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09 Nov 2023

Finding comfort with the concept of spirituality


Having put forward the case that spirituality is an integral part in any ageing well activity or initiative, what is the best way to elevate the subject matter to wider attention?

A leader in the field is the Australian Meaningful Ageing organisation, the national body for all things to do with spiritual care and ageing. 

Their mission is to enable access to high quality pastoral and spiritual care for all older people in the country. 

The orientation they adopt is this: Spirituality is integral to, but not confined by, religion and faith. It is about what gives purpose to our lives. It is about our sources of meaning and hope, which in turn is intimately related to our connectedness to ourselves, to others and to the world. There is now a large body of emerging evidence showing that pastoral and spiritual care is an essential part of holistic care for everyone, particularly older people including, importantly, those with dementia.

From their experience many working in aged care who understand the value of pastoral and spiritual care want to have the conversations around spirituality. These tend to stay at a superficial level because they don’t feel they have the knowledge or skills to respond at a deeper level. Nor necessarily in ways that are meaningful to those they are caring for. 

On that basis they developed what is believed to be the world’s first Guidelines for spiritual care in the context of ageing care. These have been formulated to recognize that the spiritual ‘dimension’ is an important aspect to cater for diversity and individual needs. 

Going forward with Guidelines   

As a world first the Australian Meaningful Ageing Guidelines currently represent international best practice and, as such, provide a useful starting point for the process. It has been argued that the Australian Meaningful Ageing Guidelines would be an appropriate starting point for opening discussions across Aotearoa New Zealand toward development of a set relevant to our country and its peoples.  

Step 1 Finding out what matters: 

Some key resources and relationships are already in place to work toward the development process and accompanying fieldwork. This step would be to source input from older people, their family/whānau; their carers/representatives; aged care providers; front line staff and volunteers; experts; national, regional, and local health and social service organisations; spiritual providers/practitioners; and anyone else relevant per individual elder consulted. This would then help to define and refine what should be covered in an Aotearoa New Zealand set of Guidelines.   

Step 2 Audit of what currently exists: 

What resources are currently available (essential this audit gives voice to elders lived experience) to satisfy their spiritual requirements? How are these accessed and how do they apply in the context of ageing well?

Step 3 What spirituality might include: 

It must be recognized that the subject of Meaningful Ageing could be ‘uncomfortable’ for those new to the notion of spirituality. What does it include or cover and is it just another way of proselytizing? Defining what the concept means in the context of ageing well would be required. A starting point is Gerontologist Wilfred Spiritual Assessment in HealthCare Practice (2013) which found that definitions cover, as per the international definition of health and wellbeing, notions of both ‘art’ and ‘science’. Information gathered from Step 1 will also be useful in authenticating appropriate notions with elder’s actual lived experiences.

Step 4 Creating the framework: 

As a working and information gathering document and process a possible framework would need to cover:

  • Key definitions and terms of reference.
  • Overlap and intersection of traditional religious care and broader pastoral/spiritual care.
  • Terms of Reference for the development process and The Guidelines philosophy and orientation.
  • Standalone values and connection to other national/international ageing well initiatives.
  • The context of the place and influence of Spirituality toward physical, social and mental wellbeing.
  • Other approaches/care models that need to be considered as having spiritual components.
  • Guiding principles including any organisations/individual’s mandates, orientations, or collaborations (e.g. The Selwyn Way)

Step 5 Special consideration and needs for delivering on the Guidelines: 

Coverage must include: Tangata whenua; Pasifika cultures; new migrant populations; people with disabilities; gender diverse people; people living with dementia; those living in remote or rural areas; and the many other population groups; and any other factors related to planning / implementation / delivery / monitoring / evaluation / etc of services and programmes.

Step 6 The points and places where the domains of ageing and spirituality will interconnect and be applied: 

The New Zealand context will be different from Australia and other countries.

The Australian Guidelines identified the following domains:

  • Organisational leadership and alignment. Where spiritual care is systematically embedded and practiced at all levels and in all processes throughout the organization.
  • Relationships and connectedness. Recognising older people (as do all age-groups) experience care in a relational context, they need to feel welcome and thus able to build connection; they want their individual worth to be respected and preserved. Those who have contact with older people need to be equipped and supported to spiritually engage and connect, to enable mutual, respectful and genuine relationships to establish, build, and be maintained.
  • Identifying and meeting spiritual needs. Understanding that spiritual care is based on identification of each individual’s needs, choices, and preferences; and that agreed knowledge is documented and made easily accessible to the full care team. It is critical the full care team recognise regular review must happen as the nature of needs and preferences for all people, inclusive of elders in care, are dynamic and may change frequently.
  • Ethical context and spiritual care. Demonstrating spiritual care is provided within an ethical framework that is reflected in organizational policies, procedure, processes and practices.
  • Enabling spiritual expression. Acknowledging that a range of individualized activities and interventions is available to encourage the finding of meaning, purpose, connectedness and hope; and to transcend loss and disability. These options, activities and interventions occur in the context of deep and abiding relationships.

For each of these a series of Outcomes & Actions were developed in relation to meeting the delivery criteria for the Australian National Guidelines. Again, a similar initiative would need to be developed for identification and planning of the New Zealand policy, system and processes.

Step 7 Turning the Guidelines into Going Forward: 

There would obviously need to be a ratification process for the Guidelines before any ‘roll out’ of policy development, and any systems and processes were introduced. Once completed the focus would need to include (not an exclusive list of considerations):

  • Education and training. At a tertiary, institutional, corporate, organizational and individual level.
  • Definition and role of formal and informal spiritual practitioners and providers.
  • Points of provision for spiritual care. Why, who, what, where, when, and how.
  • Best practice standards, monitoring, management and continuous quality improvement requirements.
  • Integration with other nationally focused undertakings related to Ageing Well.


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Published: May 2018

Reviewed: September 2022

To be reviewed: September 2025