Nurses’ Understanding of Spirituality and the Spirituality of Older People with Dementia in the Continuing Care Setting

This research paper was presented at the Third International Spirituality in Healthcare Conference 2017—‘Creating Space for Spirituality in Healthcare’ at Trinity College Dublin, The University of Dublin. 22 June 2017. The number of older people living with dementia in Ireland is rising. Dementia is prevalent among those residing in the continuing care setting. Nurses have a professional obligation to provide person centred, holistic care, to which spiritual care is a core element, yet often do not. As there are no guidelines in Ireland for spiritual care provision it is open to personal interpretation and application. This study was the first in Ireland to explore how spiritual care is understood by nurses in the context of older people living with dementia in a public, rural, continuing care setting. A qualitative descriptive design was utilized. Following purposive sampling, eight semi structured interviews were conducted in a rural Irish community hospital among registered nurses caring for older people living with dementia. A conceptual framework developed from the findings of a literature review, as well as this research study’s aim and objectives framed the interview schedule and data analysis. Data analysis utilized Newell and Burnard (2011) Thematic Content Analysis. Ethical approval was granted by the Health Service Executive (HSE) and the University of Dublin, Trinity College Dublin (TCD). Six key themes emerged from the study—1. Understandings of Spirituality, 2. Assessing spiritual need, 3. Providing spiritual care, 4. The impact of spirituality on quality of life, 5. Barriers to spiritual care and how these are addressed, and finally 6. The needs of staff. This paper presents and discusses the findings of the first theme ‘Understandings of Spirituality’ and its two sub-themes, 1. ‘The nurse’s own understanding of spirituality’ and 2. ‘The nurses’ understanding of spirituality and older people living with dementia.’ It is evident from the findings that there exists a variety of responses with regards to the nurses’ own understanding of the concept spirituality and spirituality for older people living with dementia. Participants placed emphasis on person-centred approaches to understanding and providing for the needs of care recipients’ in this area of care. Most participants acknowledged the positive impact of spiritual care on quality of life for older people living with dementia. Indications for practice suggest the need to develop suitable evidence based professional, person-centred frameworks, guidelines and educational standards for nurses which better equip them to understand spirituality and how this area of need can be properly assessed in partnership with the recipient of nursing practice in the continuing care setting to ensure comprehensive holistic, person-centred practice.