The directives heard in the United Kingdom in response to Covid-19 are: ‘Stay at Home, Save the NHS, Save Lives.’ Physical measures have been prioritised to contain the pandemic, however, the spiritual consequences of these measures have received less attention. The separation of body and soul strikes again, particularly in residential care. For my PhD research, I was fortunate to spend time in several care homes over the past two years. One of the most important observations was how relationships, community and meaningful activities are invaluable to the joy and wellbeing of residents. What spiritual sacrifices are taken to save lives and whose lives are we saving? Furthermore, are these lives ‘liveable’?
Belatedly, the media started to report on the impact of the pandemic and lockdown measures on residential care. Some examples are positive, for example, care home staff temporarily moving in with the care-recipients and family and friends visiting their loved ones in residential care through windows. Other examples are negative, such as abandonment of residents, a lack of Personal Protection Equipment (PPE), and residents being socially isolated and anxious. Care home residents have been described as “the hidden victims” of the pandemic (Plimmer and Clark 2020). Such reports raise questions as to whether human rights are indeed for all humans or just for younger (Hill, 2020), ‘healthier’, and richer humans[1]. BBC News reported on 28th April that a third of all coronavirus deaths in England and Wales are now in care homes[2]. Covid-19 affects people living and working in care homes and it is not merely a physical experience. It is also the meaning one gives to the experience and, therefore, a spiritual matter (Helman 2007).
As Cobb and Robshaw state, if healthcare is there to cure and heal people “a shallow picture of humanity will not suffice” (1998:2). We, as humans, are affected by the pandemic as a whole: physically, socially, spiritually, and psychologically. The whole person should therefore be considered, especially in times when existential questions rise to the forefront of people’s lives. In healthcare literature, spirituality and spiritual wellbeing are associated with community, connection, touch, and a sense of meaning in life (Nelson-Becker, H. & Canda 2008). Most (if not all) of these aspects have been taken away from residents in care homes. It is undeniably crucial to minimise harm and to avoid risks of contamination and this results in people making sacrifices. However, spirituality is a valuable consideration in the wellbeing of both residents and care workers in residential care and in social care decision-making. Moreover, we should examine what exactly is essential and a priority. Is it worth taking away spiritual wellbeing in order to maintain life? Especially for people who are closer to the end of life? The answer is not straightforward.
Established initiatives demonstrate that the value of spirituality is already considered in care homes. Some care providers offer 24 hour video and telephone support from Chaplains for care-recipients and their families[3]. Many care homes arrange video and telephone calls between residents and their family members. Volunteering websites and applications are overflowing with requests, demonstrating solidarity and a sense of community in fighting loneliness and isolation. Helpful strategies for care home staff are continuing conversations with residents, listening to them and trying to understand what creates joy for the individual. Furthermore, maintaining a sense of community and continuity through meaningful activities such as a (positive) newsletter, providing music, or creative projects can help minimise spiritual distress for care home residents. The pandemic exposes the importance of solidarity and caring for the whole (complex and diverse) human being more than ever. Hopefully, this difficult time will make people (re)consider what caring for the whole person and the whole population means. Looking through a ‘spiritual lens’ is essential in accomplishing this.
References
Cobb, M. and Robshaw, V. (1998). Introduction: body and soul? In: Cobb, M. and Robshaw, V. (eds.). The Spiritual Challenge of Health Care. London: Churchill Livingstone.
Helman, C. G. (2007). Culture, Health and Illness: An Introduction for Health Professionals (5th edition). London: Hodder Arnold.
Hill, Amelia. (2020) ‘Favouring young over old in Covid-19 treatment justifiable, says ethicist’, The Guardian, 22nd April. Available at: https://www.theguardian.com/world/2020/apr/22/favouring-young-over-old-in-covid-19-treatment-justifiable-says-ethicist?CMP=share_btn_link (last visited: 28/04/2020).
Nelson-Becker, H. & Canda, E. (2008). Spirituality, Religion, and Aging Research in Social Work: State of the Art and Future Possibilities. Journal of Religion, Spirituality & Aging 20(3): 177-193.
Plimmer, Gill and Clark, Pilita (2020) ‘Inside UK care
homes: why the system is failing its coronavirus test’, Financial Times, 24th April. Available at: https://www.ft.com/content/86d9807e-2a47-47b2-8dff-8ab50b16e036 (last
visited: 1/05/2020).
[1] See for example reports from Amnesty International: https://www.amnesty.org.uk/human-rights-uk/coronavirus-effect-human-rights (last visited: 28/04/2020).
[2] The BBC news report: https://www.bbc.co.uk/news/health-52455072 (last visited 28/04/2020).
[3] Methodist Home (MHA) took several measurements responding to the pandemic: https://www.mha.org.uk/news/latest-news/news_archive/coronavirus-covid-19/ (last visited 28/04/2020). v
