Spirituality is a key aspect that affects our quality of life and death, and within the health system, it is in Palliative Care where there has been a special sensitivity to the spiritual dimension. In the 90s, more importance began to be given to the spiritual aspects of the sick because it was appreciated that many people resort to their spiritual beliefs when faced with serious illnesses and for this reason they began to investigate and found that chronic and palliative patients had the expectation and desire that their doctors be interested in its spiritual dimension and that spirituality be included as part of care. Since then, there have been many publications and evidence on the benefit and value of psychological support and spiritual well-being in the adaptation to serious illnesses, showing that patients cared for in their spiritual needs have greater adaptation and better control of physical and psychological symptoms. , and a better quality of life regardless of the perception of the severity of the disease. And there is also plenty of data on the negative impact spiritual suffering has on health and symptoms such as pain and depression. This relationship has been specifically demonstrated in cancer patients and in palliative care settings.
[Sound] [Sound] Now I'm going to talk to you about The most frequent spiritual needs identified I have at the end of life And how they manifest themselves So a basic need Is the need to be recognized as a person This has to do with With a need of human beings which is to love and be loved
Why to see the whole process of disease With all the hospitalizations it entails
Of tests So That that They put the patient aside How from their family social roles Also the sometimes is that the patient was also being removed from from making decisions of decisions that concern him because sometimes the The families Also for love I have taken as responsibility From from Patient's disease Then all this How it hurts the person in his identity And the person as that is a human being that has A a first name and a last name a character Special And who should and who deserves respect Then respect Is to treat the person Well, by their first name by their last name Because many times a person in a hospital because it's The 208's sick the one with cirrhosis of the liver the one with lung cancer that person has a name That's part of depersonalization And I've also a very advanced patient because it's a It's a citizen for example who can vote in the elections Is a parent who can participate in family decisions Is an owner of Of property That I can do An inheritance So all this is about recognizing the person who retains his autonomy And their ability also to decide why Many times the The patient Well, he feels How he is underestimated Unused and as in the hands of others It is very important to recognize This is your capacity To decide And participate But not only to receive but also to give Not only to love But to be loved too This is a basic spiritual need Another spiritual need That the need for reconciliation There are people who sometimes in the end of life So you have some suffering For or because of the feeling of From To have wronged someone to have harmed someone or not to have done someone wrong behaved at all well In his personal relationships And they have guilt for this Or also There is a guilt with oneself He did not To see the feeling Of not having lived What one would have wanted to live Then at the end of life There is like a need to first reconcile with oneself
To accept Your life as it was In order to accept your death And other times you also need how to listen to the forgiveness of the other one There is a need for reconciliation For example we can see it Sometimes in people that at the end of their life they are They are Depressed or also locked up In themselves or in a desire to Of bringing forward the death or in a guilt that they directly express For this You are this feeling of therefore having failed in your interpersonal relationships So the Here We can or should we support The one who that reconciliation Can be Can be made can be made can be made can be made Another spiritual need that we see frequently And at the end of life it's like I have the need to count things To tell one's own story That there are people who in the end of life like that They need Count Your life as it was And this has a meaning In life It is counted For a with an intention because If you analyze Life and today Today's life Goes so fast Life is like a Succession of moments that occur How Stunningly at times And we are living And at every point along the way we have to make decisions that lead us down a place or the other We live so many misunderstandings also so many ruptures That sometimes and so many different experiences That sometimes we don't find as a point of union in in in in in In the things that happen to us or we say but this because we do not that What happens And at the end of life then To There is a need to tell the story precisely As for To create an order An order In those Encounters misencounters Finding a meaning too Also rescue From life the essential And to leave aside the accessory to find what has given sense Then you count your life as to find meaning and also If you haven't done that previous work Through Of knowing yourself through Of what you Has been Understand What you are at this moment And maybe Choose what you want to become If you haven't done that previous work And there are people with this And then sometimes we find ourselves in the people that do like this personal life balance of life and that you They have a life balance Negative And so They are like very very hopeless too With that feeling this negative life balance sheet has three Three Points that feeling of Of not having made the most of your life From Not being able to solve it already And not finding As the Like a One loophole So and this negative life balance we can see it also in the following attitudes Aggressive in the end or a negative communication people very closed in on themselves who refuse to To communicate Or also In a request for euthanasia Or a wish to hasten death Another other spiritual need I have identified at the end of life is the need for meaning
