As the efficacy of mind-body interventions in patients facing cancer is better appreciated by health care professionals, so should the importance of providing spiritual care as an integral component of patient care. The spiritual needs of patients, caregivers, and those who are posttreatment must be met along with their physical and emotional needs. The spiritual aspect of care helps to restore hope amidst the challenges that come with a cancer diagnosis.
Clinician education that explores spiritual care practices, spirituality, and spiritual well-being is an essential component of comprehensive patient care. This type of education can lessen apprehension about spiritual care and foster a sense of openness in the patient-clinician relationship. Understanding diverse spiritual care practices increases clinician competence in the care provided. Including spiritual care in the medical care of people affected by cancer helps them feel that all aspects of their health are being appropriately addressed.
INTRODUCING SPIRITUALITY INTO CARE
Spirituality can be difficult to define and, therefore, difficult to explore with people who have been affected by cancer. One’s spiritual identity, like one’s cultural identity, is a fluid quality, ever-changing, and distinctly personal. Some clinicians hesitate to broach the topic, leaving this essential support issue unexplored.
Although bringing spirituality into the conversation is not easy, it is essential, as patients are dealing with very existential issues. What is the meaning of life? How is the meaning different now? How can you find meaning in life when affected by cancer? A sense of meaning, purpose, and connection beyond oneself can enhance one’s quality of life. Numerous studies conducted over decades have shown that people with cancer have less anxiety, depression, and pain when they feel spiritually connected.
Nourishing your patient’s spiritual voice in the face of a serious diagnosis will help them find meaning, untapped strengths, and needed connections. As clinicians, we are charged with helping patients learn to take care of their spiritual side as we encourage them to use all their strengths to effectively manage their diagnosis and the changes it demands. The goal is to initiate the conversation and to breathe life into the exploration of spirituality.
EXPLORING SPIRITUAL IDENTITY
One’s sense of spirit is entwined in everything we do. Spiritual identity is challenged at the time of diagnosis or illness because of the strain on one’s established coping skills and the existential questions it brings up. When we talk to our patients about their cancer story, inevitably death or the fear of death comes into the room.
Talking about death without talking about the meaning of life is challenging, even more challenging is to talk about meaning without talking about spirituality. This natural progression gives us a generous platform with which to explore how the patient is making connections with others, with nature, with a higher power, and with themselves. This is when we hear about regrets and spiritual pain, as well as the inspiration and, sometimes, the often-surprising upsides of a cancer diagnosis.
Exploring spiritual identity helps us explain how spirituality leads one to find meaning and connection. People find this inspirational and grounding in many ways, and hopefully at this point, physical and psychological healing has begun. Helping clients formalize and put their thoughts into words has a powerful and regenerative affect. The goal is to increase the attention given to this important aspect of our patient’s lives.
INITIATING THE CONVERSATION
A strong therapeutic relationship is essential when broaching difficult subjects. The therapeutic relationship needs an atmosphere of trust, respect, and openness to grow. Clinicians should offer a meditative attitude using patience, gentleness, and compassion to foster this atmosphere.
However, there can be obstacles and challenges to getting the conversation started. Questions that can help open the conversation include those that encourage reflecting on the moments in life that have special meaning. When have you witnessed or experienced truly remarkable human compassion? When have you experienced waves of hope? Or, simply, what do you do to soothe yourself? There are many entrees into this profound dialogue. The words chosen do not lessen the importance of finding access to a patient’s spiritual side.
THE SPIRITUAL SELF
Clinicians should be aware of their own feelings about spirituality and spiritual identity. What comes to mind when you think about spiritual identity? Do you hear your own spiritual language? Which beliefs give you meaning? What rituals keep you grounded? What nourishes you and gives you hope? Is this part of your self-care regime?
Self-care and nourishing one’s soul are an essential part of the work we do every day interacting with clients and their families as they face illness and death. We often neglect ourselves and do not listen to our own advice. The more we understand the necessity of this practice for ourselves, the better prepared we are to guide others in this important intersection of life.
Elizabeth Ezra is Pancreatic Cancer Program Coordinator at CancerCare.