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"There is a fountain of youth! It is in your mind, your talents, the creativity you bring to your life and to the lives of others. When you tap this source, you will truly have defeated age."

—Sofia Loren


By the end of this chapter, readers will be able to:

  1. Provide a working definition of spirituality.

  2. Explain why occupational and physical therapists may be interested in the spiritual aspect of elderly clients.

  3. Identify several possibilities for engaging clients on a spiritual level.

Clinical Vignette

Joan Wilson is an 80-year-old woman who was in excellent health before a stroke that had only minor physical consequences but left her speech unintelligible. Speech therapy is involved to help with her speech, and some progress has occurred in her ability to speak more clearly. As an occupational or physical therapist, you are seeing Joan 2 months later; she is living in the home of her daughter and family. You have been asked to consult on a possible activation program because Joan currently spends all her time sitting in a chair, often crying. She often seems to be looking up at the ceiling, hands clasped tightly in front of her in a posture reminiscent of prayer.

  1. What kinds of cues might make you think that Joan is thinking about spiritual issues, like how this could happen to her, what it means about her relationship with God, whether she is ready to die?

  2. How might you be able to discover whether Joan is a spiritual person or not?

  3. As a therapist, are you guided by a personal spirituality that shapes how you encounter spiritual issues in others? If so, what effect might that have on your care of this patient and her spiritual needs? How should providers respond if they do not have a sense of spirituality?

The final chapter in this section deals with spirituality among older people. It addresses the question of why occupational and physical therapists working with older people need to understand the role of spirituality in their own lives and in the lives of others. The chapter begins—as does virtually every discussion of spirituality—by acknowledging the difficulty of defining the construct. To define spirituality, one has to accept the possibility of offending some and disappointing others. That said, the following definition is a starting point and a common reference for our discussions.

Defining Spirituality

The literature is clear that there are two features that appear in almost every definition of spirituality: a relationship to a higher power and a relationship with meaning or purpose in life (Cunningham, 2002). Let us begin with a definition derived in the simplest fashion, from etymology (McColl, 2000, 2003). It goes like this:


Spirituality is an abstract noun, made up of three parts:


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