Spiritual Care of the Dying
Daniel B. Hinshaw, M.D. Palliative Care Program, Section of Geriatrics, and GRECC VA Ann Arbor Healthcare System Department of Surgery University of Michigan
He who has a why to live for can bear with almost any how.
Nietzsche
Objectives for this Presentation
Define spirituality, particularly in the context of terminal illness Define the concept of a "good death" and whether current practice meets the expectations of the dying Explore and characterize the nature of suffering Recognize spiritual distress Identify ways that caregivers can address the spiritual distress of their patients Discover the potential for healing in the terminally ill
Clinical Practice Domains
National Consensus Project for Quality Palliative Care

Structure and Processes of Care Physical Aspects of Care Psychological and Psychiatric Aspects of Care Social Aspects of Care Spiritual, Religious and Existential Aspects of Care Cultural Aspects of Care Care of the Imminently Dying Patient Ethical and Legal Aspects of Care
"… the American people want to reclaim and reassert the spiritual dimension in dying."
"Spiritual Beliefs and the Dying Process" The George H. Gallup International Institute October, 1997
Spirituality
"…that which allows a person to experience transcendent meaning in life. This is often expressed as a relationship with God, but it can also be about nature, art, music, family, or community whatever beliefs and values give a person a sense of meaning and purpose in life."
(Puchalski, C and Romer, AL J. Pall. Med. 3:129-137, 2000)
Are You Religious or Spiritual
( Gallup, Jr, GH, Americans' Spiritual Searches Turn Inward - Gallup Poll Tuesday Briefing, February 11, 2003, www.gallup.com)
In a January 2002 poll: 50% of Americans described themselves as religious 33% are "spiritual but not religious" 11% are neither 4% are both 2%
Factors Considered Important at the End of Life by Patients, Family, Physicians and Other Care Providers

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