PHILADELPHIA – Religious and spiritual beliefs often play an important role in the lives of the elderly and should be taken into account by health care workers who care for geriatric patients.
Physicians and others who care for the elderly should take a spiritual history of their patients following the FICA model: faith, importance, community, and addressing spiritual needs, Kathleen L. Egan, Ph.D., said at a conference sponsored by the American Society on Aging.
This means asking patients if they have a faith, how important it is to them, whether they belong to a faith community, and whether they have a spiritual need that requires action, said Dr. Egan, director of geriatrics education at the Institute on Aging at the University of Pennsylvania.
The physician or other care provider should also ask elderly patients if their religious and spiritual beliefs provide them comfort or stress, if their beliefs might influence or conflict with their medical care, and if other members of their religious community are supportive. But the caregiver should not proselytize, insist on taking a spiritual history if the patient does not wish to give one, argue with the patient, or give spiritual counseling. If the patient asks to pray with the caregiver, it should only be done if the caregiver is comfortable with the request.
The caregiver who is responsible for making a spiritual assessment will vary depending on the setting. It could be done by a physician, nurse, social worker, or whoever else has the opportunity.
Patients aged 75 or older come from a generation that, in general, grew up in religious households. The elderly are, proportionately, the most actively religious segment of the United States population, Dr. Egan said. Recent results from national polls showed that among people in this age group 95% believe in God or a higher power, 80% belong to a religious organization, 75% say that religious spirituality is very important to them, and about 55% attend religious services at least weekly.
Patients who are religious or spiritual will often view their medical conditions in a religious context. They may be resigned to their current condition as something that is only controlled by divine influences. A medical caregiver should acknowledge these sentiments with respect; they should not judge patients but care for them, Dr. Egan said.