Need to know
For #TeamEEAST Last updated: 18 May 2024 at 08:04
We understand that more of our patients are now using 999 to address social problems. The Covid-19 pandemic has highlighted the issue of loneliness and how this affects the populations we serve.
Our colleagues in the Multi-Faith Network have been asking the question of whether addressing patient’s spiritual isolation may help to improve patient welfare and thus reduce calls to 999? We appreciate the diversity of our people, but we would encourage all staff, regardless of personal religious background or lack thereof, to consider implementing the suggestions in practice.
According to census data, 61.6% of the population of England and Wales identify as religious (Office of National Statistics, 20191). The majority of organised religions place emphasis on regular acts of worship as fundamental to participation in that religion. Examples of this include attending religious services or engaging with a calendar of religious festivals. Many of these elements involve leaving the house and meeting with others at certain times or places, and this can be hard to achieve for many individuals.
Examples of barriers to religious engagement:
Inability to engage with religious services can have a serious and damaging effect on an individual’s spirituality and relationships with others in their faith community.
Engagement with religion has been evidenced to have key benefits to both social wellbeing and physical health. Research has found that spirituality can improve immune function2, increase neural activity in the frontal lobes3 and positively affect mortality4. Whilst the mechanism of these changes is debated, it is clear that individuals benefit from the fellowship and social stimulation that religious communities offer.
Many local faith groups organise loneliness or befriending schemes, and it is common practice for religious leaders to offer home visits to individuals who are unable to attend regular services. Prayer groups or scripture study groups are also common among members of the congregation. These services are designed to be accessible, but many members of the general population are unaware that they exist.
The following page offers a list of suggestions for practice. These are designed to be practical to implement and accessible to all clinicians. The aim of these suggestions is to encourage consideration for spirituality as part of our holistic approach to patient welfare. They do not replace or exclude any previous communication regarding referrals and they are to be applied appropriately within the context of clinical decision making tailored to the individual patient.
Recommendations for Practice:
Including questions about spirituality in the context of gathering a Social History can help to identify key challenges beyond religion specifically.
This question can help to identify mobility and confidence problems, as well as religious barriers. Our profession makes us excellent problem solvers, and we may be able to help patients find practical solutions.
Some religious people do not feel engaging with texts is necessary, whereas others see it as fundamental. Some older people who struggle with vision and reading may benefit from audiobook versions of these texts. Another common issue is that many people struggle to understand scripture and may feel embarrassed by this. Encourage them to seek guidance from their religious leader.
It is important for many religious people to talk about their faith with others to deepen their own understanding and work through dilemmas. This is called ‘fellowship’. Often, religion is shared among family members, so encouraging patients to ask them for help can provide solutions. However, religion can also cause tension among close friends and family. Asking about this can help to assess an individual’s global support network and assist in understanding other key social problems.
Individuals may be unaware of the support available to them via their local faith organisations, so it is important to help them explore this.
The best support for religious individuals will come from their local faith community. If they are already part of an organisation, encourage them to reach out. If they don’t have a local synagogue or temple etc then use a recognised, centralised registry to help them find an appropriate one near them. For example, www.churchofengland.org provides a list of vetted and formally affiliated churches across the UK. We have a duty of care to our patients to protect them from marginal or extremist groups so avoid recommending groups unless they have a registered affiliation with a national major faith organisation.
Historically, faith leaders provided counselling and medical attention to their congregation. This means they are accustomed to personal, difficult and sensitive conversations. It has been highlighted that issues such as incontinence can affect individual’s confidence to engage with religious services5. Faith leaders will have experience in accommodating a wide variety of problems. Mainstream religions conduct themselves under UK public law, meaning they have to comply with modern confidentiality and safeguarding regulations. Registered organisations can be relied upon to deliver safe and confidential support.
There is a wealth of religious material available online in alternative formats. Many of you will be familiar with accessing podcasts for CPD purposes and so may be able to assist patients to find spiritual podcasts which can supplement or replace traditional sermons. There are also many radio stations dedicated to faith which can provide a contemporary dialogue on current affairs and key religious events. Tuning in at regular times can also promote daily routine which has been highlighted by WHO as important for mental health6.
During the pandemic, many organisations still performed regular services via Zoom or MS Teams etc. The movement of faith online has encouraged religious groups to produce more virtual content than ever before, and move many activities online which can be more accessible for individuals who struggle to leave the house.
Encourage individuals to consider key events in the future which hold spiritual significance to them. Is it especially important to them to be able to attend their niece’s wedding? Or maybe their nephew’s bar mitzvah? Key dates can form a structure for goal planning which is a psychological technique used to help individuals find motivation. Maybe they need to get their diabetes under control, or improve their fitness and mobility before being able to attend. Setting a date can provide motivation to help individuals change negative habits. This is also an apt time to discuss Advanced Plans and end of life care and encouraging planning and conversations with family on this issue.
If you have any questions relating to this article, please contact the Multi-Faith Network at: MultiFaith@eastamb.nhs.uk
Anyone can join our staff network, whether you are religious, spiritual, or keen to learn more. If you are interested in joining the Network, please contact us at the above address and we will add you to our mailing list. We also have a Facebook Group called “EEAST Multi-Faith Network”, which is updated regularly with news and content you may find interesting. We hold virtual and face to face events to celebrate faith and diversity in our workforce.
Published 5th January 2023