Spiritual and cultural issues at the end of life

Spiritual and cultural issues at the end of life are common and a natural part of the process of life and death. They often present as distress or agitation in the patient and should be considered when pain control is difficult to manage. Spirituality can be defined as our sense of meaning in life. It is often influenced by, and regularly confused with, religion and culture. While it can be suggested that society is becoming more secular and less religious, it can also be argued that it is the structure and practice of religion rather than the faith itself that is being rejected, with people picking and choosing the elements from different religions and cultures to base their sense of meaning on. Identifying and assessing spiritual and cultural issues requires healthcare professionals to engage on a human level with patients and their families/carers. Each patient is unique and individual, and while manuals and guidelines on spiritual, religious and cultural care are a guide, the only true approach is to ‘ask the patient’. As with all end-of-life issues, spiritual and cultural issues can be complex, and healthcare chaplains should be consulted for advice or the patient referred for intervention