Obviously Margaret Holloway, one of the DH leads on social care whose framework document has just been published – see the previous two posts – has had a busy month. She has also finished her research on spirituality in contermporary funerals. I’ve just had a copy and it will shortly be on the University website at Hull. They visited loads of funerals and then interviewed the professionals involved and the families about their views of what happened. There’s a lot of fascinating detail in the report; even though the theoretical material will probably pass a lot of readers by. It’s one of those sociological studies that really tells you about people’s lives, but also tells you that sociologists think very complicatedly about said lives.

What it shows is that funerals are still very important to families and there are spiritual and religious ideas within them what enable people to ‘make meaning’ of their lives and the life of the person who has died. There is still a lot of ritaul, but some of it is newish and perhaps a bit secular. It was often about celebrating and remembering a life, and while people could be sombre traditional religious music and hymn-singing was by no means universal.

I know this from singing in the choir at weddings: not a lot of the congregations can cope with hymns other than those they’ve encountered at school assmblies or the last night of the proms (not a lot). Recently, as a rather distant relative, I was invited to a funeral solely because it was known that I would know the hymns and sing loudly, to overcome the family embarassment at the fact tha nobody knew the hymns or could sing.

Any way, loads of fascinating detail here: the research website:

http://www2.hull.ac.uk/fass/socsci/research/research-projects/spirituality.aspx

A research report prepared by the prestigious group at King’s College London gives guidance (introduced by Desmond Tutu no less) on spiritual care for black and minority ethnic communities; it particularly focuses on sub-Saharan Africa (that means the countries south of the Sahara – basically the non-Arab parts of Africa) , but is widely applicable and adaptable for the UK situation.

There is a very useful chapter on spiritual care assessment.

Also nice is the recognition in several places that social workers have the skills to respond to spiritual care needs. Margaret Holloway’s fellow traveller model of thinking about spiritual care is highlighted (Margaret is Professor of Social Work at Hull University, and is a Department of Health lead on social work in end-of-life care). this is about practitioners travelling with patients and their families on their spiritual journey at the end of life.

This is (as adapted by the KCL team and shortened by me):

1. Joining (requiring spiritual awareness): Every team member should be …sufficiently spiritually aware to recognise the spirituality of the service user and to identify those people for whom spiritual concerns are important.

2. Listening (requiring spiritual sensitivity): …All team members should be able to ‘hear’ what the service user is saying and pick up the clues as to what they mean as well as what they are not saying (level 1)…[more skilled team members should be able to make] a preliminary assessment of the nature and significance of the spiritual issues is made through ‘active listening’.

3. Understanding (requiring spiritual empathy): …the staff member providing spiritual care needs to be able to understand and convey empathy with the kind of spiritual issues and dilemmas that may concern the service user, as well as the high points of spiritual experience, and understand how spiritual resources might be utilised…[the assumption is that you have to be pretty spiritually aware of your own journey to do this]

4. Interpreting (requiring spiritual exploration): …the traveller [patient] may enter a dark valley or rocky or hazardous terrain in which s/he is reliant on the knowledge, experience and expertise of the guide. The spiritual care provider will be willing to make her/ himself vulnerable through choosing to travel with the other person…This kind of depth work needs to be conducted with great care; often (but not always) a professional spiritual care provider will be the most appropriate person to engage with service users at this level.

One would like to see a similarly flexible approach to social work skills in palliative care, rather than the crude adherence to psychological care chracarteristic of NICE guidance.

The report on the web: http://www.kcl.ac.uk/content/1/c6/07/39/29/Spiritualcarerecommendations-Fullreport.pdf

To Hull to attend the final meeting of the research advisory group for the project on spirituality in contemporary funerals, final because it’s nearing its overall report after attending 46 funerals and talking to the participants about them. It seems that while, as most people know from personal experience, funerals nowadays are more about celebrating the person who has died than they used to be, this individualist celebration also reflects their spiritual conceptions; that is, their views about what is important in life. I’ll look forward to the final report, and you can get a copy by writing to the team at their website.

Research team website: http://www2.hull.ac.uk/fass/socsci/research/research-projects/spirituality.aspx

The British Humanist Association (BHA) newsletter is suggesting its members go to meetings to reclaim dying from the hands of the religious. This is what they say:

The BHA is a member of the ‘Dying Matters Coalition’ – set up by the National Council for Palliative Care. The Dying Matters Coalition is responsible for promoting public debate about death and dying and for assisting the implementation of the Department of Health’s End of Life Care strategy…[local and national meetings are being organised]

The BHA urges all BHA members, if invited or approached about these meetings, to attend them if they can to express humanist perspectives on death, dying and life and to reclaim death and dying from the monopoly of the religious.

As I’ve said before in this blog, humanists seem to think that they have some special philosophy to promote. although most people just find them anti-religious, sometimes rabidly so. I think having a personal and shared philosophy by which to live your life (and therefore also to live your dying) is a good thing for most people.

I’m not clear what a humanist view of dying might be; apparently any member of the BHA can enlighten us. But since humanism generally emphasises the human capacity to manage the world with the rational use of human knowledge and skills, we need to be clear what we can control and what we can’t. Since we all die, we can’t control that. What we can control is how we die, by thinking about and planning for the kind of care and support we might need from our sister and brother human beings in our dying process. Dying is a social thing that we do in relationships, and when we’re dying it’s often too late to build the relationships that will support us.

So building human relationships is a good way of preparing to live our dying., and we don;t build relationships by rejecting other humans’ beliefs quite so aggressively as some secularists seem to believe is appropriate.

Another element of the clinical review was the palliative care culture that we shuld talk about our deaths compared with the culture of some minority groups and the preferences of some individuals, never mind their ethnicity, not to talk about death. Does this mean that they cannot be helped so well? Is talking about your own death always good for you? Is not talking about your death always a bad thing?

Who rescues the rescuers, I ask? Sitting at home today, having decided it’s impossible to get to work in snow which is apparently the worst in London for 19 years, I see an RAC van stuck in the road outside my window, accompanied by another RAC van that has come to rescue it, only also to get stuck. I’ve often been caused to wonder who deals with the social workers who beat their children or neglect their elders. Yesterday, a nursing colleague who is in hospital has been plied with requests by her consultant to have a private room, on the grounds that she should have the privileges of a senior NHS staff member. Equality of access to health care?