptively navigate negative narrative themes. It should be considered within clinical narrative practice to improve psychological well-being for older adults.

scholarly journals Spiritual Diversity, Spiritual Assessment, and Māori End-of-Life Perspectives: Attaining Ka Ea

Religions ◽  
2020 ◽  
Vol 11 (10) ◽  
pp. 536
Author(s):  
Holly Nelson-Becker ◽  
Tess Moeke-Maxwell
Keyword(s):  
End Of Life ◽  
Rapid Assessment ◽  
Well Being ◽  
Spiritual Needs ◽  
Assessment Instruments ◽  
Spiritual Values ◽  
Spiritual Assessment ◽  
Contemporary World ◽  
Spiritual Diversity ◽  
Sense Of Satisfaction

The contemporary world is endowed with increasingly diverse spiritual and cultural perspectives, yet little is known about the spiritual concerns and spiritual resilience of Māori from Aotearoa New Zealand at the end of life. A context is provided for the value of spiritual assessment and identification of spiritual needs or concerns. Spiritual concerns and the desire to attain a state of ka ea (fulfillment, gratitude, or peace) may point to interventions, helping activities, or referrals that guide treatment. We reflect on qualitative findings from the 2017–2020 Pae Herenga study of 61 caregiving families, their helping professionals, and religious/spiritual leaders. We explore essential spiritual values and practices that support kaumātua (older tribal people) who have a life-limiting illness in achieving a sense of satisfaction and fulfilment at the end of life. Three themes emerged: the relational is spiritual, the need to live into the future, and value of spiritual end-of-life care. While some scholars have lamented the lack of culturally appropriate rapid assessment instruments, we suggest that a more open-ended assessment guide is better suited to understand key elements of spiritual diversity and spiritual concerns, particularly the spiritual strengths and resources that lead to well-being and even thriving at life’s end. Finally, learning about spiritual diversity can assist others to reconnect to lost meanings and regain a more holistic and centred view of life.

scholarly journals Spiritual Needs of Older Adults during Hospitalization: An Integrative Review

Religions ◽  
2020 ◽  
Vol 11 (10) ◽  
pp. 529
Author(s):  
Lindsy Desmet ◽  
Jessie Dezutter ◽  
Anna Vandenhoeck ◽  
Annemie Dillen
Keyword(s):  
Older Adults ◽  
Spiritual Care ◽  
Meaning In Life ◽  
Geriatric Patients ◽  
Well Being ◽  
Integrative Review ◽  
Flow Diagram ◽  
Spiritual Needs ◽  
Research Designs ◽  
Definition Of

A hospital admission presents various challenges for a patient which often result in high or intense spiritual needs. To provide the best possible care for older adults during hospitalization, it is essential to assess patients’ spiritual needs. However, little research has been done into the spiritual needs of geriatric patients. This article seeks insight into what is known in the literature on the spiritual needs of geriatric patients. This integrative review presents a summary of the articles on this topic. To select eligible studies, the PRISMA Flow Diagram was used. This resulted in ten articles that have been reviewed. Results show (1) a wide interest in researching spiritual needs, using different research designs. In addition, (2) four subcategories of spiritual needs can be distinguished: (a) the need to be connected with others or with God/the transcendent/the divine, (b) religious needs, (c) the need to find meaning in life, and (d) the need to maintain one’s identity. Moreover, results show that (3) assessing spiritual needs is required to provide the best possible spiritual care, and that (4) there are four reasons for unmet spiritual needs. Further research is needed on the definition of spiritual needs and to investigate older patients’ spiritual needs and the relation with their well-being, mental health and religious coping mechanisms, in order to provide the best spiritual care.

scholarly journals Life review therapy for older adults with depressive symptoms in general practice: results of a pilot evaluation

2019 ◽  
Vol 31 (12) ◽  
pp. 1801-1808 ◽  
Author(s):  
Lotte Hendriks ◽  
Marjolein A. Veerbeek ◽  
Daniëlle Volker ◽  
Lindsay Veenendaal ◽  
Bernadette M. Willemse
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
General Practice ◽  
Depressive Symptoms ◽  
Well Being ◽  
Life Review ◽  
Anxiety Symptoms ◽  
Psychological Well Being ◽  
Life Review Therapy ◽  
General Practices

