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“Working with the Spiritual Issues of Geriatric Patients”: A Consultation to the Outpatient Geriatric Team of Massachusetts General Hospital’s Psychiatry Department

Last Tuesday, March 9th, I facilitated a meeting of the Outpatient Geriatric Team of Massachusetts General Hospital’s Psychiatry Department.  The focus was “Working with the Spiritual Issues of Geriatric Patients.”

 To prepare for the meeting I asked team members to send me their questions about spiritual issues and the elderly.  These questions provided my initial guide in preparing for the meeting.

 Their questions were: (1) How to think about spirituality in terms of working with patients? (2) How does spirituality impact treatment? (3) How to talk to patients about their spirituality? (4) How to incorporate spirituality into treatment? (5) How can aging impact spirituality?

 Once there I asked three sets of questions in order to get to know them and their work better.  The first set consisted of the following: (1) What are the typical issues you see in your clinical encounters?  (2) What are the particular services you provide? (3) What proportion of the services are:  (a) medical; (b) psychiatric; (c) psychosocial (d) spiritual?

 The second set of questions was: (1) Does the spiritual issue ever come up? (2) Do you ever ask about this dimension of their lives? (3) Do you view a person’s spiritual or religious practice as a resource for them in coping with their presenting concerns? (4) Do you ever triage to someone who is more prepared to address such issues, e.g., a rabbi, minister, priest, or chaplain?

The third set is: (1) How comfortable are you with spiritual and religious issues? (2) Do you explicitly ask about such issues when you see a patient? (3) Is doing a “spiritual assessment” part of your overall psychiatric evaluation or intake?

 I ask such questions both to foster greater awareness of such issues and to encourage team members’ awareness of their own attitudes, biases, and feelings about discussing spiritual issues in a psychiatric context within a general medical hospital.

 To conclude, I provided them with several exercises to enhance their awareness: (1) first, an exercise to reflect upon of attitudes, biases, and feelings about spiritual issues they experienced during their professional training; (2) second, an exercise to consider the impact of their own religious/spiritual history on their current stance toward spirituality and religion; and (3) third, an exercise to think about the relationship between religion, spirituality, and mental/physical health.

 The brief one-hour meeting was just a beginning.  My hope is that it will spur greater attention to and interest in spiritual issues as an aspect of what needs attention in the clinical encounter with geriatric patients.

Posted in agingmental healthspiritual issuesspiritualitytraining and consultation on 14 March 2010
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