WAYS IN WHICH SPIRITUALITY ENHANCE THE QUALITY OF LIF IN THE ELDERLY

Introduction 

Previous researchers according to Kirby, Coleman and Daley (2001) have identified that psychological well-being (PWB) in older adults can be contributed by spiritual beliefs with less studies on the effects of spirituality on PWB after physical health deteriorates and the people becomes frail. The well-being of an older adult has been generally reported to remain stable with age, although there are reports of gender differences, where older men have elevated levels of subjective well-being than women of their age. Despite the generalized stability, studies show that older adults who are classified as chronically ill, frail or other health constraints have a low well-being level. However, there are some observations that some individuals adapt better to frailty than others with some researches showing high level of well-being despite disability or failing health. One of the contributing factors is the protective role is spiritual and religious beliefs.

Kirby, Coleman and Daley (2001) explain that religion and spirituality plays an important role in the lives of older people, with a positive correlation with mental health, well-being, and physical health which lowers mortality levels and the likelihood of hypertension. Elderly women have a stronger religious and spiritual belief than older men. Kirby and his group explain that as older people approached death, their attendance to religious events decreases but they have an increase in religious feelings which strengthened and comforted them. Therefore, a person aged 85 years and chronically 68 year old person will use religion as a coping strategy which gives them a positive adjustment to life. 

Kirby, Coleman and Daley (2001) state that, as the physical health of an elderly deteriorate, they tend to confront their mortality as they cope with the increasing challenges they face. This impacts their well-being negatively unless they get resources to buffer the effect. This is the likely feeling of an elderly with a chronic cardiac condition who can use religion and spiritual beliefs as a resource to bring comfort, control beyond their personal resources, a sense of personal meaning and intimacy with a high power. These benefits will help such an individual in transforming their lives and as well as replacing their older values with new. Therefore, religion and spirituality will assist such an individual to transcend his or her feelings and circumstances, to help them in improving their well-being.

According to Büssing and Koenig (2010), chronic heart failure is associated with depression which causes higher mortality rates, frequent hospitalizations and poor quality of life. Spiritual well-being is a modifiable and important coping strategy as it is associated with less depression. As a chronic illness, cardiac conditions are unpredictable with frequent waxing and waning, and with a long-term loss of function symptoms. Spirituality plays a role to such an individual in health status, functioning and improves quality of life. 

In cardiac patients, spirituality and religiosity assists in maintaining self-esteem, provides a sense of coping, provides a sense of meaning and purpose and provides emotional comfort. There is increasing evidence showing that distinct religious or spiritual convictions and practices impact the health outcome of a chronically cardiac ill individual. In treating such an individual, a bio-psychosocial model of care gives a conceptual framework for their support. Such individuals have unmet spiritual needs which brings feelings of communication problems with families and friends, guilt, anxiety, religious struggles, questions about meaning of life, loss of role-function, diminished self-esteem, sadness and loss. Cardiac patients from the US wants help to overcome their fear (51%), find meaning in life (42%). Find hope (40%), finding spiritual resources (38%) or getting someone to talk to about peace (45%), meaning of life (25%) and death (26%) (Büssing & Koenig, 2010).

According to Paulo (2014), when a terminally ill patient with a chronic cardiac failure grapple asking “what happens next” and “why me”, their spiritual distress is elevated increasing the need to search for meaning in life. Their spiritual concern is based on the trajectory of the disease itself like sudden death, long-term condition, restrictions imposed by age and disability. A patient suffering from cardiac failure mainly express their emotional and spiritual needs as unrecognized by healthcare staff, feels like God is punishing them and that their illness is a payback for their deeds. Some of the patient may feel valueless and hopeless as they depend on others for self-care. Isolation and depression due to altered self-image which may cause them to end their lives or ask for their dying.

A healthy elderly individual has a high probability of attending spiritual and religious service often. They take part in a religious community which helps in improving their mood and outlook. Several studies show that individuals who practice their religion are likely to experience some physiological benefits including a more hopeful and positive attitude about illness and life. The benefit is similar to that acquired by the individual with chronic cardiac failure. Attending church does not only take them out of their residence to the community but it assists them to see the goodness in the world by giving their life a deeper meaning. 

This is in contrary to an 85 years healthy individual who seeks meaning of life not because of a disease trajectory. A healthy 85 years old person seeks God for thanks giving and intimate relation. They seek a longer and peaceful life to watch their generation grow as well as passing their beliefs to the younger generations. They have hope and view themselves with value as they are depending on themselves for self-care. This group is known to attend religious and spiritual events frequently than any other age group. At this stage they may however feel lonely and isolated from their busy children and grandchildren, but unlike the chronically ill they do not end their lives or ask for death.

