Spirituality and religion in older adults: building knowledge in an emerging discipline.

So what is known in the scholarship of religion and spirituality at this point of the 21st century? Definitions of spirituality show a growing understanding of the breadth and content of spirituality, and yet, there remains no firm definition. In one sense, it might be good that spirituality has not been tightly defined. Swinton and Pattison (2010, p231) note, “multiple definitions may be indicative of the necessity and the flexibility of the term to meet particular needs that would otherwise go unmet.” The publication of the paper written by Agli et al. in this edition of the journal, is timely and provides an excellent systematic review of the recent literature. The authors show the wide variety of understanding of the terms spirituality and religion in the current literature. Meaning and relationship or connectedness are obvious in their inclusion. The relationship of religion with spirituality is also attested to, as is the rise of secular spirituality, unrelated to religious faith. Factors of hope and acceptance are also there. A shifting understanding of religion and spirituality and falling adherence to religious practices in developed societies make it difficult to set parameters for this emerging discipline of study. Yet, interest in the spiritual dimension in particular, is growing with many more papers appearing that purport to describe spirituality in pastoral care, in medicine, nursing, social work, and psychology to name a just a few of the disciplines that are studying and claiming to apply spirituality within their roles. Claims are made as to the efficacy of adopting spiritual practices to healing and coping. Yet, as can be seen in the paper by Agli et al., a systematic review of the literature over the past decade fails to provide credible evidence of the effectiveness of the application of spiritual and religious behaviors via empirical research. Why is this? Several possibilities are suggested, first, the very lack of agreement on definitions presents problems for comparison between studies. This means that it is still very difficult to set variables for research projects – questions of “what are we measuring and why?” are raised. This is shown in the paper of Agli et al., where they note the different parameters used in the various studies making cross study comparisons difficult. Researchers from different disciplines use their own lenses to study spirituality. Second, and importantly, because of the nature of the spiritual and religious dimensions, it is not possible to randomly select subjects into groups. This is because the spiritual dimension is not about the physical or even psychological dimensions that can be relatively easily quantified, and further, unlike the other dimensions of being human, the spiritual and religious dimensions are about beliefs, not facts. The spiritual dimension lies at the very core of being, perhaps most appropriately called the “heart” of being. These factors set the scene for a range of complex questions related to exploration and examination of the spiritual domain, perhaps even more emphasized in older people and those who have dementia. In a real sense, study of the spiritual dimension, and religion is about the sacred. Agli et al. reviewing the current research in this field rightly state that, “the benefits observed should be considered with caution and included in rigorous experimental research in the future.” Nevertheless they acknowledge that there do seem to be health benefits for those who have spiritual and/or religious beliefs, especially related to hope, meaning, and acceptance. The obvious effects of spirituality and religion related to health of older people make it an important domain for further study. During the second half of the 20th century with the rise and growing sophistication of scientific study of human biology, and increasing study of the mind, it seemed that scientists would soon be able to readily map the human being – biologically, psychologically, socially, and spiritually. However, the now seemingly well understood methodologies of the biological and behavioral sciences do not seem able to examine matters of the spiritual or religious to the same degree of effectiveness. As yet it is not clear that current research methods are entirely appropriate to capture the nuances of the spiritual dimension. This domain of enquiry calls for sensitive and perhaps even new ways of research. Spirituality is really a matter of the heart, not in a physiological sense, but associated with life