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In their recent paper, exploring prognostic signs and symptoms in relation to survival of 72 hours, White N, Reid F, Harries P, et al. (BMJ Open 2019), mention that a ‘large portion of data was unavailable, particularly that relating to the psychological and spiritual well-being of the patient, due to the decreased consciousness of the patient.’ This comment highlights, in my experience, the absence of documented information about a patient’s psychological and spiritual well-being prior to the final days of life. For some patients, an important aspect of spiritual well-being is religious faith, including the support of a faith community and the opportunity to receive end-of-life religious rites.
When patients are admitted for end-of-life care, there can be occasions when there is little or no time for an in-patient team to learn about a person’s spiritual or religious needs. This may be due to the fact that a patient is unconscious on admission and there are no accompanying relatives or friends. In such situations, the referral form is crucial. Yet, the pan-London Specialist Palliative Care (SPC) Community and SPC Inpatient Unit Referral Form does not provide a specific ‘religion’ box.
This form does have a section for ‘any other comments/information (including preferences expressed about care, other psychosocial or spiritual issues or DOLS)’, but almost invariably the referrer fails to mention spiritual or religious needs. Clearly, it is important to know i...
This form does have a section for ‘any other comments/information (including preferences expressed about care, other psychosocial or spiritual issues or DOLS)’, but almost invariably the referrer fails to mention spiritual or religious needs. Clearly, it is important to know if the patient has a religious faith as, for example, a Catholic patient may need to be anointed with some urgency, and a Muslim or Jewish patient may need to be buried within strict timelines. Acknowledging and ensuring that a patient’s religious needs are met, as part of end-of-life care, may contribute to the spiritual well-being not only of the patient but also of the immediate family.