Spirituality Protects Against End-Of-Life Despair

Health - Reuters

Spirituality Protects Against End-Of-Life Despair
Fri May 9,10:20 AM ET, Health - Reuters

By Alison McCook

NEW YORK (Reuters Health) - Having a sense of spiritual well-being -- or an understanding of the meaning and purpose of life, regardless of religion -- appears to help terminally ill people avoid spending their last months of life in despair, according to a report released Thursday.

Among people with less than three months to live, U.S. investigators found that those with a strong sense of spiritual well-being were less likely than others to feel hopeless, want to die or consider suicide.

Patients who were depressed only tended to want to die if they also had a low sense of spiritual well-being. In contrast, those with a strong sense of spirituality did not wish for a hastened death, regardless of whether they were also depressed.

Many terminally ill patients feel despair during their final days of life, which can manifest itself in a number of ways, such as the hopelessness, wish for death, or suicidal thoughts.

The current findings suggest that providing patients with a strong sense of spiritual well-being may enable them to avoid spending their last days in despair, according to the authors.

'Spiritual well-being is a really crucial, central aspect of how you cope with death,' study author Dr. Barry Rosenfeld of Fordham University in New York told Reuters Health.

While 'meaning-centered' therapy might also help patients who are not terminally ill, this type of assistance could be critical during the last months of life, Rosenfeld noted.

'It may be more important as you get older and closer to death, and have a more reflective perspective on life,' he said.

The findings appear in the May 10th issue of the journal The Lancet.

Numerous studies have suggested that spirituality can ease the blow from a host of difficulties, including a diagnosis of breast cancer, the death of a loved one, and even arthritis.

To study whether spirituality helps protect against the depression, despair, and hopelessness that can appear in patients told they have only a short while to live, Rosenfeld and his colleagues interviewed 160 patients with a life expectancy of less than three months.

The researchers questioned patients about a number of aspects of their well-being, including depression, hopelessness, suicidal thoughts, whether they believed they were receiving social support, their symptoms and the state of their physical functioning.

Spirituality was measured in two ways: meaning, defined as the extent to which patients felt inner peace, and faith, which addressed the comfort and strength they got from their religious beliefs.

Patients who expressed a strong sense of either type of spirituality were less likely than those with low spiritual well-being to show symptoms of end-of-life despair, the authors report.

In an interview, Rosenfeld said he would like to see health workers incorporate more psychological and spiritual elements into palliative care, which originally concentrated only on physical comfort during the last days of life.

He added that even patients with only a few months to live can respond to efforts to help them glean meaning and value from their lives, and it may never be too late to try.

'I think you can gain something up until the very end,' Rosenfeld said.

SOURCE: The Lancet 2003;361:1603-1607.