9 Recognizing Existential Suffering and Spiritual Needs and Providing Appropriate Support In addressing the spiritual needs of patients and families, hospice nurses work closely with the families’ spiritual leader, hospice social worker, and hospice chaplain to make sure that the patients’ end-of-life wishes are respected and that comforting rituals are implemented. Appropriate assessment of existential suffering ensures that the hospice team can implement interventions to ease patients’ suffering. After reading this chapter, you will be able to: ■ Identify symptoms of existential suffering ■ Assess patients for signs of spiritual suffering ■ Select spiritual assessment tools ■ Differentiate between spirituality and religion EXISTENTIAL SUFFERING Existential suffering is different from, but may be related to, physical suffering. Existential suffering involves a deep sense of loss, hopelessness, and helplessness that can evolve as one faces the end of life (Kissane, 2012). According to Kissane (2012), some types of existential suffering include: ■ Death anxiety related to facing the unknowable ■ Loss and change ■ Loss of control over choices ■ Loss of dignity ■ Aloneness ■ Poor quality relationship with others ■ Feeling that life is meaningless Fast Facts in a Nutshell
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