The Caring Spirit Approach to Eldercare A Training Guide for Professionals and Families By Nancy L. Kriseman, M.S.W. Foreword by William H. Thomas, M.D.

Excerpted from the Introduction of The Caring Spirit Approach to Eldercare: A Training Guide for Professionals and Families, by Nancy L. Kriseman, M.S.W., L.C.S.W.

Copyright © 2005 by Nancy L. Kriseman. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the author.

Introduction

CREATING A CULTURE OF CARING IN TRAINING

“[Caring] is an expression of loving.
It’s how loving makes itself known.”
John Morton, from The Blessings Already Are

As advances in medicine enable people to live longer, society will be caring for more elders than ever before. As the start of the 21st century unfolds, at least 20 percent of the population will be 65 years old and older, and the fastest-growing segment of the population is already the 85-and-older age group. The challenge, then, is how to care for this ever-increasing population so that elders are truly cared for and about and not just kept alive. 

In their book Rethinking Alzheimer’s Care, authors, Fazio, Seman, and Stansell attempted to define what caring for elders truly means. They presented several noteworthy concepts, which are prefaced with the following questions:

• What does it mean to care for someone?
• What does caring about or for others mean to the person providing the care?
• How can someone care for someone else in a way that does not make him or her feel like an object?
• How does caring for someone help him or her?
• How does caring differ from providing care?
• What does it mean to care for someone’s own family or friends, and for oneself?

The authors believe that the changes occurring in longevity rates and in health care will require staff who work with elders to have a clearer philosophy of caring that will support understanding how to preserve a caring approach. While these authors were mainly addressing professional caregivers, the same issues need to be addressed with family caregivers as well.

In conclusion, Fazio, et al., suggested guidelines for considering caring in a different way, stating that

• Caring helps support the self-esteem of the elder
• Caring helps diminish anxiety and fear
• Caring helps the elder feel safe, physically and emotionally
• Caring lets the person know he or she is important and valued
• Caring increases the likelihood of successful completion of tasks that are needed for the elder
• Caring provides the staff with a feeling of satisfaction and gratification

From these guidelines, it can be concluded that caring is one of the ways in which people manifest their spiritual selves in the world. Reflecting on caring in that way, several additional guidelines could be added to those listed above:

• Caring is a spiritual act. When staff members, families, and elders care for each other, it can help them feel more deeply connected to themselves and to one another.  
• Caring is an act of loving kindness that places two people in a sacred space together.
• Caring requires considering the spirit of the person as well as the mind and body.
• Caring requires bringing our spiritual values to the caregiving process.

Expecting quality of care for our elders requires recognizing the importance of creating a culture of caring for those who live and work in long-term care settings. Creating a culture of caring requires two components:

1. Management must ensure that all who live and work in long-term care environments are treated with respect, compassion, and caring. 
2. Staff members must be appreciated and valued.  

We cannot expect caregivers to provide quality care to elders if we do not value their work and provide them with the training and tools they need to conduct their jobs with integrity and caring. My approach to creating a culture of caring emphasizes compassionate values, a solid sense of ethics, and continued recognition of the sacredness of the end of life. The Caring Spirit philosophy provides the spiritual groundwork needed to create such a culture of caring in long-term care settings.

Questions to Ponder When Taking a Spiritual Approach to Training with Professionals and Families

The questions below set the stage for thinking about how a spiritual approach to training changes the context of the training for professionals and families.

Questions for Professionals

1. How does this training program nurture the spirits and souls of the staff so they in turn can nurture the spirits and souls of the elders?
   
   
   • Are staff members provided with ways to exhibit their strengths?
   • Are there opportunities for staff members to share their spiritual sides?
   • Are staff members empowered to tap into their spirituality to help them through the more difficult situations?
   • Are staff members provided with the “compassionate tools” they need to work in a caring way with our elders?
   • Are staff members shown that their knowledge and experience is valued?
   • What opportunities are provided for staff members to know one another?
   • Are staff members honored and respected in ways they can reciprocate with the elders?
   • What opportunities are provided for the staff to have a more spiritual environment in which to work?
   • How is a culture of caring created and maintained in the work environment?
2. How do training programs encourage staff to know the elders for whom they care?
   
