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Spiritual Growth and Care in the Fourth Age of Life

by Elizabeth MacKinlay Jessica Kingsley Publishers
Pub Date:
Pbk 272 pages
AU$49.99 NZ$52.17
Product Status: Out of stock. Not available to order.
Spiritual Growth and Care in the Fourth Age of Life explores the spiritual dimension of ageing and investigates the role of pastoral and spiritual care in helping the frail elderly cope with end-of-life issues.

Focusing on the experience of nursing home residents and anecdotes gathered in interviews, MacKinlay sensitively presents the struggles facing older people in need of care, such as loss of independence and privacy. Her findings show that despite ill health, loneliness and depression, older people near the end of their lives find meaning and support in (re)discovering their spirituality, and that this is not just the experience of those in care facilities, but of older people more generally. The book includes a useful chapter on spiritual assessment, providing carers with information on how to recognise the need for care.

This book will be of interest to nurses, care workers, pastoral support professionals and anyone else working with older people.

Your book Spiritual Growth and Care in the fourth Age of Life was nominated for the 2006 Australasian Journal on Ageing (AJA) Book Award. After much consideration, your book emerged as the winner of the Book Award. Sincere congratulations, and thank you for allowing your book to be included in the process. A cheque for $500 and a certificate will be posted to you. The decision was announced last week at the AAG Conference.

Your book was highly valued for its positive approach to ageing and as a useful resource for both students and a wider audience. The full text of one of the reviews of your book is attached and will be published in the first edition of the AJA in 2007.

This is a text about understanding spiritual growth in older age, specifically, the fourth age, “the age of frailty, dependency and being in need of care” (p. 11). It extends the author’s earlier research, which was on the development of a spiritual tasks framework with independent living older people, to frail aged residents in aged care facilities. This very readable book is an excellent successor to the author’s earlier text (MacKinlay, 2001) about the spiritual dimension of ageing.

The author, an Anglican priest and Registered Nurse, has again used in-depth interviews and the research approach of Grounded Theory to probe important spiritual themes for frail older people. MacKinlay also recognises the importance of understanding the views of residential care staff, and undertook workshops with staff to raise awareness of spiritual needs. The findings from MacKinlay’s studies form the basis for a sensitive portrayal of the spiritual tasks of ageing and, importantly, how care staff can systematically assess the spiritual needs of frail older people. Spiritual assessment, MacKinlay points out, is not limited to those with a religious affiliation.

MacKinlay introduces the topic of spiritual growth and older people with a succinct review of contemporary literature, the research methods that inform the content of this book, and the assessment tools needed to “provide guidance for practice of spiritual and pastoral care” (p. 8). Highlights include the use of excerpts from participant transcripts to explain the model of spiritual tasks of ageing; the significance of narrative or “story” to find purpose and meaning in life; the importance of meeting the challenge of older people with dementia, a chapter authored by MacKinlay’s colleague Corinne Trevitt; and worship and the use of ritual among older people. Other chapters focus on a number of challenges that face older people (and care staff) in residential care, such as vulnerability and transcendence; relationship and intimacy needs; and grief, death and dying. The concluding chapter draws together a number of ethical issues implied throughout: worth and dignity, coping with end of life, and use of health resources.

MacKinlay is an established author in this field and the text provides a welcome and accessible addition to the literature about the spiritual dimension, pastoral care, and end of life issues for older people. This text is a worthy addition to public and university libraries because of its relevance to professional and family carers and for older people themselves. The summaries provided at the end of each chapter are effective aids to learning and the assessment tools will be particularly useful to undergraduate and postgraduate students.

Deanne Gaskill
Queensland University of Technology

Preface. 1. The spiritual dimension of ageing and people in need of care. 2. The studies of frail older people and staff in aged care. 3. Assessment of spirituality and spiritual needs: A developmental approach. 4. Meaning of Life and frailty in the later years. 5. Wisdom, final meaning, the spiritual journey and frail older people. 6. Spiritual reminiscence: provisional and final meanings in frail older people. 7. The spiritual journey and mental health amongst older adults in need of care. 8. Meeting the challenge: older people with memory loss and dementia. 9. Worship and use of ritual among older people: different cultures, different religions; working in multi-faith and multicultural societies. 10. Vulnerability and transcendence, living in a disintegrating body and failure to thrive. 11. Vulnerability, transcendence and living with physical health problems. 12. Relationship and intimacy needs among nursing home residents. 13. Grief, death, dying and spirituality in an aged care facility. 14. Ethical issues in the fourth age of life. 15. The model of spiritual growth and care in the fourth age of life. 16. References. Appendix 1: Assessment of the Spiritual Needs of Older Adults - 1st Level. Appendix 2: Assessment of the Spiritual Needs of Older Adults - 2nd Level. Appendix 3: Group topics for spiritual reminiscence. References. Index.

This comprehensive book, successfully delivers the primary aim of helping people tp develop a deeper understanding of spirituality in relation to frailty and dependency in the fourth age... It explores the spiritual dimension in late life and sensitivity presents the struggles facing older people in need of care, tackling important ethical issues such as the use of staff resources to meet relationship and intimacy needs in care homes... Therapists, particularly those who are unsure how to address this topic within their practice, or interested in developing a greater understanding in this area of gerontology will find it a thought provoking, searching, but thoroughly readable book. It is a very useful book for any reference library for occupational therapists involved with end of life care in the fourth age and for those working in care homes.
Elizabeth MacKinlay, Director, St Marks National Theological Centre, Charles Sturt University, Canberra. She is the author of The Spiritual Dimension of Ageing (Jessica Kingsley Publishers, 2001).