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Senior Health

Dimensions of Wellness - Part 5: Spiritual Wellness

Our individual journey to attain and maintain spiritual wellness is highly personal and unique. Evidence indicates that the spiritual dimension of our holistic nature becomes more important in our lives as we grow older. There may be a tendency for some people to perceive religion and spirituality as one in the same because there may be shared rituals that are part of each, such as prayer and meditation. We understand that religion involves specific, agreed upon beliefs and practices by a group of people whereas spirituality involves exploring sources of power and meaning in a person's life that may occur outside of a religious base. Gerontology professionals agree that spirituality is important to older adults towards effective psychosocial function and successful aging.1

Spiritual wellness involves personal growth at every age:

Professionals need to be alert to signs of spiritual distress that may occur in the lives of older people that may negatively affect their capabilities and quality of life. It is particularly important to assess spiritual needs when addressing quality of life issues, especially in times when older adults are experiencing losses (e.g., loss of a significant others, facing own mortality, when in distress about making choices about the care of another). Times of transition such as illness, relocation, widow-hood, retirement, and episodes of acute or chronic illness may also trigger spiritual distress.

We understand the need for sensitivity about cultural influences and non-judgmental communication around discussions about spirituality. The following assessment tools are helpful in assisting professionals to assess spiritual distress:

Clues to Spiritual Distress - General Observations

Selected Questions to Assess Spiritual Distress

  1. Conflicts between your beliefs/values and actions you feel you should be taking? (e.g., entitled to time to oneself in conflict with caregiving demands)
  2. Conflicts between your beliefs and what society or health care providers are encouraging or suggesting to you? (e.g., questioning wisdom of health decisions for spouse unable to participate in the decision)
  3. Do you have any special religious considerations that are not being addressed? (e.g., dietary practices, observance of religious holidays)4

Older adults need to understand that each is responsible for making choices that impact their spiritual wellness. Knowledgeable professionals have opportunities to both assess and realistically address the spiritual component in older adults' lives, and, perhaps, make a positive impact on the quality of these lives.

To enhance spiritual wellness, recommend these actions (or others related to spiritual growth) for older people that may be helpful: Suggest that they count their blessings, experience the joy of forgiveness, do something for someone else, attend faith-based services, meditate, create, let go of past blame.

"The weak can never forgive. Forgiveness is the attribute of the strong". -Gandhi

Recommended Resources - Evelyn's Picks


  1. Miller, C. (2004). Nursing for Wellness in Older Adults: Theory and Practice. 4th Edition. Philadelphia: Williams, Lippincott Williams & Wilcott.
  2. Canadian government website focused on Six Dimensions of Wellness, Available November 2008.
  3. Miller (2004).
  4. Ibid.

GERO GEMS is a monthly publication of the Center for Aging with Dignity. Compiled by Evelyn Fitzwater, this publication is designed to raise awareness of aging and related issues impacting health care professionals and our society as a whole.

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Last Reviewed: Mar 10, 2009

Evelyn L Fitzwater, DSN, RN Evelyn L Fitzwater, DSN, RN
Associate Professor Emerita
Associate Director of the
College of Nursing
University of Cincinnati