Infusing Religion and Spirituality into the Gerontological Social Work Curriculum

Religion and spirituality are especially meaningful dimensions in the lives of many older adults. I learned that very clearly when I worked as a clinical social worker on a geriatric psych team in the early and mid 1990s. Often clients who were referred to me for depression and anxiety preferred to ask me about the meaning of their life now that their children no longer spoke with them or why God had allowed them to have a new diagnosis of cancer on top of all their other losses. In fact, 59% of Americans over age 18 indicate religion is “very important” in their daily lives while 73% of the subgroup of adults age 65 or older report religion as “very important” (Carroll, 2004). Older adults define themselves in part around the dimensions of religion and/or sometimes spirituality, both why they are important or not important to them (Nelson-Becker, 2003).

A treasure trove of data on religion and Americans is available from the Association of Religion Data Archives (http://www.thearda.com), which draws from well-known national surveys to make available both summary reports and raw data on areas such as denominational affiliation and religious beliefs. For example, a 2005 national survey reports that 61% of the population “absolutely” believes in angels. This of course has implications for social workers who may interact with such clients. Beyond the issues of religious or spiritual beliefs, experiences, ethical values, practices, and group affiliations, a key concern for social work is to discern how religion and spirituality function in the lives of older adults—either in a supportive or discouraging way. One way to do so is to help students understand how to engage in a conversation around these issues.

The goal of a spiritually-sensitive conversation is not to press one point of view or another, but rather to listen to and hear the profound questions clients bring about their life experiences. The social worker should demonstrate openness to all expressions of grief, longing, confusion, and joy that emanate from human experience. Spiritually-sensitive practice involves the ability to recognize and respond to these expressions. It is a hearing of the heart, an ability to hear stories of pain and hope and to highlight for clients important themes of which they may not be fully aware. My colleagues and I suggest four preliminary questions that may be used for assessment in these conversations as well as eleven domains of spirituality particularly applicable to older adults (Nelson-Becker, Nakashima & Canda, 2006). The preliminary questions are:

1. What helps you to experience a deep sense of meaning, purpose, and moral perspective in your life?
2. Is spirituality, religion, or faith important in your life? If so, please give examples. If not, please explain why they are not important.
3. If important to you, what terms do you prefer?
4. Would you like to incorporate spirituality, religion or faith in our work together? Please explain.

Learning how to address religion and spirituality forms one facet of competent practice with older adults. The substantive area of religion and spirituality with seniors can be infused in direct practice classes as one expression of diversity. It can be addressed through discussion of its general importance to many older adults. Research classes can incorporate data from the archives identified above, and policy classes can consider whether and how federal policies such as Medicare/Medicaid/Hospice support holistic treatment with older adults that reference their spiritual beliefs. These are just a few of the many methods for addressing this content area related to older adults.

Dr. Holly Nelson-Becker is an assistant professor of Social Welfare at the University of Kansas and is a former Hartford Faculty Scholar. She has published several articles and book chapters on spirituality and aging and has co-authored a book on the subject.

References

Carroll, J. (2004). Religion is “very important” to 6 in 10 Americans. The Gallup Poll: Tuesday Briefing, June 24.

Nelson-Becker, H. (2003). Practical philosophies: Interpretations of religion and spirituality by African-American and Jewish elders. Journal of Religious Gerontology, 14(2/3), 85-99.

Nelson-Becker, H., Nakashima, M. & Canda, E. R. (2006). Spirituality in Professional Helping Interventions. In B. Berkman & S. D’Ambruoso (Eds.), Oxford handbook of social work, health, and aging (pp.797-807). Boston: Oxford Press.