NHS Spiritual Care In The Community!

On 30^th  March Maureen and I joined 113 other delegates from the NHS and Voluntary sectors at a stimulating conference in Perth entitled Building Resilience, Enhancing Community Wellbeing.  Five pilot sites throughout Scotland placed either a Chaplain or a chaplain-trained volunteer in a GP surgery to provide a simple, reflective listening service to patients who might otherwise inappropriately be labelled “depressive”, and would leave the surgery with a prescription for antidepressants.  Another project in Dundee involved the concept “Social Prescribing” whereby similar patients were assessed for referral to various self-help groups, including the prescription of exercise through walking or a local health and fitness club.

We learnt that resilient communities “.....demonstrate love, peace, kindness, joy and goodness, accepting that people do suffer, are able to remain hopeful in adversity, and yet are able to recover meaning in their lives.”  These are spiritual concepts which NHS Healthcare Chaplains are now interested in supporting within the community.  Evidence suggests such communities stay healthier, and make better recoveries from ill health.

How exciting that the NHS is now recognising the value of enhancing community wellbeing by supporting spiritual need.  Could this be an opportunity for Faith groups, who are part of the community already, to work alongside the NHS professionals?

Why Spiritual Care Should Matter in the NHS

If, as Teilhard de Chardin has said, “We are all spiritual beings trying to express our humanity,” then the holistic definition of health as “a complete sense of physical, mental, social, and spiritual wellbeing” is crucial. For spirituality involves finding  meaning, purpose, and hope in life. Whilst belief in organised religion may have declined belief in a non-material part of life is still prevalent.

Recent developments in quantum physics tend to support the importance of non-material factors in our lives. Through the “interconnectivity of all matter” actions can have an effect at a distance (the “non-local effect”). It has been observed that electrical conductivity in the DNA of isolated human cells can be affected at a distance of 350 miles by the triggering of different emotions in their original donors. Also, studies show human cells grow more quickly in a culture dish when “touched” by positive and empathetic thoughts regularly, even though the cells are not derived from the person “touching.” Thus empathy can influence human DNA.

More significantly the empathetic intentions of spiritual healers have been shown to have a detectable effect on the MRI scans of the brains of recipients at a distance – another “non-local effect.”  The part of the brain affected is also associated with the placebo response, which is now known to be our powerful inner healing drive and not just a positive psychological response towards the doctor’s treatment. So whilst we do not yet have hard scientific evidence that prayer does work for physical and mental healing, the recent study above of healers sending prayers for healing to recipients demonstrates a clear pathway for a healing effect to happen.

Psycho-neuro-immunology is the science of understanding how psycho-social factors in our lives (are we loved? do we suffer discrimination? does our life have meaning, purpose, and hope, etc.) affect the functioning of our immune system through connections with the brain. So factors that affect our spirituality/spiritual wellbeing can influence our immune systems. In this way mind (and all its internal and external influences) and body are not separated, and we should speak of the mindbody.

The evidence base for supporting the positive link between spirituality and health is mushrooming and no longer confined to the palliative care situation with the terminally ill. HIV/Aids patients with positive spiritual wellbeing have been shown to have maintained better functioning immune systems than those without. If patients are struggling spiritually, with life having lost meaning and hope prior to significant cardiac surgery, they will not experience such a good surgical recovery and outcome. Coronary artery stenting (keyhole opening up of blocked/narrowed arteries) does not work so well in patients suffering from a sense of hopelessness.

Even today most disease cannot be cured, so “Health-Related Quality of Life” (HR-QoL) is becoming an important measure of the effectiveness of treatment. Spiritual wellbeing has now been shown to be strongly positively associated with HR-QoL, particularly with chronic long-term conditions such as arthritis, and most cancers.

The Scottish Government has stated that “...spiritual care is integral to the holistic care it provides.” With 60% of patients who use the NHS being over the age of 60 years Faith in Older People has an important role to play in influencing the NHS to care for their spiritual needs.  As the current financial restrictions impact on the NHS it is imperative that we strive for spiritual care not to be neglected.

.

Community Chaplaincy Listening Services

In the past financial year, the Scottish Government and NES have funded the development of pilot Community Chaplaincy Listening (CCL) Services within GP surgeries in several health boards across Scotland as part of a single action research project. CCL is part of a shift towards developing spiritual care services in community settings in line with Scottish Government spiritual care guidelines, the person -centred agenda of the Quality Strategy and Shifting the Balance of Care.

In most health boards chaplains have been providing CCL services although a few specially recruited, trained and supervised volunteers have also been involved. CCL tries to enable patients to explore existential questions and (re)discover their inner resources to help deal with times of adjustment and loss in their lives.

The research aims to:

·         assess patient wellbeing following involvement with the service

·         perform a cost benefit analysis in relation to savings which the services may make in relation to prescribing, GP time and hospitalisation.

In the coming year a continuation of CCL activity will enable pilot projects to be embedded further and will enable more GP surgeries to be involved in a wider range of health boards to provide this service.

