Still Living, Loving, and Laughing: Spiritual Life in the Dementia Unit

Spiritual Needs of Older Adults Living with Dementia: An Integrative Review

Older adults living with dementia experience progressive decline, prompting reliance on others for spiritual care and support. Despite a growing interest in studying persons living with dementia (PLwDs), empirical evidence on the spiritual needs of PLwDs has not been synthesized. Using the Whittemore and Knafl method, this integrative review examined the literature from 2000 to 2022 on the spiritual care needs of PLwDs. We sought to identify characteristics of the spiritual needs of PLwDs and ways to address them. The ATLA Religion, CINAHL, PsycINFO, PubMed, and Socindex databases were used to search the literature, and 12 peer-reviewed articles met the inclusion criteria. Spiritual care needs varied across studies. Overall, findings support the importance of identifying PLwDs' religious and spiritual backgrounds to inform person-centered care. Spiritual needs were identified as verbal and non-verbal expressions related to past meaning and religious and spiritual background and were not consistently addressed in care. Providers reported observing spiritual distress in the mild stage prompting the need for spiritual care. There is a great need for dementia-specific spiritual assessment tools and spiritual care interventions to support spiritual well-being in dementia care. Spiritual care involves facilitating religious rituals and providing spiritual group therapy and religious and spiritual activities.

He Tūhononga Whaiaro: A Kaupapa Māori Approach to Mate Wareware (Dementia) and Cognitive Assessment of Older Māori

AIM

The aim of this study is to investigate Māori (Indigenous peoples of Aotearoa New Zealand) understandings of dementia (mate wareware) and develop a framework to inform assessment of cognitive impairment.

METHOD

Qualitative, kaupapa Māori (Māori approach) research with 241 older Māori (kaumātua) involving 17 focus groups across Aotearoa New Zealand (NZ) and eight families (whānau) from one region. We thematically analyzed transcribed data from audio-recorded interviews.

RESULTS

Two overarching themes, namely, connection (Tūhononga) and self (Whaiaro), and eight subthemes in particular mind (hinengaro), spirit (wairua), body (tinana), family (whānau), social connection (whanaungatanga), identity and role (tuakiri), place (wāhi), and ancestors (tūpuna) emerged. Māori language (Te Reo Māori) was important for cognitive health.

CONCLUSION

The findings embedded in cultural values improve understanding of dementia (mate wareware) in Māori. These themes can inform the assessment of older Māori with cognitive impairment. For those without cognitive impairment, the Tūhononga Whaiaro framework suggests factors potentially crucial for healthy aging in Māori.

Spiritual Care in Advanced Dementia from the Perspective of Health Providers: A Qualitative Systematic Review

Background

Worldwide, 47 million people suffer from dementia. Despite recognizing the importance of spirituality within dementia care, it is still unclear how this should be integrated into dementia services.

Aim

To explore the perspective of health professionals regarding the spiritual care of people with advanced dementia.

Methods

A qualitative systematic review was performed following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines for the study design. The inclusion criteria included original articles published from January 2008 to March 2019, using either qualitative or mixed methods. The quality of the articles included was evaluated using the consolidated criteria for reporting qualitative research, Standards for Reporting Qualitative Research, and the Critical Appraisal Skills Programme. Synthesis of findings was performed using thematic analysis.

Results

Twelve studies were included in the review. Seventeen categories were identified, grouped into four themes: (1) the perception of spirituality, including the failure to address the same, (2) the spiritual needs of people with advanced dementia, (3) spiritual needs from health care providers, and (4) addressing spirituality, with the following categories: music, significant activities, among others.

Conclusions

Spirituality is not formally addressed in this population, and professionals do not feel confident enough to be able to integrate spirituality in their care. It is necessary to identify and record the spiritual needs of people with advanced dementia, as well as to design specific care programs.

The Importance of Religiosity to the Well-Being of African American Older Adults Living With Dementia

This study was a post hoc analysis of a larger qualitative descriptive study exploring family involvement in health promotion activities for African Americans living with dementia where participants identified religious practices as meaningful health promotion activities. The purpose of this study was to explore ways in which religiosity may influence the well-being of older adults living with dementia. Semi-structured interviews were conducted among a sample of 22 family caregivers and 15 older adults living with dementia (N = 37). Three themes emerged: Engagement, Promotion of Faith and Spiritual Connectedness, and Maintenance of Religious Practices. It is imperative for family caregivers to understand the important contributions of religious activities and beliefs to the well-being of their family member. This information might be of use for faith communities, policy makers, and health care providers in the provision of optimal person-centered care and the promotion of quality of life for persons living with dementia.