The Peace Plan: Redesigning the Interdisciplinary Approach to Treating Spiritual Distress in Terminally Ill Patients




Aldred, Emma

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Many terminal patients face spiritual distress at the end of life when they are receiving palliative or hospice care. Spiritual care, however, has largely been forgotten in healthcare. Even holistic medicine, which emphasizes awareness of the biological, psychological, and sociological dimensions of health, often neglects spirituality. In this thesis, I conduct a literature review of end-of-life care including studies conducted in palliative and hospice care settings. I found that spiritual distress is a subtype of existential crises that is rooted in questions concerning the meaning of life and fears of the unknown after death. Dignity therapy is a recently developed, individualized psychotherapy for spiritual distress that can increase dignity, reduce fears concerning life after death, and improve the patient’s perception of life. Healthcare chaplains are members of palliative and hospice care teams tasked with spiritual counseling. Unfortunately, the chaplain’s job is poorly understood by health professionals and patient referrals are lacking. As a result, spiritual distress is often overlooked. Treatment for spiritual distress in terminal patients could be improved with a model focusing on the healthcare chaplain’s role on the interdisciplinary healthcare team. In the proposed model, chaplain-led education initiatives for healthcare workers could aid the recognition of spiritual distress to increase patient referrals. Chaplains can proactively utilize dignity therapy to reduce or avoid patient suffering from spiritual distress. Finally, in-person or virtual team meetings can ease family caregiver involvement resulting in more socioemotional conversations and improved patient advocacy in care. Implementation of this model could increase team cooperation and improve support for patients with spiritual distress.

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