By: Dr. Suantak D Vaiphei
With the rapidly increasing terminally ill mortality rates India stood as the main contributor across the continent. The rapid growing terminal ill population makes end-of-life care more important than that of prolonging the patient’s life in the clinical settings. However, palliative end-of-life care is an untouched area of care in the Indian health care system that makes India not a place to die for many. People still died without fulfilling their needs as the biopsychosocial-spiritual factors are not considered as sickness that need to be care and attained. The immediate need in the Indian health care setting is to implement holistic treatments that focus on patient-cantered therapy, rather than treating the symptom alone.The term health and wellbeing are not merely confine within physical fitness alone, rather health includes the criteria like mental, physical, psychological, economic, and most importantly the spiritual domain of an individual concerned. It is increasingly visible that both the clinicians and the terminal patients acknowledge spiritual domain of health care as an important factor of supportive heath care in terminal diagnosis to delivered wellbeing and quality of life.
Spirituality is the mechanism that deals effectively with the treatment issues like pain and symptom control, inappropriate prolongation of death and dying, patient feeling of being burdensome to others and loved ones.Spirituality has an impact on the way the terminal patient understands their illness, recovery, and punishment Vs regrettable suffering and quality decision making with regards to their treatment policy. Spirituality becomes the central focus in the face of medical helplessness; it helps in effectively coping with terminal illness and becomes part of their existence that serves as health to many dying patients. The essences of spirituality have the potential to be in communion with self, with others, nature and with the transcendent being, which delivered the whole person treatment with regards to self-identity, inner peace, love, reconciliation, inspiration, creativity, hope, and gratitude.
The recent research on spirituality in terminal ill intervention found that patients with higher level of spirituality have lower risk of depression and anxiety. Through spirituality the dying individual can effectively construct meaning and purpose in suffering that facilitate positive role in patient’s coping with their illness. The findings also stated that even 45% of people with no religious beliefs also felt the needs for spiritual assessment in one way or the other and 94% of the terminally ill patients want their physicians to deliver spiritual assessment. In many cases spirituality is seen as the mechanism that has healing potentiality on individual health, influences in patient decision making, and plays an important role in delaying patient’s physical disability that usually occurs in the later part of any terminal illness. On the other hand, patient with lower lever of spirituality encountered higher rates of stress and depression in their terminal ill experiences.
Spirituality is not only the factor that contributes health to many, but also recognized as the central to the dying individual in terminal ill experiences, especially when death comes closer. Several findings also acknowledge that spirituality as the factor that decrease the fear of death, sense of control over emotional helplessness, enhance positive views on life and death that usually deliver a peaceful death to many.Spirituality is also the factor that gives patient to discover deeper meaning of existence in the midst of suffering and self-awareness in the face of an inevitable death.Though there are several controversial issues around spirituality in medical sciences, the existing literature on spiritual psychotherapy proved that spirituality is an important domain in end-of-life care and it has several positive outcomes in terminal diagnosis for the wellbeing of the whole and the quality of life.
(The author is an Assistant Professor in Dept. of Psychology, Christ University, Bangalore)