Making the Case: Spiritual Care in Palliative Care

According to the National Palliative Care Registry, even as the number of palliative care programs grow, 44% of programs with complete interdisciplinary teams still report only a 0.5 FTE chaplain. Of the 56% of programs without a complete interdisciplinary team, 70% report no chaplain FTE. Forty percent of palliative care teams with a chaplain fund these positions through "in kind" or volunteer staffing models, while the remaining 60% are funded directly through the palliative care budget.  

With the great opportunities for growth in palliative care chaplain staffing, the Coalition not only supports spiritual care as an essential component of quality palliative care but also advocates for palliative care chaplain staff positions to provide speciality expertise in the unique spiritual concerns of those living with or affected by serious, advanced illness.

With that in mind, the following clinical practice guidelines provide endorsement for spiritual care as a mandatory component of palliative care, preferably provided by a trained, board-certified chaplain. 

• The Joint Commission "Body, Mind, and Spirit, Part 1"

• The Joint Commission "Body, Mind, and Spirit, Part 2"

• Key quotes from “Body, Mind, and Spirit, Parts 1 & 2”

• NCP Clinical Practice Guidelines 4th Edition

• The Joint Commission Advanced Certification for Palliative Care 

• Spiritual Religious Care Competencies Marie Curie

• Using Chaplains to Facilitate Advance Care Planning in Medical Practice

• Chaplains Working in Palliative Care: Who They Are and What They Do

• A survey of chaplains' roles in pediatric palliative care: integral members of the team

• The role of professional chaplains on pediatric palliative care teams: perspectives from physicians and chaplains

• The Palliative Care Chaplain as Story Catcher

• Supportive Care Coalition Spiritual Dimension Assessment Tool

• UPDATED PALLIATIVE CARE SPIRITUAL ASSESSMENT TOOL - from the National Association of Catholic Chaplains

• Spiritual Distress Assessment Tool (SDAT)

• Steinhauser K, et al. Are you at peace?: one item to probe spiritual concerns at the end of life. Archives of Internal Medicine 2006;166(1)101-5. 

• FACIT-Sp-12 

• The Edmonton Symptom Assessment Scale-Financial Distress and Spiritual Pain (ESAS-FS)

• Dignity in Care Toolkit

• LaRocca-Pitts M. Four FACTs spiritual assessment tool. Journal of Healthcare Chaplaincy 2015;21(2)51-9. 

• An EAPC White Paper on Multi-disciplinary Education for Spiritual Care in Palliative Care: The EAPC white paper points out the importance of spiritual care as an integral part of palliative care and suggests incorporating it accordingly into educational activities and training models in palliative care.

• The Impact of Professional Spiritual Care: A co-authored and co-published e-resource with the most current expressions of and research on the profession of chaplaincy and spiritual care in the United States and Canada. Designed for use by chaplains, spiritual care staff, administrators, and leaders to explain and advocate for professional chaplaincy.

• A Three-Part Special Report from a Conference on the State of the Science of Spirituality and Palliative Care Research

  • State of the Science of Spirituality and Palliative Care Research Part I: Definitions, Measurement, and Outcomes (subscription only).

  • State of the Science of Spirituality and Palliative Care Research Part II: Screening, Assessment, and Interventions (subscription only).

  • State of the Science of Spirituality and Palliative Care Research: Research Landscape and Future Directions (subscription only).

• A 2010 study demonstrating that provision of spiritual care to patients with advanced cancer is associated with improved quality of life

• A 2011 study demonstrating that support of cancer patients' spiritual needs is associated with lower medical care costs at the end of life

• A 2013 study demonstrating that provision of spiritual support to patients with advanced cancer by religious communities is associated with increased medical care at the end of life