Attachment and Spiritual Coping: Theory and Practice With Older Adults

What is known about the spirituality in older adults living in residential care facilities? An Integrative review

AIM

To synthesize evidence regarding the spiritual needs and care of older adults living in residential care facilities from the perspectives of older adults and nurses or caregivers.

DESIGN

Integrative review of literature.

DATA SOURCES

Literature search was conducted using CINAHL Plus with Full Text via EBSCO, Scopus, PubMed, PsychInfo, Web of Science, and ProQuest Social Science Databases from March to December 2017.

REVIEW METHODS

This integrative review utilised the Whittemore and Knafl framework and PRISMA in the selection of eligible articles. Quality of the articles was evaluated using the Mixed Method Appraisal Tool.

RESULTS

Seven articles were reviewed and analysed. There is limited evidence \and no agreed definition of spiritual needs and care of older adults living in residential care facilities. Spiritual needs of older adults in residential care facilities is a psycho-social, religious and existential construct. Spiritual care in residential care facilities is linked to information gathering, religious guidance, maintaining family connections, providing companionship, discussing end of life issues, and providing counseling. Older adults highly value the role of nurses and caregivers in fulfilling their spiritual needs and providing spiritual care. However, nurses and caregivers perceived arranging a referral to a religious advisor as the main aspect of spiritual care. Therefore, nurses', caregivers', and older adults' views on spiritual care differed to some extent.

CONCLUSION

The practical aspects of spiritual needs assessment and spiritual care provision requires further investigation, which is essential to improve the effectiveness of service delivery in residential care facilities.

What Constitutes a Good and Bad Death?: Perspectives of Homeless Older Adults

This qualitative study explored perspectives toward a good or bad death among 21 older homeless adults residing in transitional housing. Using grounded theory approach, the themes for a good death were (a) dying peacefully; (b) not suffering; (c) experiencing spiritual connection; and (d) making amends with significant others. Themes for a bad death were (a) experiencing death by accident or violence; (b) prolonging life with life supports; (c) becoming dependent while entering a dying trajectory; and (d) dying alone. Healthcare professionals need to develop approaches for end-of-life care grounded in understanding unique needs of older homeless adults.