This meaning I have and the I was saying it before What we human beings need to find How to make sense of what happens to us and what we do How This sense is expressed as a need to transcend and also to go beyond
From the limits of one's own Survival And this is the need Of sense Can be manifested at the end With the questions What we call radicals That the person wonders And why to me Why now I have What about God not because he doesn't listen to me he doesn't listen to my prayers Can he You can really make sense of this sickness situation
There are people who wonder And there will be something else is there an afterlife and if there is something else What will become of me What will become of me What can help me from this moment These are frequently asked questions And if you see these questions I have clear There is no The answer is not easy to these questions Nor is there a single answer And these questions I have to be careful also when expressing them The patient the person Because many times They are He are not made to be answered because as I said is that there is no answer is not easy To the why of suffering Who has The answer To the ultimate cause of suffering Be and there arise these questions arise more How of one is a person's expression of venting And before many of these questions The most appropriate attitude is the presence A silence When your presence with all your humanity With sincerity I have therefore A I don't know But I'm here with you As a human person With all my humanity To offer you my support Because they are radical questions How does this need for meaning and transcendence manifest itself? Another need In the At the end of life that is very important It is the Hope Hope is a It is something that Must be maintained until the very moment of death
What happens is that Hope hope hope is usually It is usually identified with the hope of healing Hope is to wait Healing But of course in the context of disease Final Advanced disease Hope has another meaning is more In one's own person It goes like resizing the hope During the different stages of the disease here the hope is not the hope of the cure And the question is If You can Let's see hope Even if there is no Expectation of healing And clear Of course there is hope And the many levels Hope can mean The what Something good can always happen something good can always happen Even if there is no hope of healing And and a sick person may be a hopeful person And hope can mean for example So the Power we can wait Being cared for at the end of our life by a team Professional Specialized Attending Not only our Our physical needs But also to attend with humanity all those other aspects that make part of me as a person My appearance Emotional my spiritual aspect We can Wait for Not to be abandoned at the end Wait for To be taken into account And to be able to make decisions And influence our disease process And yet If we couldn't do it why would our body Is very deteriorated We can Have the hope that we will be treated with respect Agree To the wishes we had previously expressed We can also hope Then close The cycle of our life arranges Satisfaction For having completed and thus having completed the cycle of life Our purpose For having fulfilled what we have What we have come to do We can also expect The Leaving a legacy having contributed something A To the community Artistic, social and political legacy We can also have hope in the hereafter [Sound] Son es es Different is how you go different dimensions of hope wider Of course And work with the hope in the in the forme life situation also goes In the in Propose as small Targets Very practical and short term On which the person can have an impact And what Let the person decide and that he/she can already make them How small Small achievements Day by day We work Day by day The here Then I have for example That of the The one that the patient can I have decided At Ask for medication at night if you have Pain Ask for an extra medication for that pain That autonomy give him the possibility to be able to Request Medication The patient can I have called To his grandchildren or granddaughter Your relative to come and see you To visit you or wait for the weekend when your family comes to see you Or wait That important family event Helping you to To arrive Ah then to that first communion to that important birth They are ways to work the hope at the end of life [Sound] And another necessity is also the expression of one's own religiosity In the in the context In this context of spirituality Of course the Spirituality It has nothing to do with religion, but it's true that for many people Their spirituality is expressed through religion and religious beliefs
So there are people that at the end of life then They have the need to Of praying of praying as a way of being coherent With their With their beliefs Also to have as a union With that is what he believes with God And it is important therefore to accompany the person also So that he/she can express his/her own religiosity To summarize we can say that The person who is dying is frequently found In a process Of introspection From As from Analysis of its values What you have experienced and where these values have led you to
Searching for meaning Communication Of being able to love To say goodbye To wonder If there is a hereafter and to prepare for a hereafter Even from Accept And to be able to transform and transcend the suffering So then to die It is an arduous inner work What can be done with more or less consciousness [Sound] [Sound]
Audio:
Subtitles:
Spiritual dimension at the end of life - Part 2
Palliative care and advanced disease - Part 1
Trailer_Meet Death
Integrate death - Part 2
Live well, die well - Part 2
Live well, die well - Part 3
Relationship with the sick person
Integrate death - Part 1
Live well, die well - Part 1
Introduction to the course