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Table 4 Aspects and dimensions of care provided by spiritual caregivers

From: Spiritual care at the end of life in the primary care setting: experiences from spiritual caregivers - a mixed methods study

Category 1: Aspects of spiritual care and exemplifying quotes

Helping to find meaning, acceptance or reconciliation

 - She accepted the fact she was going to need increasingly more help and that she eventually was going to die. (R10)

 - He felt heard and had the specific question for me to help him learn to pray again. Additionally, I helped him realize he wanted to ask forgiveness from his wife and son for his alcohol abuse in the past. (R26)

 

Attention for patient’s relative(s)

 - In separate conversations with the patient and his spouse, it turned out that the patient’s demise was a difficult subject. I facilitated a conversation between patient and wife about the coming death. (R14)

 - The children disagreed about the treatment plan. We talked about their thoughts, expectations and fears and the underlying pain and grief from the death of their other parent 16 years ago. Taking time for their suffering. (R25)

Performing a (farewell-)rite

 - Good guidance, a farewell-ritual with children. Let go of life and died three days later. (R04)

 - Only one granddaughter was present at the time of the farewell rite. Based on the son’s description of his mother, I read a poem about saying farewell, a prayer of Mary and I asked the granddaughter to tell her grandmother what she was grateful for. Finally, we prayed. Madam seemed unconscious for the greater part of the rite, but at the end of the prayer she said a heartfelt ‘amen’. (R17)

Helping to say farewell

 - She opened up, was able to enjoy things and she said goodbye to her family and friends very consciously. In the end there was surrender and faith that everything was alright. (R08)

 - I began visiting him weekly where we spoke about the end of life, saying farewell, and ways to inform loved ones et cetera. (R20)

Acknowledgement (n = 5)

 - He felt recognized and heard because of the respectful and reticent position I took regarding my own way of thinking. (R27)

 - Being around him, connecting to his world, talking about the place after the end of this life. Offering encouragement and trust. Comradery, ganging up together. (R01)

(Help) organizing the funeral

 - I discussed preparations for the funeral with him and organized it along with the children. (R21)

 - I met the family and talked to them. It was nice to be able to do the funeral in cooperation with the companies, wife and family. (R05)

Spiritual counselling (not specified)

 - She and her son wanted counselling on a spiritual level and I was able to provide this. (R07)

 - I guided him spiritually and I had conversations with him about his life and its conclusion, and his wishes and expectations. (R16)

Category 2: Dimensions of care and exemplifying quotes

Existential

 - I came to talk with them about the illness of the husband, what it meant for him, what he still wanted in life. And also for the wife: how to spend time together, how to say goodbye etcetera. (R12)

 - I guided the patient in looking back on her life, existential questions and in the terminal phase by being there and conversing and supporting the caregiver and her family. (R24)

Relational

 - The patient was very concerned with the future of her partner, at first this eclipsed her own process of dying. I had weekly conversations with her, and later also with her daughter and granddaughter. (R19)

 - She wanted to be eligible for euthanasia in order to not be a burden for her children, and because of her fear of pain and death. When her wish was declined, I assisted her in accepting that. There were also some feelings of anger and resentment towards her son-in-law, the husband of her deceased daughter. I assisted her in managing this. (R31)

Religious

 - Madam used to be member of a church denomination that ended in the previous century and she found out her belief system didn’t work anymore. This increased her anxiety. As spiritual caregiver I provided her a listening ear and understanding. I could also assist her in her way of seeking religious answers. These conversations gave her consolation. (R31)

 - He became a Buddhist in the final five years of his life. I guided him in his existential questions which he approached either from the more traditional Christian framework from his ‘former’ life or from his recent search for Buddhist answers. (R27)