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The Leveson Centre for the study of Ageing, Spirituality and Social Policy
Spiritual assessment and intervention with older adults

Spiritual assessment and intervention with older adults: Current directions and applications

Mark Brennan and Deborah Heiser (eds) (2004)
The Haworth Press.

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Review by Euan Sadler, PhD research student, Institute of Gerontology, King's College London

This edited book focuses on the relatively unexplored area of spiritual assessment and intervention with older people. In general, I thought that the collection of papers sensitively covered a diversity of issues, which includes the spiritual care of older adults with dementia, and those being cared for in a palliative care setting. It also addressed well the neglected role of faith communities in raising awareness of elder abuse and in facilitating parent care models, and the role of intergenerational relations in shaping spiritual well being in later life. I also liked the fact that the book had a multi-cultural and ethnic focus, which included the views of older people from different ethic backgrounds.

I particularly found the introductory chapter by Brennan & Heiser provided a comprehensive summary of the key issues to consider when researching the field of spiritual assessment and intervention among older people. This included a detailed discussion around the main conceptual and methodological problems involved in exploring spirituality in later life. The authors provided a useful critique on using standardized scales to measure spiritual well being, which fail to account for the diversity of human experience. They usefully discuss these issues in line with a general overview of the empirical evidence in relation to spiritual interventions and its links with physical health, mental health, and psychological well being. The conclusion to the book complements this introduction by discussing and summarizing the critical issues involved in the implementation and evaluation of spiritual assessments and interventions with older people, coping with a variety of health problems or when negotiating some of life's challenges.

I also found two further chapters particularly interesting. The chapter by Nelson-Becker is insightful because of its life-course focus on narrative therapy. In the presentation of four diverse vignettes, and drawing on the work of Zinnbauer et al (1997), the author interestingly makes the distinction between the role of both religious and spiritual resources, only religious, only spiritual and neither spiritual or religious resources in the lives of four older people, when coping with various changes and transitions in their life. The vignette of an older women who rejects religion and embraces nature as a spiritual resource in later life, due to her traumatic prisoner of war experiences, sensitively highlights the dynamic and socially contextualized nature of a person's spirituality throughout life.

Further, the paper by Vance who discusses a religious activity programme among older people at different stages of Alzheimer's disease, addresses the important issue of tailoring the intervention, as well as theoretically and empirically embedding it in the existing literature. I particularly found the table summarizing and comparing the different activity approaches among older adults with dementia useful. The author also discusses how the implementation of their programme can be sensitively adapted to meet the needs of older people from different religious traditions. In his conclusion, the author cautions that their particular religious activity programme would not be suitable for older people who do not hold a strong religious faith. This begs the question that there is still the need to empirically investigate programmes which provide alternative ways of facilitating spirituality among older people suffering from dementia, for example, examining the possible role of nature on the spiritual well-being of non-believers.

Euan Sadler

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