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Chapter 18 - Ageing
- Edited by Christopher C. H. Cook, Andrew Powell
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- Book:
- Spirituality and Psychiatry
- Published online:
- 07 October 2022
- Print publication:
- 20 October 2022, pp 355-374
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Summary
This chapter provides a brief overview of the ageing process in relation to psychopathologies encountered in the practice of old age psychiatry. In addition, it addresses the role of spirituality and religion in ageing, and discusses ways in which people approach the challenges of transition in later life. The authors discuss the importance of a multidimensional and holistic approach that includes paying sufficient attention to core aspects of being and personality, which can convey important information with regard to coping skills and how they influence responses to diagnosis, treatment and outcome. Deep among these core aspects lie the root constructs of a person’s vision of life and personal meanings, and what some would describe as the presence of a spiritual/transcendent dimension.
12 - Religion and spirituality
- from Part III - Women and their environment
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- By Julia Head, Consultant Forensic Psychiatrist at Ravenswood House, Southern Health Foundation Trust
- Edited by Kathryn M. Abel, Rosalind Ramsay
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- Book:
- The Female Mind
- Published online:
- 02 January 2018
- Print publication:
- 01 October 2017, pp 77-82
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Summary
Sonia's story
Sonia had always been part of her faith community, which
she found supportive at many times during her life. She attended worship on a regular basis, but more recently her weekly attendance had turned into a daily routine and she became distressed when other responsibilities in her life threatened to disrupt the frequency of her visits. Sonia's partner became increasingly concerned about this change in her lifestyle and contacted her general practitioner (GP), who suggested that Sonia might find it helpful to discuss this with a spiritual advisor. It emerged that Sonia was very anxious about her elderly mother, who had been diagnosed with a heart condition. When she was able to discuss this with the spiritual advisor, her anxiety lessened. She was appreciative of being able to speak about what was happening in her wider relationships in the light of her faith.
When people are unwell or experience some kind of distress, they usually search for an explanation for their condition, its cause and what might help their recovery. In addition to searching for physical explanations and treatments, they might focus more deeply on the meaning of what is happening in their lives as a whole.
Spirituality v. religion
Many people do not have a specific religion, but still refer to spiritual needs and resources, particularly at difficult times. For instance, they might say, ‘I'm not a religious person, but I do think of myself as spiritual’. Spirituality and religion are integrally related, but there are important distinctions to be made.
Spirituality is concerned with the search for ultimate meaning, truth and orientation in life. There are many dimensions, and many individual expressions, of spirituality. Religion in its many forms – worship, ritual, prayer, social groupings and so on – is a more ‘corporate’ concept. Spirituality often expresses itself through religion, but it tends to be a more personal concept, concerned with meanings and essential values. It is often important to be able to see beyond what seems to be a ‘religious’ problem to discover the meanings that individuals attribute to their lives and challenges. Sonia's story is a good example of this, where the increasingly obsessive religious behaviour is secondary to (and could indicate) underlying spiritual/existential concerns.
14 - Ageing
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- By Robert M. Lawrence, South West London and St George's Mental Health NHS Trust, Julia H. Head, University of London, UK
- Edited by Christopher C. H. Cook, Andrew Powell, Andrew Sims
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- Book:
- Spirituality and Psychiatry
- Published online:
- 02 January 2018
- Print publication:
- 01 June 2009, pp 273-294
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Summary
For the suffering individual … what he makes of his suffering – whether it becomes a triumph or a tragedy of the human spirit, whether hope gains, or despair – matters, not just to himself, but to the creation itself … Whatever anyone may think then, the response of the suffering individual matters: he is not powerless. But his power is not apparent: its true measure is relative not to the achievement of others, but to the suffering individual's own condition [Boyd, 2000: p. 88].
Old age psychiatry is a discipline of particular ‘confluence’, where medical and psychological sciences meet in more integrated and interrelated presentations than at any other time in a patient's life. Pathology increases and psychopathology becomes more frequent, the latter being brought about by the substantial occurrence of dementia or functional illness, or both. The social profile of an older person can be marked by the accumulation of progressive losses in social meaning and networks. For example, their relationship with family members and friends may undergo significant changes as a result of relocation to supported accommodation or residential and nursing facilities. The challenge of a personal journey into degrees of fragility and isolation creates fertile ground for increased vulnerability and the generation of specific needs, related to mental, emotional, spiritual and physical well-being. The relevance of a multidimensional and holistic approach therefore becomes paramount in the teaching and training of old age psychiatrists.