In the case of the 85 year old individual, attending church ceremonies fosters a satisfying social network to them. Chelsea Jewish Life Care (2014) explains that according to a research in the journal American Sociologic Review, 28% of the participants attending religious ceremonies every week were extremely satisfied in their lives as compared to the less than 20% who never attended services. The elderly who are healthy searches for new friend due to loneliness and this is one podium where they can make new friends to help them in staying social. 

Many researches show that individuals who are religious and spiritual live longer than those without belief of any super power. This factor is applicable both to the healthy and terminally ill. The increased longevity is attributed by factors which reduce stress, contributing to good health and the belief that their life has some meaning. There is a theory that posits that reduced cardiovascular risk, perhaps related to lifestyle or either religious behavior of cardio-protective effects increases longevity both for the healthy and ill religious persons. 

Therefore there is a difference between a healthy 85years old and a chronically ill 68years old in the essence that the chronically ill searches for hope and peace. This is in contrary to the 85years old as their number priority in spirituality is a divine and sacred relationship with God. However, both individuals use spirituality as a way to look for love, connection and acceptance of death. 

Whether chronically ill or healthy, the elderly are always somewhere in the process of grief. For majority, their experience is dominated by reduction of income, decrease in physical functioning and losses such as death of loved ones. Accumulation of these losses and the increased awareness of their death trigger them in exploring the spiritual issues. Spirituality increases with age making the elderly to shift from doing to being. For many of the elderly, the focus on accomplishments and products throughout their other phases in life gives way in their later years to concentrate more on their interior life. The spiritual connection thus grows which reduces their anxiety and depression and increases faith and hope. 

There is a difference in which the spirituality of the healthy 85 year old and the 68 years chronically ill person. A person with a chronic cardiac condition uses spirituality to cope, rise above adversity and make sense of their current situation. Spirituality will invigorate the unique psychosocial strength of such an individual to assist him in organizing and valuing their life. This is because cardiac attacks are unpredictable and the infected individual sees death as any day occurrence. However, in medical care, spirituality is not valued and it is considered personal, elusive, soft and non-scientific. 

Both individuals are helped by spirituality in receiving optimism and serenity. Spirituality will lift up the two individuals out of their narrow selves by giving them a glimpse, even if temporary, other ways of viewing life. However, the 65 years old individual uses spirituality as a way to prepare from any negative outcome like death. As the 65 years individual continues to receive palliative care, their relationship with God will provide him or her with emotional strength, spiritual support, a sense of belonging, control, empowerment and social support. According to Paulo (2014) , the elderly individuals who use religious as their coping mechanism are less likely to develop anxiety or depression than those who are not. This fact is applicable both to the healthy and the terminally ill.

Conclusion

There is an interaction effect among negative life events, age and spirituality, and the elderly utilizes spirituality in coping with life adversities. This is the reason that seniors get more involved spiritually for a wider assortment of practical reasons. Either if chronic ailment hit them early or later in their lives, spirituality provides hope and prolongs their life. Spiritual individuals have less anxiety stress or depression thus enhancing their life. However there are few differences between the individual who is 68 years and have a chronic cardiac failure and an 85 years healthy individual. The individual with a chronic cardiac failure uses spirituality as a trajectory of his suffering, as he or she seeks answers of “why me”. This is in contrary to a healthy 85 years senior who uses spirituality for interior strength. Therefore, due to the power that spirituality have on enhancing life, both individuals can acquire an interior strength from the spiritual connection in supporting the death of loved ones, demoralization, terminal illness, isolation and poverty.

References

Büssing, A. & Koenig, H. (2010). Spiritual Needs of Patients with Chronic Diseases. Religions, (ISSN 2077-1444). doi:10.3390/rel1010018

Chelsea Jewish Lifecare,. (2014). Benefits of Religion and Spirituality on Seniors. Celebrating Life Through The Jewish Traditions. Retrieved from http://www.chelseajewish.org/benefits-of-religion-and-spirituality-on-seniors/Kirby, S., Coleman, P., & Daley, D. (2001). Spirituality and Well-Being in Frail and Nonfrail Older Adults. The Journals Of Gerontology: Series B, 59(3). doi:https://doi.org/10.1093/geronb/59.3.P123