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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.

Thesis (M.S.)--East Carolina University, 2009. / Presented to the faculty the Department of Occupational Therapy. Advisor: Anne Dickerson. Assessing the Risk of IADL Tasks from the Perspective of Medically-at-risk Older Adults and their Caregivers. Includes bibliographical references.

The purpose of this study is twofold: first, to find out to what extent and for what reasons contacts with relatives have been exhausted for long-term geriatric patients in public institutions, and second, whether there is a significant difference in family contacts for the State Hospital patient as compared to the County Hospital patient. Are the reasons for changes in the family contacts basically social-psychological, medical, or economic. Such a study of family interaction requires an investigation of (a) living arrangements, family relationships, and socio-economic background prior to the hospitalization; (b) the reasons for hospitalization and the present medical diagnosis; (c) the currents economic situation of the patients and her family; and (d) the distance of the relatives’ residence from the hospital. This study attempts to obtain objective evidence in order to find answers to the above questions and to clarify the key issue of whether long-term hospitalized geriatric patients are in fact abandoned by their families.

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Mental health disorders interfere with the daily functioning of an individual’s meaningful occupations, the ability to interact with others, and decrease their ability to continue with life events (Frahm, Gammonley, Zhang, & Paek, 2010). Mental health disorders are often unreported in older adults, but the frequency is relatively high among older adults residing in long-term care settings. Further, individuals who have mental health problems are primarily located in long-term facilities (Frahm, et al. 2010). Among these diagnoses, major depressive disorder remains common within the long-term care environment. Depression could be secondary but not limited to decreased physical activity, poor social interaction, and limited participation in leisure activities. Engaging in adequate physical activities has been determined as one of the most essential factors of maintaining good health (Lipovcan, Brkljacic, Larsen, Zganec, & Franc, 2018). However, despite the widespread promotion of maintaining active lifestyles in order to live longer, many older adults live inactive lives. Research shows that activity in later life cannot be determined by only participating in exercise routines, but quality of life is measured by several domains including social, leisure, and physical (Lipovcan et al., 2018). Occupational therapists (OT) and other professionals who work with older adults should create routine programs of physical activity to increase their occupational needs and make it possible for them to maintain a meaningful life (Lok, Lok, & Canbaz, 2017). M(OT)IVATION: The Benefits of a Physical and Leisure Activity Program for Older Adults with Depression in Long-Term Care Settings is an evidence-based model program created to increase the well-being of older adults and decrease depression by engaging in exercise and leisure activities.