Spiritual and existential care in nursing homes

https://doi.org/10.14528/snr.2022.56.4.3196 Spiritual-existential questions are defined as the fundamental questions of human life, e.g., what makes life worth living and how to cope with the finality of life. Difficulties in finding answers to such questions can result in existential suffering and distress (Grech & Marks, 2017). The European Association for Palliative Care (EAPC, 2022) defines spirituality as “the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred”. Accordingly, in the face of life-changing events (such as birth, trauma, ill health, loss, high age, serious illness) or sadness, spiritual care acknowledges and responds to the human spirit. It may include the need for meaning, for self-worth, for self-expression, for faith support, perhaps for rites, prayers or sacraments, or simply the need for an empathetic listener. Therefore, spiritual care begins with encouraging human contact through compassionate relationships and moves in the direction of what is needed (McSherry et al., 2020). Nursing is based on a holistic understanding of human health which includes a physical, mental, social, and spiritual/existential dimension. Controlled by the brain, these different dimensions are in constant interaction and form an integrated whole of physical, mental, social, and spiritual/existential aspects (Seligman 2006, 2012). Accordingly, patients are unique and indivisible physical-psycho-socialspiritual entities in which the body, soul and spirit are integrated and constantly interact with each other. That is, human experiences, expectations, thoughts, and feelings are at the same time spiritual, emotional and physiological states or biochemical conditions in the body that affect the body and thereby also the entire person (Pace-Schotta, et al., 2019). Research shows that most diseases, ailments and suffering develop through interactions)between the spirit, the soul (the mind; our thoughts, feelings and experiences) and the body. Patients' emotions are biochemical bodily realities. Candace Pert (1999), an internationally renowned scholar in the field of stress, shows that the brain communicates with the immune system using "messenger cells", i.e., neuropeptides or transmitters. What is more, all our immune cells are immediately informed of how the brain interprets emotions (e.g., fear, anger, sadness). Several studies show that the count of a certain type of white blood cells termed “natural killer cells” increases during cognitive therapy and different methods of relaxation and visualisation (Haugan, 2021). This process has been described as "bits of the brain floating around the body" (Pert 1999). As explained by Haugan (2021), our emotions and thoughts "float around the body" in the form of protein molecules (peptides) through countless biochemical and physiological processes. Therefore, rather than mere changes in mood, positive attitude and optimistic expectations are actual biological facts, and optimism has a significantly favourable effect on human health (Seligman, 2006;2012; Keyes 2002;2007;2014). Recent studies also show that the perception of meaning in life is essential for the maintenance of not only mental and emotional but also physical and functional well-being (Haugan 2014a, b; Mwilambwe-Tshilobo et al., 2019). One of such studies exploring human holistic existence shows that the perceptions of meaning and loneliness have a direct impact on the brain function in older adults (Mwilambwe-Tshilobo et al., 2019), thereby advancing our knowledge of the phenomena of meaning and loneliness. While operating through emotions and experiences, these phenomena also represent physical states that take place in the intrinsic network of the human brain (ibid.). Health-promoting interventions, adapted to the individual's needs and circumstances, Editorial/Uvodnik