A DVD is available from NES which includes feedback from the stakeholders involved in the initial pilots - service users, GPs, a health board medical director and chaplains.

This received very positive feedback when showcased at a national conference held recently in Perth Concert Hall

Further information from: Ewan Kelly, Programme Director for Healthcare Chaplaincy and Spiritual Care  email:  ewan.kelly@nes.scot.nhs.uk

Handwritten Bible Project

To celebrate the 400^th anniversary of the publication of the King James Version of the Bible, MHA encouragedits residents to produce a new testament written entirely by hand.

Each home was invited to pen a few chapters, either individually or as a group.  As Auchlochan has more residents than any other MHA development, I suggested that we could complete 60 chapters. 

A large group of willing residents gathered in Auchlochan’s Douglas Suite on the afternoon of March 7^th2011, bringing their favourite pens, and by the end of the allotted time the bulk of the work was completed.  Individuals spoke warmly of the scriptures coming alive as they concentrated on forming each sentence and spelling each word. 

Only when the sheets of writing were gathered in were we able to witness the miracle that had taken place.  Each hand was so very different from the next, but every page fitted into the whole, in just the same way in which the bible itself was formed.  Rarely is such evidence of diversity within community so clearly expressed during a group activity in which every member is working towards the same goal.

We look forward to seeing the finished article and giving thanks to God for the gift of the bible.

The Revd. Cliff G. Jackson

Chaplaincy Team Leader

MHA Auchlochan Garden Village,

Lesmahagow

.

Is there a retirement age from spirituality?

What can I change in life? 

There is only one thing we can change - the way we see things.

Can we apply this truth to the ageing process? 

We can change all kinds of things around us.       

We cannot abolish the ageing process; death is certain.

What can we do? 

We can see our ageing process differently.

We must face the facts of ageing: 

if we fail to do this, we miss the treasure that lies hidden in our fears.

Ageing brings diminishment.  You can fill in the details for yourself! 

Besides physical loss, there are the mental and emotional pains which can accompany loss of job, of status and of independence.  Regret for past losses of close relatives, friends, for broken relationships, for injustices suffered, for the harm we have done, the good we have failed to do. There is also the pain we may suffer from ‘nice’ people, who put us firmly into the elderly category and treat us as helpless objects of their compassion!

Here is an imaginative exercise you can do to enable you to catch a glimpse of the treasure within you.  Write the kind of obituary you would love to have after your death.  Do not let reality limit you in the slightest.

Keep asking yourself  ‘What do I most long for in my life?’  That is the most valuable search you can undertake whatever your age.  You have started on a journey of discovery.  Yes, you have thousands of desires, but keep searching for the deepest.  The process takes time, a lifetime. We shall never find a neat, clear answer.  The answer is greater than anything we can think or imagine: the search is worth every moment.  It is the diminishment we are suffering which is forcing us down to new and very painful depths of ourselves.  We are becoming aware of our fragility, our feelings of helplessness and hopelessness.  To acknowledge to ourselves the truth of this experience is the first step to discovering the treasure.

The poet Francis Thompson called God ‘The Hound of Heaven’, who pursued him down the arches of the years until God cornered him, then spoke:-

Halts by me that footfall:

Is my gloom, after all,

Shade of his hand outstretched caressingly?

‘Ah fondest, blindest weakest,

I am he whom thou seekest!’

Our pain of diminishment is the pain of desire, the desire to let God be the God of love and compassion to us and through us, and this God is nearer to us than we are to ourselves!     

                    

                                   Gerard W. Hughes sj  Edinburgh

Due to weather conditions not many people were able to attend Father Gerard’s talk but we were able to film it – we have a limited number of DVD’s available but could get more if response is great. Cost £5

Please contact info@fiop.org.uk  if you would like a copy

A Coming to Terms

On Monday, 9^th August, as part of the ‘Festival of Spirituality and Peace’ held at St John’s Church Edinburgh, an audience of around 150 heard a conversation between Simon Callow and Malcolm Goldsmith which no-one present will easily forget.

The subject was ‘Living with Dementia: My Mother And I’, and Simon began by filling in the picture of his mother’s life and personality predementia. He described her as displaying ‘containable eccentricity’ and being ‘rather a quirky woman’. She had always had a very imperfect memory and wrote everything down. 

She experienced ‘a mental and physical collapse’ at the age of 87, and it soon became clear that the combination of paranoia, malnutrition and dementia made finding a nursing home for her an imperative.  Simon commented on ‘the astounding difference between homes’, but he managed to find one in Central London which proved to be near-ideal.  It was small, modern, well-designed, run by an enlightened group of doctors, and progressive in its ethos.  Music and art were a focus, there was a beautiful garden, and an emphasis on activity and humour.  Simon commended the caring staff, many of whom were from ethnic minorities: every day was treated as special, and there were many celebrations held in a family atmosphere.