ABSTRACTObjective:General practices play an important role in the detection and treatment of depressive symptoms in older adults. An adapted version of the indicated preventive life review therapy group intervention called Looking for Meaning (LFM) was developed for general practice and a pilot evaluation was conducted.Design:A pretest-posttest design was used. One week before and one week after the intervention participants filled out questionnaires.Setting:In six general practices in the Netherlands the adapted intervention was given.Participants:Inclusion criteria were > 60 years and a score of 5 or higher on the Center for Epidemiological Studies Depression Scale (CES-D).Intervention:The length and number of LFM sessions were shortened and the intervention was given by one mental health care nurse practitioner (MHCNP).Measurements:The impact on mental health was analyzed by depressive symptoms (CES-D) as the primary outcome and anxiety symptoms (HADS-A), psychological well-being (PGCMS) and mastery (PMS) as secondary outcomes. An evaluative questionnaire was included to evaluate the feasibility and acceptability.Results:Most participants were satisfied with the adaptations of the number (72%) and length (72%) of sessions. The overall sample showed a significant decrease in depressive symptoms after the intervention. No impact was found on psychological well-being, anxiety symptoms and mastery.Conclusions:The intervention is feasible and acceptable for older adults with depressive symptoms and has an impact on their depressive symptoms.

International comparison study on the primary concerns of terminally ill cancer patients in short-term life review interviews among Japanese, Koreans, and Americans

2009 ◽  
Vol 7 (3) ◽  
pp. 349-355 ◽  
Author(s):  
Michiyo Ando ◽  
Tatsuya Morita ◽  
Sung-Hee Ahn ◽  
Felicia Marquez-Wong ◽  
Saburo Ide
Keyword(s):  
Cancer Patients ◽  
Terminally Ill ◽  
Depression Scale ◽  
Well Being ◽  
The United States ◽  
Life Review ◽  
Short Term ◽  
Terminally Ill Cancer Patients ◽  
Interview Session ◽  
First Session

AbstractObjective:The aim of this study was to investigate the primary concerns of terminally ill cancer patients in a Short-Term Life Review among Japanese, Koreans, and Americans to develop intervention programs to be tailored to patients in other countries.Method:Twenty Japanese, 16 Korean, and 7 American terminally ill cancer patients who were in the hospice wards of general Christian hospitals in each country participated in this study. Medical staff members (nurses, social workers, clinical psychologists) performed Short-Term Life Review Interviews with each patient. Patients reviewed their lives in the first session, the interviewers made simple albums for each patient in the week following the first session, and patients and interviewers then confirmed the contents of the album. The treatment period was 1 week. Measurement instruments included the Functional Assessment Chronic Illness Therapy–Spiritual (FACIT-Sp) and the Hospital Anxiety and Depression Scale (HADS). The contents of each interview session were transcribed, and correspondence analysis and a significance test were conducted on these data to select characteristic words or phrases.Results:Using the FACIT-Sp scores, the following concerns were chosen, in descending order of frequency. In Japan, primary concerns consisted of such ideas as “good human relationships and transcendence,” “achievements and satisfaction,” “good memories and important things,” and “bitter memories.” In Korea, “religious life,” “right behavior for living,” “strong consideration for children and will,” and “life for living” were primary concerns. In the United States, “love, pride, will to children,” “good, sweet memories,” and “regret and a feeling of loss” were primary concerns.Significance of results:We clarify the differences among the primary concerns from the Short-Term Life Reviews, arguing that we can improve the spiritual well-being of terminally ill cancer patients by focusing on the primary concerns within each country.

scholarly journals Older Adults’ Spiritual Needs in Health Care Settings

2011 ◽  
Vol 34 (2) ◽  
pp. 131-155 ◽  
Author(s):  
David R. Hodge ◽  
Violet E. Horvath ◽  
Heather Larkin ◽  
Angela L. Curl
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Professional Staff ◽  
Joint Commission ◽  
Assessment Process ◽  
Spiritual Needs ◽  
Relationship With God ◽  
Health Care Settings ◽  
Spiritual Assessment ◽  
Staff Interactions

Recognizing that spiritual needs often emerge in health care settings, the Joint Commission requires spiritual assessments in numerous organizations frequented by older adults. Given that many gerontological practitioners have received little training in identifying spiritual needs, a qualitative meta-synthesis ( N = 9 studies) was conducted to identify and describe older adults’ perceptions of their spiritual needs in health care settings. Five interrelated categories emerged: (a) spiritual practices; (b) relationship with God; (c) hope, meaning, and purpose; (d) interpersonal connection; and (e) professional staff interactions. The implications of the findings are discussed as they inform the spiritual assessment process.

