I’m pleased to introduce you to Chad Federwitz, who preceded me as Chaplain at Balfour Cherrywood for seven years and was my first role model of spiritual care for elders. He’s now the Manager of Senior Services in Pitkin County, Colorado.

I asked Chad if he’d provide a guest Q&A blog because of his longtime research interest in seniors and spirituality. Earlier this week, Chad presented a paper at the 7^th International Conference on Ageing and Spirituality in Chicago. “My research focuses on the current landscape of spiritual care programming within memory care communities,” he wrote to me in an email. “By looking at a small snapshot of current practices, I’m hoping to shed light on the importance of these programs and offer possible solutions on how to offer such programming and care for older adults with memory loss.” Here are some of his insights.

Q: What first got you interested in spiritual care for people with dementia?

When I first moved to Colorado in 2009, I was attending graduate school in religious studies at Naropa University in Boulder. Having worked for a few years in Alzheimer’s care before coming to Colorado, I wanted to remain in that field while working on my Masters. I found my way to Balfour Cherrywood, and around Christmas I received a phone call from Megan, the Chaplain, asking if I would be interested to fill in for Christmas. I couldn’t make it at that time, but I told them I was very interested in helping, even though I was not an MDiv [Masters of Divinity] student.

Long story short, after Christmas Megan was moving on, and I was asked to step in for her while we took some time to look for another Chaplain. We never found one, and they stuck with me.

Easter Sunday 2010 was my first service alone as the Balfour Cherrywood Chaplain. I was very nervous because I didn’t feel like I knew much about being a Chaplain. So I took what I knew about Alzheimer’s and religion and just ran with it. What I found was that many residents and their families really valued this kind of “program.” Soon I was reading and researching everything I could find on the subject of spiritual care and dementia.

Q: Why did this particular element of dementia care capture your attention?

I think because of the training I received both from Naropa and in Alzheimer’s and dementia. In my opinion, spiritual care for people with dementia is the best practice within the field. It is about seeing people as people, treating them as such, and being fully present with them in their moments where they are.

When providing care with a spiritual lens, even the slightest moments can show you the impact that it has, bringing real meaning—not just bingo or movies, but real meaning—to the people we care for and their families.

Q: How has the importance of spiritual care for those with dementia evolved for you?

At first I felt like I didn’t know what I was doing, which was true—I didn’t. But after running a few Bible studies and worship services, I became more comfortable. At first I did things exactly as Megan had. Over time, I slowly changed how I did things. I found that when I was more authentic I got better responses, and I truly began to see the importance of what I was doing.

Making it my own also truly connected me to what I was doing, and it became a personal spiritual practice. I also found that few other care communities were doing something similar, and my research into the topic was not finding much, so that grew my passion for this work.

Q: Give us a synopsis of your research focus: What is it, and why did you choose this topic?

After finishing my MA in Religious Studies I became much more focused on spiritual care and dementia care. After seeing gaps in research and practice, I decided to go back and get a MA in Gerontology with a focus on spirituality and dementia.

So my research focuses on spiritual care programming for older adults with memory loss. I am particularly interested in what non-religiously-affiliated memory care communities are providing in the realm of spiritual care. My main research questions revolve around if a care community provides spiritual care (or not), what does this look like, who provides such care, and what training (in both dementia and religion) does that person have?

I chose this topic because I perceived gaps in both research and practice. The available research strongly supports that spiritual care is important and why, but I didn’t find much on the current practice of providing spiritual care.

Q: What is currently happening nationwide in long-term care spiritual programming?

That’s a little difficult to answer. I looked at a small sample of care communities, so it may not be the best judge of a larger landscape. But what I did find is rather interesting, and also not too surprising to me.

I see large gaps. Some communities provide some spiritual services such as worship services, bible studies, and spiritual singing or music, while others provide little to no support along spiritual lines. A large majority of communities that I spoke with do not have Chaplains. Sometimes they use volunteers such as a community pastor.

Also interesting was that in nearly all of the communities, the people who were providing spiritual care received almost no training in Alzheimer’s and dementia.

Although some communities attempt to address spiritual diversity, the lack of diversity among residents makes this less of an issue. Most residents within surveyed communities were within the Christian tradition, though a few had a number of Jewish residents, for which some spiritual programming was provided. Diversity within Christendom was mainly addressed in the form of Catholic communion. Other [denominations] within Christendom were not overly present.

Currently, I think some wonderful things are happening out there in the realm of spiritual care for those with dementia, but it looks drastically different from community to community. Generally, care communities either provide spiritual services for dementia residents via staff or volunteers, or they don’t provide such services at all. If we as senior care professionals use the notion of “person-centered care” as our mantra, then we need to provide care for the entire person, which includes spiritual needs.

Q: What are your hopes for this field?

Wow, I could really talk about this for a while! I think I’d start with an increased awareness of the spiritual care needs of a person with dementia.

I want to be sure to recognize the wonderful work hospice and skilled nursing communities do in this realm. Much has been said and researched in the area of spiritual care near and at end of life. That is and always will be an important area of work and study.

My focus and concern is before that—what I call “your ‘normal’ person with dementia.” I’m not trying to normalize dementia, but simply point out that a person with dementia who is not activity dying has spiritual needs as well, for which they could have support for many years as they travel through their dementia.

I hope that increased awareness of this need will bring others into the conversation and lead to training and academic programs to address spiritual needs of the aging and those with dementia.

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Thanks, Chad, for your passion and work in this field!

Do you have any questions or comments about this? I’d love to hear them; please post below.

Peace be with you,