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Lifting their spirits: Who provides spiritual care at the end of life?

2015: Hot Topics in Palliative Care: Lifting their spirits: Who provides spiritual care at the end of life? Presented by: Dr Bruce Rumbold (Director, Palliative Care Unit, Department of Public Health, La Trobe University) on 10 November 2015. Over the past decade or so spiritual care has become enshrined in palliative care rhetoric and is increasingly reported upon in the general healthcare literature. This literature is not entirely coherent; nor is the rhetoric. There is no agreed definition of spirituality, for example, and this both undermines measurement and blurs the formulation and implementation of policy. But there is a growing consensus around the core themes of spirituality and the need for an organised response. One of these core themes is meaning-making. Clearly an encounter with the health system is for many people an event that shatters security and disrupts meaning; creates spiritual need, in other words. What is less clear is how the health system should respond – to what extent should healthcare practitioners be responsible for the effects of news they deliver? And if spirituality is a whole-of-life phenomenon, what are limits to a healthcare contribution? A multi-disciplinary team that takes spiritual care seriously thus faces a range of questions, and some of these were explored in the hot topic discussion.