Spiritual care to persons with dementia in nursing homes; a qualitative study of nurses and care workers experiences

BACKGROUND Spiritual care for people with dementia who are in nursing homes is one aspect of the holistic care provided by nurses. A number of studies have explored the concepts of spirituality and religiosity, but fewer studies describe how nurses provide spiritual care in practice. The Purpose of the study was thus to investigate how nurses and care workers can provide spiritual care for people with dementia who live in nursing homes. METHODS This is a qualitative study with an exploratory design using a phenomenological-hermeneutic approach. Interviews were conducted in eight focus groups with 31 nurses and care workers in 4 Norwegian nursing homes. RESULTS The nurses were unsure about whether they actually provided spiritual care. Through discussions in the focus groups, a new understanding and insight was developed. The spiritual care that the nurses provided included: (1) integrating spiritual care into general care, described as 'physical touch' and 'responsiveness and intuition'; (2) spiritual care in terms of togetherness, described as 'being present' and 'sensitivity in communication'; and (3) spiritual care as providing meaningful activities for everyday life, described as 'facilitating activities' and 'meeting the residents' religious needs'. CONCLUSIONS This study demonstrates the need for nurses and care workers to discuss and reflect on how to understand and describe spiritual care for people with dementia in practice. There is a need to develop and expand the knowledge about how to teach carers to recognize resident's spiritual needs and expressions of spirituality and to establish a comprehensive view of spiritual care for people with dementia in nursing homes.