Helping with spiritual distress

Each whānau is different and so there will be variations in the spiritual rituals they use, what they want to happen when someone is nearing the end of life or is dying and how they respond. Being able to identify spiritual concerns or distress is very important, as is having the right people to contact to support the whānau if this is needed. Spiritual care assessments, and Advanced Care Plans, can be helpful to establish the spiritual preferences of individual kaumātua when they come into a service; these information gathering activities can help to identify if the older person’s whānau has the capacity and resources to support the kaumātua and their whānau manaaki with spiritual care. The practice of karakia (prayers, incantations, chants) is a critical healing resource that whānau manaaki rely at this time.

Kaumātua Tom gave a definition of karakia as he understands it:

Well I would look at karakia, ‘ka’ is the light. And ‘ri’ for me is insight. And ‘ki’ is again inclusive so a karakia for me is a path of enlightenment that you must travel.

Whaea S. (health professional) talked about how whānau may work with health professionals to provide the care needed at end-of-life:

… And most of it is that they can manage what they know. And bring us as health professionals into manage what they don’t’ know which is often the medications, which is the giving confidence when they’re in the you now 2o’clock in the morning type things, [quoting whānau] ‘We don’t know what to do. He smells. [It’s] sounding horrible when he breathes,’ things like that.

Recommendations

For health and palliative care professionals, we recommend:

Sensitively enquiring about whether the whānau has access to people who have the cultural knowledge and skills to lead the spiritual care they need. Is there someone in the whānau that can help comfort the whānau and provide spiritual healing? Perhaps the health services may need to provide someone with the right skills and expertise (conduct karakia, provide spiritual healing) to support the whānau.