Communication Strategies to Promote Spiritual Well-Being among People with Dementia

2005 ◽  
Vol 59 (1-2) ◽  
pp. 43-55 ◽  
Author(s):  
Ellen B. Ryan ◽  
Lori Schindel Martin ◽  
Amanda Beaman
Keyword(s):  
Older Adults ◽  
Communication Skills ◽  
Life Stories ◽  
Sense Of Self ◽  
Communication Strategies ◽  
Religious Life ◽  
Well Being ◽  
Spiritual Needs ◽  
People With Dementia ◽  
Spiritual Well Being

Declining communication skills in dementia threaten a person's sense of self. Building on enduring capabilities, pastoral visitors can significantly enhance spiritual well-being through the use of individualized, person-centered strategies. This article outlines the primary spiritual needs of older adults with dementia and some general strategies to improve communication based on enduring abilities. Detailed examples illustrate how these personhood-centered strategies can meet spiritual needs by connecting with individuals with dementia through life stories and through helping them to participate in religious life.

scholarly journals Spiritual Well-Being Measurement of Older Adults in a Community-Dwelling: A Short-Form Development

2021 ◽  
Vol 29 ◽  
pp. 286-298
Author(s):  
Junya Pattaraarchachai ◽  
◽  
Kanvee Viwatpanich ◽  
Keyword(s):  
Older Adults ◽  
Factor Analysis ◽  
Short Form ◽  
Well Being ◽  
Community Dwelling ◽  
Measurement Tool ◽  
Second Phase ◽  
Spiritual Assessment ◽  
Qualitative Approaches ◽  
Spiritual Well Being

This combination of quantitative and qualitative approaches was performed in Chiang Mai, Samut Prakan, Nakhon Ratchasima, and Nakhon Si Thammarat to develop the general measurement tool of spiritual well-being among older adults who are living in the community. The research was divided into two phases. The first phase was a pilot questionnaire with 41 questions for 106 older adults, and ten focus group discussions. The exploratory factor analysis extracted and reduced the questionnaire to 30 questions. The revised questionnaires were used in the second phase survey on 512 older adults. Exploratory and Confirmatory Factor Analysis affirmed the fit model of 12 questions on the four components of spiritual well-being (satisfaction, social participation, faith, and awareness), which explain the spiritual well-being condition of older adults, with a 73.8% extraction. Cronbach's coefficient of scale reliability (α) = 0.836, while the inter-item to total correlation was 0.328-0.682. Moreover, the reliability of each component was also high (0.759 < Cronbach α < 0.846). Therefore, the evaluation of spiritual health and well-being, as determined by the short-form (12 questions), is reliable and can apply as a screening tool for spiritual assessment, especially in the case of older adults in the Thai community.

scholarly journals Spiritual Experience in Dementia From the Health Care Provider Perspective: Implications for Intervention

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 465-465
Author(s):  
Jennifer Palmer ◽  
Michelle Hilgeman ◽  
Tracy Balboni ◽  
Sara Paasche-Orlow ◽  
Jennifer Sullivan
Keyword(s):  
Spiritual Care ◽  
Qualitative Interviews ◽  
Well Being ◽  
Spiritual Experience ◽  
Assessment Tools ◽  
Spiritual Needs ◽  
Care Needs ◽  
Spiritual Assessment ◽  
Spiritual Distress ◽  
Linguistic Challenges

Abstract Spiritual care seeks to counter negative outcomes from spiritual distress and is notably needed in dementia. Such care needs disease-appropriate customization. Employing “cognitive apprenticeship” theory’s focus on learning from contrast, we explored spiritual needs salient within dementia as related to other disease states; we aimed to inform future dementia-focused spiritual care design. Accordingly, we conducted semi-structured qualitative interviews with 24 providers who serve older adults inclusive of persons with dementia. We sampled participants purposively by discipline (chaplains, nursing staff, social workers, activities professionals) and religious tradition (for chaplains). Our interview guide inquired about the nature of spiritual needs in dementia and stakeholders’ roles in addressing them. Hybrid inductive/deductive thematic analysis was employed. A thematic structure emerged with two themes: 1) spiritual experience in dementia compared to other medical conditions (sub-themes: the salience of (a) fear; (b) loss of self; (c) dementia’s progressive and incurable nature; (d) dementia’s impact on accessing faith); and 2) the need for spiritual intervention at the mild stage of dementia (sub-themes: (a) awareness in mild dementia and its influence on spiritual distress; (b) a window of opportunity). These findings pointed to possibilities for the “what” of spiritual needs and the “who” and “when” of implementing spiritual care. Implications included the imperative for dementia-specific spiritual assessment tools, interventions targeting fear and loss early in the disease, and stakeholder training. Researchers should study the “how” of dementia-appropriate spiritual care given recipients’ cognitive and linguistic challenges. Conjointly, these efforts could promote the spiritual well-being of persons with dementia worldwide.

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