The spirituality of people with late-stage dementia: a review of the research literature, a critical analysis and some implications for person-centred spirituality and dementia care

Abstract

If spirituality is fundamental to personhood, it must be as integral to the life of a person with dementia as to any other person. In this paper, the author uses a three-stage process to explore the features, meanings and significance of spirituality in late-stage dementia. First, a critical literature review is undertaken to evaluate the present state of research and its methodological limitations. The second stage of the argument comprises a critical analysis of the available models of how spirituality may persist beyond the loss of cognitive and communicative capacity, leading the elucidation of two dimensions to spirituality (duration over time and the role of social space) that can sometimes be overlooked. Finally, these findings are brought to bear on wider questions of how person-centred spiritual care may be offered to people with dementia and the role of shared social values in building spiritual resilience.

Keywords:

• dementia
• spirituality
• concept analysis
• extended self
• cognitive psychology

Acknowledgements

An earlier version of parts of this paper was presented at the RCPsych Special Interest Group on Spirituality meeting, London 1st November 2013. I am indebted to the anonymous reviewer whose comments have significantly improved the presentation of this manuscript.

Notes

1 The description of dementia as progressing through “stages” needs to be used with caution, as it can obscure the diversity in the order and type of symptoms. Here, I am employing the simple three-stage categorisation used by the Alzheimer's Society (UK), in which the “late stage” is characterised by (among other symptoms) the loss of speech and communicative capacity. See Alzheimer's Society (2011).