Spiritual Care Engagement Tool



Section 1 – Community… Help me to learn about, “What supports you?” First, tell me, is there a person, group or community of people you really love or who are really important to you? Name them. Regarding each …Are they currently supporting and/or helping you? How?[Struggles, part 1:] Are there aspects of the relationship that, in your current situation, are not so helpful?Is there disagreement (between you and them) about how to think, believe or make decisions?Do feel trusting toward them? Do you feel abandoned?If the answer to any of these questions indicates struggle, provide “Summary” feedback; and consider a referral to “Spiritual and Religious Care” and/or to Social Work.Section 2 – Meaning & HopeNext, tell me “deep inside” what are your personal sources of strength, meaning, hope, comfort and peace? Or, to ask another way,What do you ‘hold onto’ during difficult times?, andWhat sustains you and keeps you going?For some people, certain practices are important towards strength and resilience; things like artistic expression, artistic appreciation, communing with nature, physical activity, meditation, prayer, reading scripture, studying religious/cultural tradition(s), attending religious services, and/or relationships within faith or cultural community; is this true for you?If “Yes”, then, “What is on your list of such practices? … Your list is what we together are going to call, and think about, as your ‘spiritual practices’.”For some people, their religious or spiritual beliefs are important resources; is this true for you?If “Yes”, then, “Describe (or name), for me, your religious or spiritual community or tradition.”If “No” for both the previous two questions, then omit Section 3 and proceed to Section 4.Section 3 – Personal Spirituality / Religious practices1Is there something from your list of “spiritual practices” [Section 2, question 2] that you are ‘most missing’ because of your (medical) situation?Can some of your “spiritual practices” be done here?Is there anything you need ‘from us’ to do so?What influence do your faith/belief/spiritual practices have, in general, on how you take care of yourself? And how have they shaped your thinking-and-feelings-and-actions during this illness? Are you worried about any conflicts between your beliefs-and-practices on the one hand and your medical situation/care/decisions on the other?Are there any specific religious or spiritual restrictions we should know about in providing your medical care (e.g., dietary restrictions, use of blood products, …)[Struggles, part 2:] Are any of the following statements currently true, for you?...I am having doubts about my faith/beliefs/practices.I am not sure what I believe anymore.I somehow keep doing other than what-I-know-I-ought-to-be-doing.I feel guilty about the way I think, feel or act.If the answer to any of these questions is “Yes”, provide “Summary” feedback and consider a referral to “Spiritual and Religious Care”.Section 4 – Struggles [part 3]In the midst of your current (medical) situation …Does it sometimes seem to you like you are being “punished”? [If so, by what?, or whom?]Do you feel angry for what is happening to you?Do you feel alone?Does it feel like you’ve let someone (or something) down?Do you wrestle with whether-or-not you “measure up” and are loved?Do you ever think that ‘evil’ is somehow involved? Do you ever ask, “Why?”; or, in other words, “What is the meaning or purpose of this (medical) situation?”If the answer to any of these questions is “Yes”, provide “Summary” feedback; and consider a referral to “Spiritual and Religious Care”._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ If the patient is palliative: How do your way of thinking and your normal life-practices affect the kind of care you want to receive from now till your end-of-life?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Having pondered all these questions, would it be useful to speak with a spiritual care specialist (i.e. someone on our staff here)?, or (if you have one) with a leader of your own religious/spiritual/cultural community? If so, then please forward the patient’s self-referral. ................
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