Palliative and supportive care offers a holistic approach to helping individuals facing life-limiting illnesses achieve a higher quality of life in their remaining days (Breitbart Reference Breitbart2019). While the primary goal is to manage physical symptoms and emotional distress, an often overlooked aspect of this care is spirituality. Spirituality plays a profound role in the lives of many patients and can greatly impact their experience of illness and end-of-life care (Corpuz Reference Corpuz2021a). In recent years, scientific research has started to shed light on the intersection of spirituality and palliative care, revealing the positive effects it can have on patient outcomes (Stein et al. Reference Stein, Kolidas and Moadel2015). This article aims to discuss the need to integrate a very important yet often not discussed topic in scientific literature, which is about the last rites in palliative care and supportive care.
Spirituality is a deeply personal and individualized aspect of human existence that encompasses one’s beliefs, values, meaning, and purpose in life. In the context of palliative and supportive care, spirituality is not limited to religious beliefs but extends to a broader sense of connection and transcendence, which can be experienced in various ways (Corpuz Reference Corpuz2023b). It might involve a connection with a higher power, nature, art, or a sense of inner peace and purpose. Palliative and supportive care focus on the quality of life of patients and of their families who are facing challenges in end-of-life scenario (Corpuz Reference Corpuz2021a, Reference Corpuz2023b). The belief in the existence of soul makes spirituality relevant in palliative care (Wein Reference Wein2014).
Breitbart (Reference Breitbart2009) highlighted the spiritual domain of palliative care. Providing spiritual care is identified as a core domain by the World Health Organization (2018). These insights emphasize the potential benefits of addressing patients’ spiritual needs. First, the integration of spirituality in palliative and supportive care improves the quality of life of the patient and caregiver. Studies have shown that patients who receive spiritual support in palliative care tend to experience a better quality of life (Corpuz Reference Corpuz2021a). Spiritual interventions, such as prayer, meditation, or discussions about meaning and purpose, can provide comfort and alleviate suffering (Corpuz Reference Corpuz2021b). Second, the integration of spirituality in palliative and supportive care enhances the coping mechanism. Spiritual beliefs and practices often serve as powerful coping mechanisms for patients facing serious illnesses. Research suggests that individuals with strong spiritual beliefs are better equipped to deal with the emotional and existential challenges of terminal illness. In a study conducted by Ichihara et al. (Reference Ichihara, Ouchi and Okayama2019), the authors delivered an intervention of spiritual care to a group of patients with advanced cancer using SpiPas by trained nurses, and explored the effects on the patients’ spiritual well-being. The results showed that spiritual care using the SpiPas might be useful in improving patients’ spiritual well-being (Ichihara et al. Reference Ichihara, Ouchi and Okayama2019). Third, spiritual care can contribute to a reduction in anxiety and depression among patients. Engaging in spiritual practices and discussions can provide a sense of hope and peace, which can counteract the emotional distress associated with end-of-life circumstances. Lastly, spirituality fosters a sense of interconnectedness, both with oneself and with others. Patients who feel spiritually supported often report feeling less isolated and more connected to their loved ones, their healthcare providers, and the world around them (Corpuz Reference Corpuz2023b).
In providing effective spiritual support in palliative and supportive care, healthcare providers should adopt a patient-centered approach (PCA) that respects individual beliefs and values. The last rites in palliative and supportive care vary across different religions and belief systems. These rituals are intended to provide spiritual comfort, solace, and guidance to individuals nearing the end of their lives. In Roman Catholicism, the sacrament of Anointing of the Sick is administered to individuals who are seriously ill or near the end of their lives (Corpuz Reference Corpuz2021b). A priest blesses the person with holy oil and prays for their physical and spiritual well-being. In Islam, when a Muslim is nearing death, it is common for family and friends to recite special prayers and verses from the Quran at the bedside. After death, the deceased is prepared for burial according to Islamic customs, which include washing and wrapping the body in a white shroud. In Judaism, a person nearing death may recite the Vidui, a confession and plea for forgiveness. Family and friends often surround the individual to provide emotional and spiritual support. Hindu last rites involve various rituals, including cremation, that are guided by the belief in the cycle of birth and rebirth (samsara). Family members often play a central role in performing these rituals. In Buddhism, individuals may engage in meditation and chanting in the presence of the dying person to help them focus their mind, find peace, and achieve a peaceful transition. Sikhs often recite the Ardaas, a prayer of supplication, during times of distress or illness, including when someone is approaching death. The Guru Granth Sahib (Sikh holy scripture) is also read in the presence of the dying. Native American tribes have their own unique spiritual practices related to death and dying. These may involve ceremonies, prayers, smudging with sage, and rituals specific to the tribe’s tradition. In the Bahá’í Faith, prayers and sacred writings are recited at the bedside of the dying individual to provide spiritual comfort and guidance. In Protestant Christianity, pastors and clergy often provide pastoral care and pray with the dying person and their family. They may also read from the Bible and offer words of comfort.
These examples demonstrate the diversity of last rites and end-of-life rituals across various religions. The specific practices and beliefs surrounding death and dying can vary greatly, but they all share the common goal of providing spiritual support and solace to individuals and their loved ones during the end-of-life journey (Corpuz Reference Corpuz2023b). Indeed, spirituality is a fundamental aspect of human existence, and its importance becomes even more evident in the context of palliative and supportive care (Corpuz Reference Corpuz2023a). Scientific research is increasingly recognizing the novel and positive impact of spirituality on patients facing life-limiting illnesses. Integrating spiritual care into the holistic approach of palliative care can help patients find solace, meaning, and connection during their final journey.
Supplementary material
The supplementary material for this article can be found at https://doi.org/10.1017/S1478951523001827.
Funding
No funding was received for this article.
Competing interests
The author declares no conflict of interest in this article.
