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By JULIE MINDA

Leaders in ministry continuing care facilities long have expressed concern about the lack of defined standards for spiritual care delivery in their sector. The "Essential Services of Spiritual Care in Continuing Care Settings," a new CHA resource, is intended to address that gap and grow consensus in the ministry around what constitutes excellence in spiritual care in facilities for the aged and infirmed.

Michael J. Prince, Trinity Health Senior Communities director of mission and pastoral care, shares the Eucharist with Marycrest resident Genevieve Ostrowski. Marycrest continuum of care campus is in Livonia, Michigan, where its parent, Trinity Health, is headquartered.

The guide lists 15 services that continuing care facilities should offer to advance whole-person care for their residents and to provide support to residents' loved ones and staff. The resource is available at chausa.org/15services.

It is the product of two-plus years of work by seven mission and spiritual care professionals convened as the Continuing Care Subcommittee of CHA's Spiritual Care Advisory Committee. CHA formed the workgroup after leaders at continuing care facilities in the Catholic health ministry asked for guidance on essential spiritual care services. Another CHA workgroup had created a similar tool for acute care providers.

The continuing care workgroup sought input from spiritual care experts at CHA and at CHA member systems. Mission and spiritual care staff at ministry facilities reviewed, vetted and made suggestions for honing the list of essential services for continuing care providers. The subcommittee completed that work in January and shared it with CHA's Spiritual Care Advisory Committee, and then further refined the guide with that committee's input.

Bowman

Evidence-based practice
Two members of the Continuing Care Subcommittee, Alan E. Bowman and Timothy G. Serban, introduced the guide during an Aug. 11 webinar. Bowman is vice president of mission integration for Trinity Health Continuing Care and Serban is system executive director of spiritual health for the home and community care division of Providence St. Joseph Health.

Serban

Bowman said the tool sets out vital services and promotes evidence-based practices in spiritual health and pastoral care, end of life and palliative care, and education and caregiver support. The latter includes ongoing professional development of staffs in continuing care facilities.

The subcommittee's work is ongoing and now aimed at developing methods by which facilities can assess whether and how well they are delivering the essential services. The workgroup also plans to lead the development of resources to help facilities improve their spiritual care programming.

By the book
Bowman and Serban walked attendees through the essential services guide.

Some of the services categorized as spiritual health and pastoral care include completing individualized spiritual assessments and spiritual care plans for residents; being present and developing relationships with residents, families and staff; supporting these people spiritually in times of duress; accompanying residents experiencing memory loss; providing religious, sacramental and spiritual supports for people of various faiths; and promoting diversity and health equity at a facility.

Services included in the end of life and palliative care category are assisting with advance care planning, delivering supportive care for dying people and providing grief support for surviving loved ones.

Essentials in the education and caregiver support category include offering educational opportunities to staff, attending to their well-being and ensuring an ethical culture.

Hess

Post-pandemic stress
Joining Bowman and Serban on the webinar were Denise Hess, CHA director of supportive care; and Julie Trocchio, CHA senior director of community benefit and continuing care.

Hess noted that there currently is a debate among palliative care professionals about whether, how and when to offer advance care planning, so that people's wishes can be carried out effectively. She said it is important that eldercare facilities ensure advance care planning and supportive care of the dying are offered in a way that addresses the individual needs of residents.

Trocchio

Trocchio said that the pandemic has brought stress, loneliness and isolation for residents of supportive care and long-term care facilities, their families and staff. She said continuing care facilities should be intentional about how they address the well-being of each of these groups. She added that assembling interdisciplinary teams to develop essential services will force facility leaders out of silos so that they can come up with integrated, comprehensive ways to address people's needs.

Trocchio urged webinar attendees to investigate Age-Friendly Health Systems approaches to care. Originally rolled out in hospitals, these whole-person care concepts are now being applied increasingly in continuing care settings, she said. Launched in 2017 by the John A. Hartford Foundation, the Institute for Healthcare Improvement, the American Hospital Association and CHA, the age-friendly care model calls on providers to address with older adults what matters to the individual, medications, mentation and mobility.

Four levels
Bowman and Serban emphasized that it is not up to individual spiritual care staff members to try to provide the full menu of essential services alone. Instead, the vision is that continuing care facilities would have well-staffed spiritual care departments to provide the menu of services. And, those departments would work as part of interdisciplinary teams to deliver the services.

Serban said continuing care facilities should assess how well their spiritual care departments are staffed to be able to offer the 15 services in a high-quality way.

The Continuing Care Subcommittee is coming up with ideas for how to assess spiritual care service delivery. Bowman said metrics to gauge appropriate spiritual care staffing for continuing care facilities will have to take into account the wide variety of continuing care facilities, their size, financial resources and the characteristics of the population.

CHA is holding a series of bimonthly dialogues on spiritual care topics. In the spring, one dialogue will be aimed at helping ministry facilities use the essential services document, hearing about the member impact of the document, sharing resources and getting feedback on next steps.

People can learn more about the essential services and/or provide feedback on the guide by contacting Jill Fisk, CHA director of mission services.