Despite all the social opportunities, however, his mother had, he believed, ‘embarked upon a journey of re-evaluation internally’.  Gone was the fanatical Catholicism of her earlier life; now she was ‘thinking, trying to solve a dilemma’. Coming to terms with someone with the condition, he suggested, ‘you transcend the individual relationship and embrace common humanity’.  I was struck by the congruity of this process with FIOP’s definition of spirituality as ‘developing an understanding of what gives meaning to people’s lives.’  This was a thought-provoking morning for us all.

                                      John Killick

The Spiritual Journey And Well-Being In Old Age

Faith in Older People was delighted to have the opportunity to organise this conference held in the Glasgow University Crichton Centre for Research in Health and Social Issues which brought together participants from churches, health and social care to consider the importance of the spiritual journey for older people.

 This was presented in terms of old age as a time for celebration, by Rev. Malcolm Goldsmith, in which we approach ageing with a sense of wonder and contentment and continuing creativity so that our journey towards death is not met with fear and apprehension but rather with gratitude and a sense of mystery.   “The problem with ageing is not age – it is petrifaction – a rigidity of the soul – inflexibility.  It is when we close our minds to our responsibility to ourselves and to others to keep on growing”, (Joan Chittister).  Although there are some wonderful examples of the support provided to older people in congregations it was felt that this needs to develop and new ways of providing a presence found.

Ageing as a spiritual matter was the theme of Dr. Harriet Mowat’s presentation.  We must capture the story of individuals to reinforce that lives have been meaningful; what will to be remembered about us and who will hold our memories; do we allow time to review and reflect upon our lives and to allow time for reconciliation.  What is important is to live in the present and have opportunities to be creative and playful.

Professor David Clark gave an overview of end of life issues and considered the traditional approach to death as being sudden, accepted, having rituals and probably at home but contrasted with modern end of life being gradual, more secular with less ritual and in hospital. Post modern he felt was unpredictable, with a stronger focus on personal spirituality and a consumer choice as to where to die.  There was a strong focus on the hospice movement and who should take responsibility for spiritual care at the end of life and how do we prepare staff and carers to undertake this role.

Jenny Henderson through practical exercises and examples illustrated the importance of being able to communicate well with older people who had dementia.  It was more than speech.  It was thinking of ways to help them express themselves and their needs through a variety of creative ways and ensuring that we adapt to their individual requirements.  This required time and patience.

The presentations were followed by a lively Panel Discussion

“A most encouraging event, with some very impressive people” (Conference participant)

The conference was a collaborative event between, Faith in Older People, Glasgow University, Scottish Episcopal Diocese of Glasgow and Galloway and the Church of Scotland.  We received support from St. John’s Dumfries; ACTS and Glasgow University.

DVD ‘Spirituality – Have you found any yet?

This DVD, jointly produced by FiOP, Alzheimer’s Scotland and Artlink, was previewed at the recent Scottish Caring Conference and formally launched at the FiOP Conference on the ‘Spiritual Journey and well-being in old age’ in Dumfries in May.

The aim of the DVD is to assist those who care for older people to understand better their spiritual needs and to find ways of enabling them to be fulfilled.  Spiritual care is not easily understood.  The work undertaken by Alzheimer’s Scotland in the Beyond Barriers’ project and the Palliative Care Initiative together with the work undertaken by FiOP in ‘Delivering Spiritual Care’ has highlighted the reservations and discomfort of staff in discussing the issue with residents and relatives.

We hope that the DVD will help to de-mystify the issue and give clues to considering this important aspect of our lives.  Spiritual care is made up of many factors and we have looked at the issue in terms of ‘what gives meaning to people’s lives’.

The conversations in the DVD open up these issues for staff and residents and there are case studies and questions for discussion.  We do not attempt to provide answers but to ensure that the issue is given the importance it deserves and that people become more confident in exploring issues which contribute to a holistic approach to care.

The DVD has been widely circulated to all care homes in Scotland and its use will be evaluated over the coming months.  A workshop on the DVD has been included in the forthcoming Dementia Services Development Conference in London in October 2010.

If you would like FiOP to facilitate a discussion or training session based on the DVD or to obtain copies of the DVD please contact  info@fiop.org.uk

North of Scotland training programme

In the Autumn, and before the snow came, we ran three day workshops in the North of Scotland in Inverness, Skye and Aberdeen. The intention was to offer residential care home staff the opportunity to take a day to think through some of the issues around ageing and spirituality and the implications of this for spiritual care for older people. We were delighted with the response to our invitation. The workshops were intended to accommodate only 12 people – in two of the three cases we were bursting at the seams. However it was good to see such an interest in the topic. 

The day consisted of three parts. We thought about our own ageing and what that might mean in terms of our understanding of the ageing of others. We considered the challenges of working in residential care and the pressures on time and energies for the staff. We also thought about what “successful” ageing might look like. In the afternoon we thought about the spiritual care of older people using an exercise called cards on the table. This allowed the group to share ideas and develop their thinking around the priorities and  practicalities of spiritual care. We finished by looking at a model of spiritual care that has been developed by a group of healthcare chaplains and researchers working in the North of Scotland.  This is now written up and about to be published in the Scottish Journal of Health Care Chaplaincy. 

Harriet Mowat

March 3^rd 2010