How Spirituality Training impacts the Practice of Social Workers Assisting Elderly Clients in End-of-Live Care: A Hermeneutical Phenomenological Approach

Abstract

Social workers in end-of-life care settings are presented with many challenges. They are not only confronted by the common stressors associated with death and dying, but also with the existential concerns of the patients and their families. Social workers typically outnumber spiritual advisors or chaplains in a hospice palliative care unit, and therefore have more frequent exposure to these needs of the patients. As an elderly patient, in particular, approaches end-of-life, the notions of religion and spirituality can take on a more significant role in acceptance of mortality. Social workers have reported reluctance in addressing the spiritual matters of their patients and have also expressed feeling ill equipped to deal with these issues. Spirituality training seminars have been linked with significant improvements in self-perceived compassion for the dying, compassion for oneself, and in reducing work-place stress. The research goal for this project was to seek to understand how spirituality and current spirituality training impacts the practice of social workers assisting elderly clients in end-of-life care settings. A secondary goal of this study was to explore the phenomenon of what it is like to deliver spiritual care as an end-of-life care social worker. A tertiary goal was to define and describe the nature of spirituality as social workers in hospice and palliative care settings conceive of it today. This study employed a hermeneutic phenomenological research approach (Gadamer, 1998) to explore the experience of five social workers in a local hospice/palliative care setting utilizing spirituality training with their elderly clients. Participants were sampled based on convenience from the cities of Winnipeg and Regina. Themes relating to the impact of spirituality training on participants’ practice emerging from the data include: feeling poised in difficult circumstances, appreciating different perspectives, complementing innate skills, and perception of greater connection. The themes emerging from data relating to how participants experience delivery of spiritual care include: being curious and aware, listening and being present, and drawing on interdisciplinary teams. Finally, the main themes expressing how participants describe spirituality are: the disparity between spirituality and religiosity, belief in a greater power, feeling of connectivity, and the pursuit of meaning and purpose. The conclusions of this research help to illuminate how spirituality training exercises are implemented in practice, as well as provide a better understanding of how spirituality education could be integrated into the post-secondary curriculum of social work study.