   
   • Are staff members asked in training exercises to share information and stories about the elders in their care?
   • Are staff members provided with good background information about every elder for whom they are expected to provide care?
   • Are staff members given enough time to provide individualized care to residents in their care? 
   • Are staff members given information about the religious or cultural back-grounds of elders in their care?
   • Once these questions are addressed, staff can begin receiving the best possible training in the most spiritual way.

Questions for Families

1. How does this training program nurture the spirits and souls of family caregivers so they in turn can nurture the spirits and souls of their loved ones?
   
   
   • Are there opportunities for family caregivers to recognize their spiritual sides?
   • Are families empowered to lean on their spirituality to help them through difficult situations?
   • Are family caregivers encouraged to nurture themselves? Are they provided with the skills needed to do so?
   • Are they taught to recognize how stress and depression can be indicators that their spirits are not being nurtured?
   • Are family caregivers taught spiritual approaches to coping with stress in addition to other traditional approaches?

Once these questions are addressed, it is likely that more effective coping skills can be available for family caregivers. By participating in The Caring Spirit program, family caregivers will have the opportunity to find comfort in a spiritual approach to caring for themselves while they are caring for their loved ones.

OVERVIEW OF THE CARING SPIRIT TRAINING PROGRAM FOR PROFESSIONAL STAFF

The objectives of The Caring Spirit training program for professionals are 

• To promote a more positive culture within a facility’s care community
• To encourage a more compassionate, spiritual approach to caring for elders
• To improve staff morale
• To promote more positive feelings and job satisfaction

The Caring Spirit training program for professionals contains ten interactive training modules designed to meet these objectives. Together, the modules also accomplish these additional tasks:

• Encourage team building.
• Help build a bond of trust among participants.
• Help participants become more aware of their inner selves.
• Help participants recognize their talents and skills.
• Generate more positive communication among participants, with the goal of building a culture of caring among all staff members and elders.
• Help participants recognize when their own spirits are in jeopardy so they can take a more spiritual approach to providing better care for themselves.

Each module is an hour-and-a-half in length and was created to be a stand-alone session. Each module builds upon the others, however, and it is recommended that participants commit to attending all ten sessions. 

Module One: Understanding Spirituality and Your Spiritual Self

The focus of this training module is to open the pathways for participants to explore what spirituality means to them and to others. They will explore ways to tap into their own spiritual selves. In addition, they will learn how being spiritual can lead to a different way of caring for themselves and for the elders with whom they work.

Module Two: Creating a Spiritual Work Environment

The focus here is on how to create a more spiritual work environment, exploring what home means to participants and to the elders in their care. Participants also develop a definition of the concept of a culture of caring, exploring the importance of having a caring culture in which to live and work.

Module Three: Why Working in Eldercare Is a Blessing

Working through this module helps participants appreciate the work they do and gain a better understanding of why they do this kind of work. They explore why working with elders is a blessing. Participants also examine the many ways in which they are blessed to work with each other and how it is a privilege to help elders finish well. As participants become more aware of the many blessings in their lives, they are more apt to feel the abundance they gain from their jobs.

Module Four: How Inspiration Affects Staff Members and Those for Whom They Care

Inspiration helps motivate staff members and reinforces the value of their work. This training module helps them identify who has inspired them in their lives and what inspiration means to them. It helps them answer the questions, “What inspires me to work with elders?” and “How can we inspire each other?” 

Module Five: Spiritual Approaches to Caring for Elders

Caring for elders at the end of their lives is challenging but can also be seen as sacred. Understanding how to approach elders in a more spiritual way can transform the caregiving experience. The following issues are explored in this module:

• How professionals can be more spiritual in their approach to care 
• How a spiritual approach to care differs from a more traditional approach
• How taking a more spiritual approach to caring affects the way  caregivers feel about themselves and the elders for whom they care

Module Six: How Staff Members Can  Find Support within the Work They Do

This training module takes participants on a journey to find their inner strengths and additional ways to help them care for elders. Participants will also explore external sources of strength. They will consider how the work they do is angel-like.

