Spiritual care is important, too; Doctors recognizing importance of spiritual as well as physical care

Spiritual care is important, too; Doctors recognizing importance of spiritual as well as physical care | Local | The Bulletin

“Doctor, will you pray with me?” Dr. Michel Boileau, a longtime Central Oregon urologist, said patients have asked him that question or something like it many times. Often, it is before surgery. They perhaps felt anxious or scared and wanted comfort from the person giving them care. Boileau had years of medical education and hundreds of hours of practice before becoming a full-fledged doctor. But, he said, he had absolutely no training in how to respond to that question. Medicine and medical training, not just for physicians but for many who work in health care, are typically focused on science. Certainly the complex biology of the human body and disease is crucially important. Yet for many people who have a health problem serious enough to land them in the hospital, the physical ailments may only be a small part of what's troubling them. They are also likely grappling with the emotional toll of their illness and how it may affect them. They may be scared of death, pain, hospitals or any number of things. And many, even those who aren't typically religious, may be looking for spiritual comfort. “Medicine and religion are really the two areas where we grapple with the significant events in our lives,” said Boileau. “It's often the religious world where we go for solace.” The two were long intertwined. St. Charles Bend was founded by nuns, who served as caregivers for many years. Years ago, religious leaders were often physical as well as spiritual healers, and still are in some places. But as Western medicine focused more on the physical causes of disease, the spiritual aspect was often left out. Now, there's a movement to bring it back. “In the last 15 years, we've noticed a big change,” said Richard Groves, founder of the Sacred Art of Living, a local nonprofit that offers courses in using spirituality in secular settings. “Some of the leading medical institutions in this country ~ are now really explicitly talking about the importance of having conversations about spirituality.” As an example, the number of chaplains certified by one of the country's largest certifying agencies has increased 20 percent in the past 10 years, according to Carol Pape, a manager at the Association of Professional Chaplains. Today, there are about 3,100 chaplains certified by the agency. Elk hunting at the hospital Spiritual care is a somewhat nebulous concept, though experts seem to agree that it has, at its core, an aspect of making sure a person feels connected to something outside him- or herself. It's related to an idea gaining traction in health care that hospitals need to treat the whole person, not just the disease. “We're seeing a wonderful resurgence in person-centered care,” said Boileau. “We have begun paying attention to those things that we didn't before, which was to the patient's detriment.” Chaplains have long been used in hospice care and in some hospitals, particularly those founded by religious groups, including St. Charles Bend. The current shift has to do with a growing recognition that this kind of care may also be useful for patients not near the end of life. Bill Danaher, a chaplain at St. Charles Bend, said any patient in emotional pain could benefit. He recalled a patient he went to see one day at a nurse's request. The patient had been a logger but now was sick with cancer. He hadn't spoken much all week and Danaher recalled that he was sent in to check on him. “You're not really churchy, are you?” Danaher said he asked the man. “Nope,” the man replied. Danaher sat down and assured the man he wasn't there to sell him religion. He just wanted to talk. Pretty soon, he asked the man, still short of words, a question: “Given no restrictions, where would you be right now and what would you be doing?” At that, Danaher recalled, the man “took me elk hunting for two solid hours. I didn't say a word and he was sitting on stumps and jumping over fences. When it was done, he apologized profusely for talking my leg off. He asked me to please come back.” This man was in “emotional pain,” Danaher said. By telling his story, “he touched some place within him that ‘This is where I find my peace in life.'” Patients, Danaher said, “need all this biological stuff we are doing here (at the hospital). But it does no good without the spiritual wellness.” Treating the whole person Danaher, who is Catholic, said he's seen more medical professionals, even those who are not religious, accept the idea of spiritual wellness. “I've had atheist surgeons come up to me and say, ‘I want you to go visit a patient.' “And I say, ‘Why? You have no belief in what I do.' And they say, ‘If I have two patients who are otherwise equal and one whose spirits are up and one who are down, the one whose spirits are up is going to do better every single time.'” Research studies support Danaher's anecdotal contention. Most find that people who report a greater sense of spiritual well-being have less pain, less stress and feel better about their lives. In one study, women with metastatic breast cancer who received intensive social support did not live longer, but did say they lived better in their final months than those without it. They reported less pain than the group of women who did not make such strong connections. Another study found that this type of support, particularly through “spiritual activities” correlated with better medication adherence in AIDS patients. This month a study from researchers at Brigham Young University found lower blood pressure and other markers of heart health were better in people who scored higher on tests of spiritual well-being. Beyond the physical symptoms, a chaplain or other spiritual care provider can provide a shoulder or be an advocate. Chaplains will often sit in on family meetings, said Kit Hall, another chaplain at St. Charles Bend. These meetings, which typically take place when a patient is in very serious condition, often leave the family in shock, Hall said. He will sometimes stay with a family after the medical team leaves, to listen, help guide discussion or pray with a family, if that's what they want. “They are trying to make sense of what's going on,” Hall said. “Ours is not to help them answer that question, but to support them.” Praying with patients Chaplains have explicit training in how to care for the emotional and spiritual needs of patients, but they are by no means the only people in the health care system called on to do so. Groves, through the Sacred Art of Living, has trained health care workers all over the country in aspects of spiritual care. At first, he said, most of his trainings were done with people working in hospice. Now they come from all areas of health care. The idea behind his program, he said, is to make caregivers aware of spiritual issues and how they can affect a patient's overall well-being. “If someone can show up and start talking about that ~ everything else that's going on in the health care system is going to benefit. The medications are going to work better, the therapies are going to work better. The person is going to be able to take care of themselves better.” Of course, some people are going to be naturally more comfortable with this aspect of care than others, due to their own belief systems. Dr. Heather West, an oncologist at Bend Memorial Clinic, said that when physicians are not spiritual or religious, it can be hard to talk about that subject with patients. “You want your input to be meaningful,” she said. “If you are not very religious, then your input is not going to be helpful.” West, who said she is spiritual but not religious, said she doesn't see spiritual issues brought up often until the end of life. Sometimes that's by patient choice. “I've had people say, ‘Oh, I'm not ready for that yet,' because they think that you're calling a priest to give them last rites.” Like Boileau, she has had people ask her to pray with them. She doesn't feel comfortable saying a prayer, she said, but will be there with them to pray. Boileau, too, said he always prays with people who ask. He described himself as spiritual though not religious, and said he sees it as part of his role as a caregiver. “I realized how important it is to people, and exercising their belief is comforting to them. I would fully support that.”