Using Integrative Therapies at the End of Life: Connecting through the Lifespan

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352 BUMC PROCEEDINGS 2001;14:352–357 The technological advances of the past century tended tochange the focus of medicine from a caring, service-oriented model to a technological, cure-oriented model. Technology has led to phenomenal advances in medicine and has given us the ability to prolong life. However, in the past few decades physicians have attempted to balance their care by re- claiming medicine’s more spiritual roots, recognizing that until modern times spirituality was often linked with health care. Spiritual or compassionate care involves serving the whole per- son—the physical, emotional, social, and spiritual. Such service is inherently a spiritual activity. Rachel Naomi Remen, MD, who has developed Commonweal retreats for people with cancer, de- scribed it well: Helping, fixing, and serving represent three different ways of see- ing life. When you help, you see life as weak. When you fix, you see life as broken. When you serve, you see life as whole. Fixing and helping may be the work of the ego, and service the work of the soul (1). Serving patients may involve spending time with them, hold- ing their hands, and talking about what is important to them. Patients value these experiences with their physicians. In this article, I discuss elements of compassionate care, review some research on the role of spirituality in health care, highlight ad- vantages of understanding patients’ spirituality, explain ways to practice spiritual care, and summarize some national efforts to incorporate spirituality into medicine. COMPASSIONATE CARE: HELPING PATIENTS FIND MEANING IN THEIR SUFFERING AND ADDRESSING THEIR SPIRITUALITY The word compassion means “to suffer with.” Compassionate care calls physicians to walk with people in the midst of their pain, to be partners with patients rather than experts dictating information to them. Victor Frankl, a psychiatrist who wrote of his experiences in a Nazi concentration camp, wrote: “Man is not destroyed by suf- fering; he is destroyed by suffering without meaning” (2). One of the challenges physicians face is to help people find meaning and acceptance in the midst of suffering and chronic illness. Medical ethicists have reminded us that religion and spiritual- ity form the basis of meaning and purpose for many people (3). At the same time, while patients struggle with the physical as- pects of their disease, they have other pain as well: pain related to mental and spiritual suffering, to an inability to engage the deepest questions of life. Patients may be asking questions such The role of spirituality in health care CHRISTINA M. PUCHALSKI, MD, MS From The George Washington Institute for Spirituality and Health (GWish), The George Washington University Medical Center Departments of Medicine and Health Care Sciences, and The George Washington University, Washington, DC. Presented at Baylor University Medical Center on February 28, 2001, as the Baylor- Charles A. Sammons Cancer Center Charlotte ...

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Understanding cultural differences is a very important aspect of delivering health care to various populations who have immigrated to the United States from various parts of the world. Collaborating with others to explore these differences allows you to gather varying viewpoints on these differences and how they might impact health care delivery. Part I: Individual work Select 1 chapter in The Spirit Catches You and You Fall Down that discusses Hmong history (Ch. 8 to 14) to read individually. Write a 350-word summary of the chapter that includes the following: · Identify the historical events or cultural practices in your selected chapter. · Examine and describe how these differences create disparities between U.S. health care and the Hmong in California. Share your summary with your team. Part IA: Teamwork Discuss as a team the key historical events or cultural practices you each found in your reading and summary. As a team, identify commonalities of Hmong history and cultural practices that recur throughout the chapters. Create a list of 3 to 5 key cultural practices or factors that could impact health care program delivery to the Hmong community. Include a 2- to 3-sentence description to support your choices .(All you need to do is come up with 1 key cultural with a 2-3 sentence description for this part) Part B: Individual Reflection: Write a 350-word summary explaining how the 3- to 5-key factors your team identified apply to the chapter you read. Describe how these factors impact the differences in disparities between U.S. health care and the Hmong in California. Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality). PART2::: DISCUSSION QUESTION Visit the Child Welfare Information Gateway. · What are the primary responsibilities of the health care industry in preventing child abuse and neglect, responding to child abuse and neglect, and supporting and preserving families? · What circumstances should be present (or what considerations should be made) before removing a child from the guardianship of the parent? Include sources/references to support your perspective. Classmate1: Summary There were many historical events and cultural practices in the Hmong culture. First of all it was so hard to appropriately treat Lia's epilepsy due to unfortunate circumstances. The family had their cultural beliefs and secondly there was a language barrier that stood in the way, that did not allow them to fully understand the diagnosis, and the severity if not treated. They believed that the seizures she was having made her special. They believed in traditional healing per their cultural beliefs, and this was was to call back her soul. They believed that tradi.

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