Spiritual Care in the OPDSpiritual Care in the OPD

Harvey A. Elder, M. D.

Spiritual:Spiritual: Searching the sacred for meaning and purpose

Who am I? Where did I come from? Where am I going? What is there after death?

Relating to the Sacred, Ultimate, to God Faith is the name of the relationship

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What Is Spiritual Care?What Is Spiritual Care?

Who are the patients in the OPD? Integrated multifactor unity Who do you see? Why come? What supports their identity? What core issues do they face?

What are their central spiritual needs?

How well are they coping? Providing Spiritual Care

What Supports Their IdentityWhat Supports Their Identity

If physical illness challenges identity If mental mental slowing threatens If emotional emotional varieties threaten If social how perceived threatens If spiritual: belief in Almighty Being stability

If merciful/gracious past forgiven If personal love specific, deep and tender If creative self-worth stable not subject to threat

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Core Issues FacedCore Issues Faced

Who are you? What are you worth? Who cares about you? Who cares for you? What drives you? Are you free from your past? What does you future look like? How do you cope with life? with illness? with

stress? All of these complicate illness, compliance and

recovery

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Meet JoeMeet Joe

Joe: 23 yr. old, 2nd yr. of professional school married 6 mo., a committed Christian During exam week for 1st yr. nocturnal diarrhea, often

keeping awake all night.

What are his spiritual needs?

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More about JoeMore about Joe

He took Benadryl and this helped a little His mother died of lymphoma, 05/08 He has small lymph nodes below his rt. Jaw What are his spiritual needs?

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What Is Spiritual Care?What Is Spiritual Care?

Who are the patients in the OPD? What are their central spiritual

needs? Connection: past, present, future What questions do they deal with?

How well are they coping? Providing Spiritual Care

What Are Their Questions?What Are Their Questions? Physical:

Meaning, outcome Suffering, impairment

Mental/cognitive: Mental faculties, “loose it,” employment, hobbies

Social: Social support, abandonment, financial stability

Spiritual: Why me? Where is God in all of this?

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Meet CaraMeet Cara 71 yr. old lady living with her third husband

1 mo. cough that worsened, especially at night 1 wk. cough can’t breath unless sits up Believes in God and trusts Him when necessary

What are her spiritual needs?

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Additional Info for CaraAdditional Info for Cara

Additional information: Second husband died of cancer of the lungs Father died, age 72, of heart failure with severe

dyspnea

What are her spiritual needs?

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What Is Spiritual Care?What Is Spiritual Care?

Who are the patients in the OPD? What are their central spiritual

needs? How well are they coping?

Orienting System Role of illness if Identity based on:

physical, mental, emotional, social, spiritual

Spiritual Care in the OPD

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What Is Spiritual Care?What Is Spiritual Care?

Who are the patients in the OPD? What are their central spiritual

needs? How well are they coping? Spiritual Care in the OPD

Initial visit Strategy Meeting spiritual needs

Initial Visit: QuestionsInitial Visit: Questions

“How coping with symptoms/illness/life?” “Religious heritage? Still practicing?” “What are you famous for?” “How has this illness affected the way you see

yourself?” “What about your symptoms concerns you?”

“How do you view the future”?

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StrategyStrategy

Ask something at the first visit Note in the chart something not clarified Keep the conversation going from visit to visit Asking questions about multiple aspects of life

frees patients to ask about their concerns Treat each area of concern as you would, any

clinical problem: query, evaluate and fine help At some point they will have a major crisis!

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Respond to Spiritual NeedsRespond to Spiritual Needs Connection: presence, listening, hearing Identity: God’s precious child

Self-worth, loved

Grace: accepted (no shame) Forgiveness confession, repentance (gift), humility

Commitment: faith praise and obedience, hope

Bring specific spiritual answers to their needs, not generic ones (pray more, read Bible, etc.)

No proselytizing

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Spiritual CareSpiritual Care

Speaking TRUTH to meet human needs Friendship, building a safe relationship (not Amway!) Connection, willing to share in their suffering

Freedom from judgment Helping them find support

God, Holy Spirit, Christians friends Stand with encourage, hold as they struggle with

Acceptance and love Forgiveness: self and others Self-worth: precious child of God

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