'The care that shines from within': the role of spirituality in aged and palliative care: A qualitative study that explores how spirituality informs care-giving to the elderly and dying in home and residential care in a regional area on the Mid North Coast

The importance of spirituality in relation to mental well-being and physical health is currently well regarded in the academic literature. Therefore spiritual care is now considered an important aspect of holistic healing practices. However, research is showing that most health care providers do not feel competent or confident in this area of care. In this thesis I explore how spiritual care is understood and experienced by practitioners in aged and palliative care in a regional area on the coast of New South Wales. The 26 participants, whose insights and experiences are depicted in this thesis, were very happy to be involved in this qualitative research project, because they felt that they now had the opportunity to explore spirituality and spiritual care. The participants in this research describe spiritual care as involving doing in the form of religious practices, such as praying or bible readings and non-religious activities that were seen as spiritual such as talking about dying, touching people or reminiscing. Additionally, they also commented about spiritual care as a special way of being with clients, which involved qualities and attitudes that were clearly felt or recognized by the participants as special. Not necessarily labeled as spiritual care, this special way of being was described as not being separate, but being an integral part of the daily acts of caring such as feeding a patient or preparing them for a bath. Participants found it often difficult to elaborate on what made such an interaction spiritual or how to describe the quality of these interactions as there seemed to be no familiar language to share the experiences of spirituality and spiritual care. Additionally, participants commented quite regularly that, although spiritual care was seen as important, there were many factors that inhibited these practices. In reflecting on these issues I put forward that, although the practitioners in this research are familiar with spiritual care, the most important contribution to encouraging health care providers to feel more confident is to continue conversations about spiritual care to increase competency in a non-denominational spiritual discourse in aged and palliative care.