Finding Meaning in Serious Illness: The Role of Spiritual, Religious, and Existential Care in Palliative Support

Domain 5: Spiritual, Religious, and Existential Aspects of Care

Serious illness often brings about profound questions of meaning, purpose, and spirituality. Domain 5 of the Clinical Practice Guidelines for Quality Palliative Care highlights the importance of addressing spiritual, religious, and existential needs as part of a holistic approach to care. By doing so, we support patients of all ages, their families and caregivers in navigating the emotional and existential challenges that accompany illness.

Why Spiritual Care Matters

Spirituality encompasses a broad range of beliefs and values, from organized religion to deeply personal concepts of purpose and connection. For many, spirituality provides solace and strength during times of uncertainty. When unaddressed, spiritual distress can manifest as feelings of hopelessness, anxiety, or a sense of isolation.

Patients of all ages and their families often seek meaning in their experiences and rely on spiritual or religious practices to cope with the challenges of illness. By recognizing and supporting these needs, healthcare professionals on the interdisciplinary team can provide a greater sense of comfort and peace.

Screening and Assessment

Healthcare providers play a key role in initiating conversations about spirituality. Asking open-ended questions such as, “What gives you strength during difficult times?” or “Are there spiritual or religious practices that are important to you?” can open the door to meaningful dialogue.

Structured tools, like the FICA Spiritual History Tool (Faith, Importance, Community, Address in Care), can help providers assess the role of spirituality in a patient’s life. Understanding these dimensions allows the care team to align medical decisions with the patient’s values and beliefs.

Addressing Spiritual Needs

Meeting spiritual needs can involve a range of approaches, including:

• Facilitating Access: Connecting patients with chaplains, clergy, or spiritual counselors who can offer guidance and support.
• Supporting Rituals: Providing opportunities for prayer, meditation, or other meaningful practices.
• Creating Space for Reflection: Allowing time and space for patients and families to express their concerns, fears, and hopes without judgment.

For non-religious individuals, exploring sources of meaning, legacy, and connection to loved ones can provide significant comfort.

The Role of Clinicians

All healthcare providers should develop cultural humility and comfort in addressing spiritual and existential concerns. Training in spiritual care equips clinicians with the tools to recognize and respond to signs of spiritual distress. Partnering with spiritual care professionals ensures that patients’ diverse needs are met comprehensively.

Conclusion

By integrating spiritual, religious, and existential care into their practice, clinicians honor the individuality of each patient and family. This approach fosters a deeper sense of connection and resilience, allowing patients to find meaning and peace even in the most challenging circumstances. Spiritual care is not just a supplementary aspect of care—it is a cornerstone of holistic, patient-centered support.