Older people

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Older peoples residencesSpiritual needs of
older peopleGood Life in Old Age project

• Arja Suni
• Master of Health Science (Nursing), RN
• arja.suni_at_ikainstituutti.fi

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Background

• The mental health promoting tool was Good
  everyday life in old age? Spiritual needs and
  elder care Models of action
• The field trial started October 9th 2008 and
  ended May 28th 2009
• Why this tool?
• - Spiritual life is part of the history of an
  ageing person
• - The fulfilment of spiritual needs promotes
  the psychosocial wellbeing of older adults
• - The right to fulfil spiritual needs is a
  valuable part of good everyday life
• - The spiritual dimension includes not only
  religious beliefs but also a sense of purpose
  and meaning in life

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The Aim

• To develop methods for investigating the
  spiritual needs of older adults and how to answer
  them
• To take into account individual religious and
  existential needs and habits
• To understand the spiritual dimension as an issue
  of quality
• To empower older individuals and their behaviour

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The Subjects

• The setting for implementation Inhabitants and
  staff at the Residential Home Päiväkumpu (private
  sector) in Helsinki
• 17 older people between 70 103 years, average
  age 75 years
• Male 15, female 85
• Education mostly secondary education
• Illness both physical and mental diagnoses
• Staff 9 nurses, voluntary workers and students
  of nursing

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Implementation process (methods)

• There was a need to develop a personal
  questionnaire
• Permission to carry out the project received in
  November 2008
• Before the questionnaire was ready there were 7
  planning meetings with the staff and the
  questions were tested verbally
• The new tool included 17 questions about the
  spiritual needs and habits of the older people
• Participants and family members were given
  information about the purpose of the study, the
  voluntary nature of participation, and assurances
  that anonymity and confidentiality would be
  maintained
• A personal nurse of each older adult performed
  the interview (1 April 15 May 2009)
• Information was gathered and evaluated
• New daily work methods were created and tested

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Results What gives you strength in times of
adversity?

• Put ones trust in God and Jesus Christ
• Find solace in arts, music, nature and friends
• There is a carrying force in prayer
• The close ones and nature are meaningful
• 90 of the residents prayed daily or when
  necessary
• Almost all residents wished to say evening
  prayers together with their nurses
• 90 of the residents followed radio and TV
  prayers
• 30 of the residents wished for help in reading
  the Bible
• A half of the residents were interested in
  spiritual literature and recordings

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Results (strengths)

• Nursing staff learned to understand individual
  spiritual needs and how to meet and talk about
  them
• Open discussion about spiritual needs and habits
  brought older people and nurses closer to each
  other
• Openness incereased the sense of community and
  mutual respect
• Openness decreased anxiety, brought comfort and
  more attention was paid to spiritual needs

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Results (weaknesses)

• The questionnaire was made for people in Lutheran
  Church, it has to be modified for other religions
• Cultural and social needs, i.e., personal freedom
  to choose own life style must be respected
• How to train nurses from other ethnic cultures to
  understand and use this tool to provide holistic
  care?
• How to teach ethnic and native older people to
  respect each other and their religions?

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Conclusions

• It is important to be a good listener, to respect
  and meet older people at their level without
  imposing ones own values on them
• It is important to facilitate the creation of
  contemplative surroundings
• In order to implement holistic care and to pay
  attention to older peoples spiritual needs, it
  is essential that the organization of the care
  system is supportive both for patients and
  personnel
• 90 of these older people prayed every day
  prayer is a strong psycho-social source of power
• Are spiritual needs adequately observed, e.g., in
  the prevention of suicides among older adults?

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My lessons from practice for policy makers

• Unfortunately, policy makers dont realize what
  goes on in mental health work and how people with
  mental health disorders wish their care should be
  developed
• Authorities should participate more often in
  seminars and conferences with staff who could
  tell them how to develop and support mental
  health work
• Policy makers should learn to respect
  service-users and understand that user-led policy
  is a key to better life

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Opportunities for the development of mental
health promotion

• More open discussion and information is needed
  about mental health problems, because anyone of
  us can face these problems sometime in life
• More resources are needed in mental health work
  (funds, residences, doctors, therapists, nurses)
• We must create and maintain supported work places
  for the mentally ill and disabled people
• Young parents must be supported in parenting and
  taking responsibility of the family

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The three main missing elements of policy at
present my opinion

• Lack of knowledge, attitudes to diversity
• Lack of will to improve things for example, in
  Finland, responsibility for mental health issues
  is divided between many actors but nobody seems
  to take final responsibility
• Skills and will to cooperation are insufficient
  (public sector, private sector, non-profit
  organisations and service users)