It appears that in the assessment of the older person insufficient attention has been paid to core aspects of the personality, which can convey important information on coping skills and how they influence responses to treatment, and thus overall outcome. Deep among these lie the root constructs of a person's vision of life and personal meanings, and the presence of a spiritual core. This may or may not be accompanied by formal religious adherence and integration into a faith community.
The scope of this chapter is to review the ageing process and the emerging psychopathologies of old age psychiatry, the role of spirituality in ageing and the diverse ways in which individuals approach the transition to later life. In addition, we consider an approach that goes beyond standard medical practice.
14 - Ageing
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- By Robert M. Lawrence, St George's University of London, UK, Julia H. Head, University of London, UK
- Edited by Chris Cook, Andrew Powell, Andrew Sims
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- Book:
- Spirituality and Psychiatry
- Published by:
- Royal College of Psychiatrists
- Published online:
- 25 February 2017
- Print publication:
- 01 June 2009, pp 273-294
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Summary
For the suffering individual … what he makes of his suffering – whether it becomes a triumph or a tragedy of the human spirit, whether hope gains, or despair – matters, not just to himself, but to the creation itself … Whatever anyone may think then, the response of the suffering individual matters: he is not powerless. But his power is not apparent: its true measure is relative not to the achievement of others, but to the suffering individual's own condition [Boyd, 2000: p. 88].
Old age psychiatry is a discipline of particular ‘confluence’, where medical and psychological sciences meet in more integrated and interrelated presentations than at any other time in a patient's life. Pathology increases and psychopathology becomes more frequent, the latter being brought about by the substantial occurrence of dementia or functional illness, or both. The social profile of an older person can be marked by the accumulation of progressive losses in social meaning and networks. For example, their relationship with family members and friends may undergo significant changes as a result of relocation to supported accommodation or residential and nursing facilities. The challenge of a personal journey into degrees of fragility and isolation creates fertile ground for increased vulnerability and the generation of specific needs, related to mental, emotional, spiritual and physical well-being. The relevance of a multidimensional and holistic approach therefore becomes paramount in the teaching and training of old age psychiatrists.
It appears that in the assessment of the older person insufficient attention has been paid to core aspects of the personality, which can convey important information on coping skills and how they influence responses to treatment, and thus overall outcome. Deep among these lie the root constructs of a person's vision of life and personal meanings, and the presence of a spiritual core. This may or may not be accompanied by formal religious adherence and integration into a faith community.
The scope of this chapter is to review the ageing process and the emerging psychopathologies of old age psychiatry, the role of spirituality in ageing and the diverse ways in which individuals approach the transition to later life. In addition, we consider an approach that goes beyond standard medical practice.
Clinicians' attitudes to spirituality in old age psychiatry
- Robert M. Lawrence, Julia Head, Georgina Christodoulou, Biljana Andonovska, Samina Karamat, Anita Duggal, Jonathan Hillam, Sarah Eagger
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- Journal:
- International Psychogeriatrics / Volume 19 / Issue 5 / October 2007
- Published online by Cambridge University Press:
- 04 October 2006, pp. 962-973
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- Article
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Background: The aim of this survey is to investigate professional attitudes to the presence and value of spiritual care from Old Age Psychiatrists.
Method: All registered members of the Faculty of the Psychiatry of Old Age in the United Kingdom were asked to complete a 21-question semi-structured questionnaire. The first mail shot took place in 2002 and the second mail shot to non-respondents in 2003. Quantitative and qualitative analyses were carried out on the answers received.
Results: The response rate was 46%. The majority of respondents (92%) recognize the importance of spiritual dimensions of care for older people with mental health needs and about a quarter of respondents appear to consider referring patients to the chaplaincy service. In contrast, integration of spiritual advisors within the assessment and management of individual cases is rare.
Conclusions: Opinions vary as to whether provision of spiritual care should become widely available to older people with mental health needs who are admitted to hospital. Old age psychiatrists recognize that awareness of spiritual dimensions may be important for their patients. They seem less clear about the role of spiritual advisors and how NHS multidisciplinary clinical teams and spiritual and pastoral care services can be best integrated. Much work needs to be done on developing effective training and operational policies in this area.
Practical Theology for Aging, Editor: DERREL WATKINS, Haworth Pastoral Press, New York, 2002, U.S. $24.95. Paperback, pp. 225. ISBN 0 7890 22273
- JULIA HEAD
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- Journal:
- International Psychogeriatrics / Volume 17 / Issue 3 / September 2005
- Published online by Cambridge University Press:
- 14 September 2005, pp. 525-526
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