NCM 114 GERONTOLOGICAL NURSING LECTURE (MIDTERM)

GERONTOLOGICAL NURSING
SPIRITUALITY AND RELIGIONS are not synonymous. The
fact that people are atheists or agnostics does not mean they
SPIRITUALITY are not spiritual, because they can search meaning in their
lives, have a strong sense of moral values and be in awe at the
The spiritual nurse mysteries and wonders of life (Udan)
“ Everyone practices or experiences spirituality differently, but “Awe is the feeling we get in the presence of something vast
we get to bring that part of ourselves to address the spiritual that challenges our understanding of the world”
needs of our patients” 
“ The nurse promotes an environment in which the human TERMINOLOGIES 
rights, values, customs and spiritual beliefs of the individual, 
family and community are respected” AGNOSTIC - a person who claims not to know with
 certainty whether or not God exists
INTRODUCTION   ATHEIST - a person who believes God does not exist.
  RELIGION - human-created structures, rituals,
People are spiritual beings, therefore spiritual care must be an symbolism and rules for relating to God/higher power
integral part of comprehensive, holistic care  SPIRITUALITY - relationship and feeling with that
 Most people are comforted by the knowledge that they which transcends the physical world. It is the essence of
have connection with a power that is greater than
themselves
 A positive harmonious relationship with God or other ASSESSMENT GUIDE ON SPIRITUAL
higher power (divine) helps individual to feel unified NEEDS (INTERVIEW QUESTIONS)
with other people, nature and their imperfection or errors
 People derive joy, hope, peace and purpose when they our being that transcends and connects us to the divine
transcend beyond themselves: Suffering, hardship can and other living organisms
have meaning and be faced with added strength  What is your faith or religion?
 Are you Involved with a church, temple or faith
THE ROLE OF THE NURSE IN THE community? What is it? Would you like them to be
involved with your care?
SPIRITUAL NEEDS OF THE CLIENT  Are there religious practices that are important to you?
Nurses honor client’s spiritual needs by being available to Are you able to practice them now? If not, is there a way
offer support and opportunities for patients to express their I can assist in practicing them?
feelings, respecting their beliefs, providing opportunities for  Do you believe in God or higher power? could you
patients to express their faith, promoting hope and assisting please describe what that belief means to you?
patients find meaning in challenging situations that they face  Do you read the bible or other religious texts? are you
and if not in conflict with the nurses personal beliefs, praying able to do this reading now?
 What do you think God’s role is in your illness and
healing?
ASSESSING SPIRITUAL NEEDS  Is there anything about your faith or spiritual beliefs that
is causing you distress, discomfort or conflict?
with or for patients.  What is most meaningful to you?
SPIRITUAL NEEDS  What gives your life purpose?
 Love  What is your source of strength or support?
 Meaning and Purpose  From whom do you receive love?
 Hope  Who are the most significant recipients of love?
 Dignity  Do you feel like you have unfinished business?
 Forgiveness Forgiveness you wish to seek or offer?
 Gratitude  What are your fears?
 Transcendence  How can I best support your spiritual beliefs and
 Expression of Faith practices at this time?

