Older people´s residences Spiritual needs of older people Good Life in Old Age –project

1. Older people´s residencesSpiritual needs of older peopleGood Life in Old Age –project Arja Suni Master of Health Science (Nursing), RN arja.suni@ikainstituutti.fi

2. 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 A. Suni 8.10.2009

3. 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 A. Suni 8.10.2009

4. 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 A. Suni 8.10.2009

5. 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 A. Suni 8.10.2009

6. Results: What gives you strength in times of adversity? • Put one’s 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 A. Suni 8.10.2009

7. 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 A. Suni 8.10.2009

8. 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? A. Suni 8.10.2009

9. Conclusions • It is important to be a good listener, to respect and meet older people at their level without imposing one´s 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 people´s 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? A. Suni 8.10.2009

10. My lessons from practice for policy makers • Unfortunately, policy makers don’t 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 A. Suni 8.10.2009

11. 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 A. Suni 8.10.2009

12. 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) A. Suni 8.10.2009