Module Seven: Spiritual Ways to Cope with Stress

Through this training module participants acknowledge how stressful their jobs can be. They learn some less traditional ways to cope with stress, including spiritual coping tools introduced through various exercises that allow participants to practice these different ways to cope with stress. Participants can come to see stress as an opportunity for growth and change.

Module Eight: Communicating from the Heart

In this training module, participants find the path to their hearts. They learn the concept of spiritual listening and recognize how it can help them communicate more successfully with the elders for whom they care. Participants will learn about barriers that interfere with communicating from the heart, as well as some alternative ways to communicate in their personal and work lives.

Module Nine: Staying Connected Through Rituals

Connecting to the past and to the present can often be accomplished by exploring rituals. This training module looks at the role participants’ own family rituals play in their relationships at work and in their day-to-day activities. Participants will have a better understanding of why it is important to preserve the rituals of the elders in their care.

Module Ten: Taking Care of Our Own Spirits

This module allows participants to explore why they tend not to take adequate care of themselves and how this impacts their work lives. They learn the concept of being self-full along with the symptoms of burnout. Finally, participants learn ways to take care of themselves in a more caring spirit way.

OVERVIEW OF THE CARING SPIRIT TRAINING PROGRAM FOR FAMILY CAREGIVERS

The objectives of The Caring Spirit training program for family caregivers are:

• To promote a more compassionate understanding of the role of the family caregiver
• To encourage family caregivers to take better care of their own spirits by using spiritual coping tools
• To help family members understand both the grieving process and the role changes that occur when caring for a loved one

The Caring Spirit training program for family caregivers meets these objectives in four interactive training modules. The specific purpose of each module varies, but all are designed to accomplish the following tasks:

• Encourage participants to share their feelings and concerns.
• Help build a bond of trust among participants.
• Help participants recognize their shared concerns and challenges.
• Help participants recognize when their own spirits are in jeopardy so they can take a more spiritual approach to providing better care for themselves.

Each module is an hour-and-a-half in length and was created to be a stand-alone session. Each module builds upon the others, however, and it is recommended that participants commit to participating in all four sessions.

Module Eleven: Why a Spiritual Approach to Caring Matters

The focus of this training module is to help families learn additional ways to cope with the caregiving experience. They will have the opportunity to explore what their spirituality means to them and to their loved ones. They will learn how to tap into their own spiritual sides and gain a clearer understanding of how being spiritual can lead to a different way of caring for themselves and their loved ones.

Module Twelve: Helping Families Connect from the Heart

This training module helps participants find the path to their hearts. They will explore how communicating from their hearts can help them communicate with their loved ones in a deeper way, and how communicating solely from the “head” blocks them from their heart and from the ways of the heart. Participants will discuss barriers to communicating from the heart and learn more compassionate, gentler ways to communicate with their loved ones and other family members.

Module Thirteen: Spiritual Approaches to Coping with Stress

In this training module, participants explore how stress is an inevitable part of the caregiving experience and how best to cope with this stress using spiritual resources. Through stories and exercises they will have the opportunity to practice some spiritual ways of coping with the stress of caregiving.

Module Fourteen: Helping Your Family Member Finish Well

This training module helps family caregivers learn the importance of finding ways to cope with the impending loss of a loved one and of preparing to say goodbye. It explores these issues:

• Recognizing the signs of when it might be time to let go of a loved one
• Understanding the stages of grieving
• Learning how to be with a loved one at the end of life
• Learning how to say goodbye
• Understanding hospice care and how it can be helpful

Identifying the spiritual sides to caregiving can help family members find new ways to connect to their loved ones. The caregiving experience can be challenging at times, and spiritual approaches to caring can provide family caregivers with additional support to help them cope and connect in positive ways.

REFERENCES

Apple Health Care, Inc. The Better Life Philosophy of Care. See website: http://www.applehealthcare.com/new/life.shtml.

Bell, V., & Troxel, D. (2001). The best friends staff: Building a culture of care in Alzheimer’s programs. Baltimore: Health Professions Press.

Fazio, S., Seman, D., & Stansell, J. (1999). Rethinking Alzheimer’s care. Baltimore: Health Professions Press. Wellspring Innovative Solutions, Inc. See website: http://www.wellspringis.org.