Integrating Spiritual Care in Palliative Care Goals of Care Conversations
The "Integrating Spiritual Care in Palliative Care Goals of Care Conversations" project seeks to promote deeper spiritual engagement with patients and families as well as within the interdisciplinary palliative care team. With 20 palliative care teams over the course of three years, the Coalition has provided an interprofessional learning experience for palliative care teams interested in going deeper in their practice of providing whole-person care.
Palliative care team project participants engage in a six-month long formational process designed to help each member of the interdisciplinary team better address and be present to spiritual concerns that arise in the context of palliative care patient/family meetings. Project participants report improved interdisciplinary team functioning, increased comfort addressing patient spiritual suffering, and greater commitment to practices that cultivate resilience.
According to Parker Palmer in his book A Hidden Wholeness, "In this culture, we know how to create spaces that invite the intellect to show up, to argue its case, to make its point. We know how to create spaces that invite the emotions to show up, to express anger or joy. We know how to create spaces that invite the will to show up, to consolidate effort and energy round a common task. And we surely know how to create spaces that invite the ego to show up, preening itself and claiming its turf! But we seem to know very little about creating spaces that invite the soul to show up, this core of ourselves, our selfhood."
Consistently, project participants report a greater sense of making space for the "soul" to appear in the midst of a family meeting. A physician participant reports:
"I have carried forward [from this project] a feeling of family meetings being spiritual experiences for me as well as the patient...creating space for the person's true self to come forward. I go into these meetings feeling less anxious and more curious to see what's there."
A nurse participant reports: "Team debriefing will continue as a standard practice in the future because each person's perspective of what was heard/observed in a family meeting can be very different, and we get a much more rounded/unified view."
A chaplain participant reports: "What has the most staying power is the centering and spiritual grounding practice...because it brings us back home to ourselves when we get flooded, triggered, or off-kilter in the presence of existential pain, sadness, family strife, and angst that is so often a component of our work."