“treasure the question” martyn joseph mervyn mcgowan with a lot of help from tom mcgowan

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“Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

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Page 1: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

“Treasure the Question”Martyn Joseph

Mervyn McGowan with a lot of help from Tom McGowan

Page 2: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan
Page 3: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

How we live with the scream

Page 4: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

What is spirituality?

The engagement to explore – and deeply and meaningfully connect one’s inner self – to the known world and beyond (Kale, 2004)

Page 5: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan
Page 6: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

Spiritual pain

Spiritual pain more common symptom than pain in cancer patients (Portenoy et al., 1994)

Accounts for 47% of requests for physician assisted suicide (Meier et al 1998)

Speck defines spiritual pain as linked to:– Sense of hopelessness– Focus on suffering rather than pain– Feelings of guilt/shame– Unresolved anger– Inability to trust– Lack of inner peace– Sense of dis-connectedness or fragmentation

Page 7: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

Psychological effects

Religion appears to help protect against depression and hopelessness (Breitbart et al) which are associated with poorer survival in cancer patients (Watson et al)

But spirituality possibly linked to psychological distress (Higher Education Research Institute 2005)

Page 8: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

THE MEANING OF LIFE

   

   Sometimes life just doesn't make any sense at all.

   

   

Sometimes life doesn’t make any sense

Page 9: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

Spiritual histories

Speck:– In the course of your life, with all of its ups and

downs, have you developed ways of making sense of things that have happened to you?

– When life has been difficult what has helped you to cope?

– Would you like to talk to someone about the effect your illness is having on you or your family?

Page 10: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan
Page 11: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

Spiritual histories

NICE says

“Assessment of spiritual needs does not have to be structured, but should include core elements such as exploring how people make sense of what happens to them, what sources of strength they can draw upon, and whether these are felt to be helpful to them at this point in their life.”

Page 12: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

NATIONAL CARE OF THE DYING AUDIT – HOSPITAL (DONE BY MARIE CURIE IN LIVERPOOL AND ROYAL COLLEGE OF PHYSICIANS) THEY LOOKED AT 2672 PATIENTS IN 118 HOSPITALS SEPT – NOV 2006 (BMJ DEC 2007)

33% of dying patients had their spiritual needs assessed whereas 53% of carers had theirs assessed

Page 13: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan
Page 14: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

“Treating” spiritual suffering

Lunn (2003) defined spiritual care as:

“Meeting people where they are and assisting them in connecting or reconnecting to things, practices, ideas and principles that are at their core of their being – the breath of their life, making a connection between yourself and that person”

Page 15: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

“Treating” spiritual suffering Rousseau suggested a seven stage process:

1. Controlling physical symptoms2. Providing a supportive presence3. Encouraging life review to assist in recognizing

purpose, value, and meaning4. Exploring guilt, remorse, forgiveness,

reconciliation5. Facilitating religious expression6. Reframing goals7. Encouraging meditative practices, focusing on

healing rather than cure

Page 16: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

“At medical school I learned to repair violins”

Page 17: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

“It took many more years for me to hear the music” Barry Bub

Page 18: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

Tenderness dialogue

Page 19: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

Victor Frankl

Page 20: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan
Page 21: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan
Page 22: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

Dignity therapy

Based on Chochinov’s work Targets depression, suffering, lack of meaning,

purpose and will to live in palliative care patients. Protocol poses questions that offer

– opportunity for patients to address aspects of life that they feel most proud of/are most meaningful

– the personal history they most want remembered– things that need to be said.

Sessions recorded, transcribed and returned. Brief, done at bedside, benefits family and patient.

Page 23: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

Dignity therapy

91% satisfied 76% more dignity 68% more purpose 47% increased will to live 81% of benefit to family Reduced depressive symptoms

Page 24: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

Your “dignity” profile?

Page 25: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

CONTEMPLATIVE AWARENESS

COMMUNITY

AUTHENTIC ACTION IN THE WORLD

LIFE IS ONE

A FOUNDATION LIFE STANCE “OPENNESS”

ROOTEDNESS

Signs of a balanced spirituality

Page 26: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

Another saying from a book of wisdom

Page 27: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

A man (or a woman) can do nothing better than to eat

Page 28: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

And drink

Page 29: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan

And find satisfaction in his work

Ecclesiastes 2:24

Page 30: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan
Page 31: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan
Page 32: “Treasure the Question” Martyn Joseph Mervyn McGowan with a lot of help from Tom McGowan