"I forgive you
Please forgive me
Thank you
I love you"
Ira Byock, ‘The Four Things that Matter Most’
Spiritual Care
We define spirituality as that which gives meaning and purpose to life and helps build resilience in the face of life’s uncertainties. As such, it includes religious belief and practice but is more than that. It is to do with what makes us human, and so with human relationships as well as our relationship with the transcendent, that which is beyond us, with God.
​
While not everyone is religious, everyone has a spirituality, an inner life, something that is at the heart of who we are as human beings and is of our ‘essence’. And many of us believe that this essence is also closely linked to something greater than ourselves, something infinite, only partially defined by religious beliefs but is beyond us in ways we struggle to comprehend, something that is often called ‘transcendence’ .
​
We reconnect with this inner essence or spirit at various times in our lives, and notably when we consider our mortality, when we are facing our own death or the death of someone we love. And if possible, recognising and reconnecting with this deeper source, can be an enormous source of strength, comfort and fruitfulness both in our day-today lives and as we live with the reality of our dying.
​
Inner life , culture , belief, and religious resources
Spirituality and Compassion
Rev Mark Thomas describes the essence of spiritual care for people nearing the end of life
Religion provides beliefs and practices which help make sense of life and death and gives resources to sustain us and the support of a loving community.
Religious practice and custom and attitudes to death and dying are many and varied and it is important not to make assumptions; the questions you ask will be more important than the answers you give.
You may need to contact the local religious minister, priest or pastor and so your directory of those people will need to be kept up to date.
​
Religious practices can help provide resources and rituals for living well in the present and as we near the time of dying, making sense of things, moving towards a sense of resolution and peace .
​
We also have a sense of refocussing and prioritising what’s important and what’s not. They help us make time to say the things that are important to say to those we love. In Ira Byock’s book, ‘The Four Things that Matter Most’, he suggests the four things that matter most to say to and hear from people who are dying are:
​
-
I forgive you;
-
please forgive me;
-
thank you;
-
I love you.”
​​
To hear and say these important things, either in the final days of life, or even every day, can help to make it easier for people say goodbye, and to let go, when the time eventually comes.
Spirituality is to do with our humanity; it helps us deal with the fact that we are all mortal, both the person you are caring for and you yourself (something brought firmly home to us by the COVID 19 pandemic). Compassion starts with that recognition, an acknowledgement of our shared humanity with those for whom we care. Yes, we must be professional, but that doesn’t mean hiding behind our professional expertise.
​
In the spiritual care that we give as care-providers, it is important to acknowledge our common human vulnerability, and that we don’t have all the answers. But that we can meet the person at a deeper level, and support them, as much in our silent presence, as in our actions, our touch and our words. Once we recognise this in ourselves, we can take steps to recognise it in others, and to begin to help meet the deeper needs of people as they journey towards the end of their lives.
Finding meaning and purpose- a Care Home Chaplain discusses the importance of spiritual care for all residents
Rituals
It is important to pay attention to the rituals that accompany death and dying – how a body is treated after death, funeral rites, the way someone is remembered and how relatives are informed, and other practices. Paying attention to these is important because they represent something of deeper meaning and significance.
These practices will vary according to tradition, religious practice and custom, so the understanding of the cultural context in care for people who are dying , and importantly the after death care , is a vitally important area in our multi-cultural societies. Guidance should be specifically sought , from the family, from the advance care plans, religious leader or other sources for each variation of religious practice, to ensure care is in line with peoples' wishes.
