What happens during death, that final life transition? With the knowledge of impending death, spiritual and religious beliefs play an essential role for individuals in making sense out of life. However, most people have done little to psychologically, spiritually, or socially prepare for death.
Spiritual issues may not surface until individuals are faced with mortality. At that point, they often search for meaning in their own death or in the death of a loved one. Bereaved people may ponder the existential issues of life, not only with regard to the loss of a loved one but for themselves as well. During this life transition, a person’s most deeply held beliefs are challenged and opportunities for growth are experienced. To die peacefully and to die with the knowledge that life has had meaning is important to the dying person (Kuebler, Berry, & Heidrich, 2002; Marchand, 2007; Olson & Keegan, 2013).
In the past, health care has typically avoided the topic of spiritual care at the end of life and left clients to their own private beliefs and practices. However, as the interest in, and importance of, spirituality grows, care at the end of life is emerging as an essential dimension of integrative and holistic health care.
Spiritual care is the responsibility of all individuals involved in caring for the dying person. Spiritual care at the end of life means acknowledging and supporting the beliefs of the dying so that during the dying process, their needs are met (Cancer Research, 2016; O’Gorman, 2002).
Spiritual care of the dying considers and acknowledges the relationships of a person’s life—relationships with the Ultimate, the self, and others. Spiritual care at the end of life provides an opportunity for the dying person to reflect on his or her successes, failures, hopes, fears, and sorrows. A framework for treatment decisions can be based on an understanding of the person’s goals, values, and wishes, taking into account spiritual and religious as well as cultural beliefs (O’Gorman, 2002).
At the end of life, people usually go through a process of integration, an attempt to put the pieces of their life together in a pattern consistent with the whole of their life. This can include honoring significant relationships and commitments, exploring questions of meaning and purpose in life, engaging in relevant rituals, and making plans consistent with their values.
Integration also involves the grieving and mourning of multiple losses associated with the ending of life. Spiritual integration is a healing process that provides closure and a sense of dignity as well as addressing unfinished business and mending broken relationships (O’Gorman, 2002).
Healthcare professionals can assist dying individuals and their families by incorporating the physiological, psychosocial, spiritual, and cultural aspects of dying into the care they provide and acting as guides to help the dying person and family members through this final life transition.