ADDRESSING SPIRITUAL NEEDS 
SPIRITUALI RELIGIO 
WhereTY
do I find Evidence suggests that strong spiritual beliefs facilitate health
Belief What practices,
meaning?
Comfort Rules should I and healing
Follow
How do I feel Reflection  Nurses can use variety of interventions to assist patients
Connected? Ethics What is right and support their spirituality
Awe and wrong?
How should I
live? What is true
1 And false?
ERICA MEI CAPILI – BSN 3C
 NCM 114 GERONTOLOGICAL NURSING LECTURE (MIDTERM)
 Attentive listening and encouraging communication
remain important even if the patient’s beliefs differ from
those of the nurses
INTERVENTIONS TO MEET SPIRITUAL
being available
 Honoring beliefs and practices
 Providing opportunities for solitude
 Promoting hope
 Assisting in discovering meaning in challenging
situations
 Facilitating religious practices
 Praying with or for
RELIGIOUS BELIEFS AND PRACTICES
RELEVANT TO GERONTOLOGICAL
PROTESTANTISM
 BAPTIST - encourage abstinence from alcohol;
communion provided by clergy, scripture reading
important as savior; may believe illness is God’s will and
respond passively to care; some believe in healing power
or laying on hands
 EPISCOPAL (ANGLICAN) - fasting not required;
some may abstain form meat on Fridays, communion
provided by clergy; anointing of sick may be offered but
not required, believe in Jesus Christ as savior
 ASSEMBLES OF GOD (PENTECOSTAL) - believe
in divine healing through prayer and laying on hands;
communion provided by clergy; pray for God’s
intervention in healing
 METHODIST - communion provided by clergy;
anointing of the sick; praying and reading the bible are
important during illness; organ donation are encouraged;
believed in Jesus Christ as savior
 SEVENTH DAY ADVENTIST - healthy lifestyle
practices are promoted as the body is seen as the temple
of the holy spirit; alcohol, tobacco, coffee, tea and
recreational drugs are prohibited; Pork and shellfish are
avoided by most; many are vegetarians; sabbath observe
on Saturday, treatment may be opposed on sabbath; bible
reading important
ROMAN CATHOLICISM
 Fasting during lent and on Fridays optional
 Priest provided communion, sacrament of the sick and
hears confession
 Rosary beads, medal, statues and other religious objects
important
 Pope is head of the church on earth
 Express faith in the apostle’s creed
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ERICA MEI CAPILI – BSN 3C
EASTERN ORTHODOX
 Believes holy spirit proceeds from father
 Reject authority of the Pope
 Fast from meat and dairy products on Wednesday and
Friday during lent and on other holy days
 holy unction administered to sick but not necessarily as
last rites
  Last rites must be provided by ordained priest



CHRISTIAN SCIENCE
 Religion based on use of faith for healing
 May decline drugs, psychotherapy, hypnotism,
vaccinations and some treatment
 Desires to be active participants in care
 JEHOVAH’S WITNESSES - discourage the use of
alcohol and tobacco, blood transfusions not accepted,
although alternative methods can be used
 CHURCH OF JESUS CHRIST OF LATTER DAY
SAINTS (MORMON) - prayer and reading sacred
writings important, use of divine healing through laying
of hands; abstain from alcohol; discourage use of
caffeine
JUDAISM
 Observe sabbath from sundown Friday to nightfall
Saturday
 Orthodox: believe in the torah (five books of Moses);
Kosher diet (not mixing milk and meat, no pork,
shellfish; no consumption of meat slaughtered in
accordance with jewish law
 Strict restriction during sabbath
 Married women cover their hair
 Family and friends remain with dying person
 In death body should not be left alone, orthodox person
should touch or wash the body, body is buried within 24
hours
ISLAM
 Founded by Prophet Mohammed
 Their scriptures is the Koran
 May pray five times a day facing mecca; privacy in
prayer
 Abstain from pork and alcohol
 Prayer time, washing is important even by the sick
 Women cannot sign consent or make decision without
the husband
 Family or any practicing muslim can pray with drying
person
 Prefer family to wash or prepare body of deceased; burial
Is within 24 hours, cremation is not allowed
 Organ donation not allowed
BUDDHISM
 NCM 114 GERONTOLOGICAL NURSING LECTURE (MIDTERM)
 Enlightenment found in individual meditation rather than  Using music therapy
communal worship  Referring to support group
 Follow moral code known as eightfold path that leads to  Guiding the patient in life review to high light past
nirvana (form of liberation and enlightenment) successes in meeting life challenges that can be
 Vegetarian: Abstain from alcohol and tobacco linked to current situations
 May opposite medications and refuse treatments on holy  Helping patient to find pleasure and enjoyment in
days current life activities
 Private, uninterrupted time for meditation is important  Encouraging relaxing, uplifting environment
 (flowers, sunshine, fresh air., pleasant scents, pes,
OPPORTUNITIES FOR SOLITUDE  stimulating colors)
  Using humor therapeutically
SOLITUDE IS AN IMPORTANT ASPECTS OF THE  Referring to clergy as needed
EXPRESSION OF SPIRITUALITY  Assisting patient in participating in religious services
 UNINTERRUPTED TIME ALLOWS PERSONAL 
COMMUNICATION WITH ONE’S GOD OR OTHER SPIRITUAL DISTRESS 
HIGHER POWER: Offering of prayers, reflecting, 
medications, listen for answers from a divine source A state In which one’s relationship to God or other higher
 Nurses must respect and protect periods of solitude power is disrupted or at risk of being disrupted and or/
 Remember: Choosing solitude is different from being spiritual needs cannot be fulfilled
socially isolated  Illness declining health, losses, awareness of mortality
and conflicts between beliefs and medical treatments
MEDITATION could promote spiritual distress

