Understanding spiritual care in long- term care: Before, during and beyond the pandemic

Spiritual care is an important part of life in long-term care (LTC) homes. Spiritual care providers can support well-being, promote resilience and provide opportunities for religious practice and rituals. However, there isn’t much regulation or consistency across LTC homes. Jane Kuepfer, Schlegel Specialist in Spirituality and Aging, wanted to better understand how this type of care is provided across Ontario.

Kuepfer started this study by reaching out to Ontario LTC homes. She contacted over 177 homes and completed phone interviews with team members responsible for providing spiritual care. Though she expected to see lots of variety when it came to how homes delivered this care, she was surprised by some of the findings.

“Only 49% of homes have a dedicated spiritual care provider” says Kuepfer, “and there is a large range in how much time is dedicated. I heard from homes that have two full time spiritual care providers and some homes have a contracted team member who only provides one to two hours of care a week for the entire home. So there is a lot of variety.”

She also learned about the individuals providing care. Spiritual care providers ranged in age from 25 to 85 years old, 61% are female and all but one of the respondents identified as Christian. In the homes that do not have a team member dedicated to spiritual care, recreation team members often were taking on this work as part of their position.

When it comes to the specifics of spiritual care, there is again a wide variety of services offered. Before the pandemic, care providers organized in-person worship services, singing, groups for prayer, study or support, and multi-faith observances.

During the pandemic, spiritual care shifted to more one-to-one visits with residents to meet their spiritual needs. Through interviews, Kuepfer has learned that spiritual care providers are now coordinating access to spiritual resources outside the home, like organizing resident participation in virtual worship services with their faith community, connecting residents with families virtually, leading morale boosting activities like hallway hymn-sings and creating inspirational handouts and displays.

Pandemic or not, some common themes emerged from this research into spiritual care. The most prominent of which was the importance of presence. By being present for residents, spiritual care providers help them to tap into the love, peace and hope needed to navigate later life. Regardless of dedicated time, education level or faith background, spiritual care providers provided for the spirit of residents by assuring them they were there to support them however they were needed.

Through this research, Kuepfer developed several recommendations for the future of spiritual care in LTC. She hopes that this work will highlight the need for a dedicated team member with a skill set in spiritual care at every LTC home, LTC-specific training to equip spiritual care providers to accompany people through the challenges of later life, and online resources that can support current spiritual care providers in their role.

“Understanding how homes are currently providing spiritual care, and their challenges in doing so, invites conversation about how we can do better. We can learn from homes where spiritual care is prioritized, as we strive to provide spiritual care that is accessible and inclusive, in changing times. My hope is that, in the new era of LTC, people will be able to trust not only that they will get the best of physical care in LTC, but also that their spirits will be nurtured and honoured.”