 Solitude provides opportunity for meditation, an SIGNS OF SPIRITUAL DISTRESS
activity that calms the mind and assists in focusing 
thoughts to be present It can take the form of: 
 CONCENTRATIVE MEDITATION - attention is Anger, anxiety, complaints, crying, cynicism, depression,
focused on breathing, a sound or an image; this calms guilt, hopelessness, isolation, low self-esteem,
and promotes mental clarity and acuity powerlessness, refusal to make plans, sarcasm, suicidal
thoughts or plans, physical symptoms (fatigue, poor
 MINDFULNESS MEDITATION - attention is on the
appetite, sleep disturbances and sighing)
sensations being experienced such as sounds or
thoughts; this promotes calm, non reactive mental state  Person questions his or her faith and beliefs
 TRANSCENDENTAL MEDITATION - involves 
guiding the body to a level of profound relaxation
INTERVENTIONS FOR SPIRITUAL 

Assist patient in identifying factors contributing to SD
PROMOTING HOPE  Support client's religious practices
 Pray with or for patient (without violating one’s own
while the mind becomes more alert
faith)
 Hope is Important to human beings
 Refer to clergy. native healer, support group
 Hope helps people to commit to goals and actions
 Contact patient's church, temple for visitation and follow
 In older adults with serious health conditions or up
disabilities maintaining hope can be challenging
 Respect client's desire not to be visited by clergy
 Hopelessness can interfere with self care and healing
 Do not challenge patient's religious beliefs or attempt to
and drain energies
change them
 Promoting hope begins in establishing a trusting
relationship with the patients
SEXUALITY AND INTIMACY 
 Careful assessment in identifying factors that contribute

to hopelessness
Discuss the effect of societal attitudes towards sex and older
 Interventions should be planned to address specific adults
factors that contribute to hopelessness
 Explain the effects of aging on sexuality and sexual
OTHER INTERVENTIONS IN PROMOTING function
 Identify measures to manage menopausal symptoms
 Assisting in developing realistic short term goals and  Describe factors that can contribute to sexual dysfunction
acknowledging the achievement of goals 
 Developing affirmations (I am loved by God; I am TERMINOLOGIES 
unique) 
 Maintain a personal journal ANDROPAUSE : a decline in testosterone levels with aging
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ERICA MEI CAPILI – BSN 3C
 NCM 114 GERONTOLOGICAL NURSING LECTURE (MIDTERM)
 DYSPAREUNIA : painful intercourse
 ERECTILE DYSFUNCTION : the inability to attain and
maintain an erection of the penis sufficient to engage in
sexual intercourse
 HORMONE REPLACEMENT THERAPY :
replacement of estrogen and/or progestin hormone that is

INTRODUCTION
no longer being produced by the body
 Nurses need to appreciate that sexual interest and activity
can continue Into late life
 Nurses must recognize, respect and accept sexuality in
older adults with great consideration to cultural aspects

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ERICA MEI CAPILI – BSN 3C