This plan for an assisted living facility will incorporate designs for spiritual amenities such as assessing the unique spirituality of residents, designing a culturally diverse, therapeutic environment for them, feeding them carefully planned meals, allowing privacy, and selecting and training employees. We also aim to provide Complementary and Alternative remedies suited to each resident’s needs. The following is an action plan and facility design that will integrate spiritual, religious, therapeutic, and health care functions into a new, culturally diverse assisted-living/long-term care facility for elderly people. The building is planned to house 150 people. There will be 75 assisted-living apartments and 50 rooms for residents in long-term care; of these rooms, 25 will be single-occupancy, and the other 25 will be double occupancy. The plan will consider spiritual needs in ways that can have universal applications. Interfaith discussion groups would be one voluntary activity for residents, because you are never too old to learn new things. The people ought to be able to own pets. The music playing should be the choice of the residents. Perhaps a lot of natural images in the settings would make the place nice and comfortable. The family here is given full disclosure, waiving no rights, and is allowed to visit anytime, day or night or by phone.
First will be a discussion of a spiritual assessment questionnaire that individuals applying to become residents would first need to answer. “To provide optimal services, a spiritual assessment is often administered to understand the intersection between clients' spirituality and service provision. Traditional assessment approaches, however, may be ineffective with clients who are uncomfortable with spiritual language or who are otherwise hesitant to discuss spirituality overtly." This facility provides a unique and specific variety of services. Here, below is each question on the spiritual assessment questionnaire including a discussion about why the question is important, what information will be gleaned from the clients answer, and with an explanation of how the answer will apply to a spiritual intervention and/or therapy plan. “Spirituality is posited to be a universal human impulse that may or may not be expressed in religious forums” (Derezotes, 2006).
Question 1. Do you believe in God?
Prime Creator Source is in actuality an absolute, fixed, systematic observation of objective truth. In this facility, dogma and language barriers will be put in proper, concordant contexts so to avoid conflict between residents, especially in double occupancy rooms. “Although a bio-psychosocial assessment is typically conducted at the beginning of therapy, practitioners must remain open to revising their initial suppositions as additional information is obtained during subsequent sessions. Similarly, one should remain open to the possibility that spirituality plays an important role in clients' lives, even though the initial preliminary assessment indicates that spirituality is not a salient life dimension” (Hodge, 2013). The answer here would apply to intervention and/or therapy in educating the resident of needing to be aware of the unity underlining all of creation and that that very system would no less be the basis of the theology that is unanimously agreed to and encouraged at the facility. The purpose of such information is to create friendships not “motivated by obligation” as those, according to Hodge (2013), “are distinguished from those which are perceived to emerge from voluntary responses such as caring.”
Question 2. Do you have prestige?
Self concept is a projector of the world we observe and is the fashions the ways in which we relate to others. We would prefer residents have self-knowledge and decide for themselves to join or not join this community. Aged individuals usually depict more of a necessity to control whatever is being arranged about their care. Carstensen’s (1996) socioemotional selectivity theory states that older adults become more selective about their social contacts, narrowing choices to those with whom they have the strongest emotional connections. This question would be a qualification for admitting individuals to be residents here, where application of the knowledge is to boost morale and strengthen esteem.
Question 3. Who are some of your oldest known ancestors, and can you relate to their plight?
“The family karma affects can be found not only as imprints in one’s personality traits, belief systems, and lifestyle but also within the mental body, the emotional body and the physical body; within one’s DNA.” Despite the Epigenetic truth that one can freely react to stimuli as they choose, these “family karma effects can be limiting beliefs, habits, repetitive scenarios, ways of thinking and acting which do not serve the person’s greatest and highest good in this present birth or traumatic experiences with unfavorable consequences to one’s life. These aspects often are carried forward to future generations and can manifest similar experiences, limitations to progress and even ill health” (Sadoriniou – Adhen, 2010). An objective reason for acquiring this detailed information is for selecting a concrete, socio-familial plan for individuals therapy and for the pairing together of roommates.
Question 4: Do you consent to the alternative treatment methods that will be recommended by your attending physician?
This facility would be privately funded, and therefore would not require “permission” from the FDA, HMOs, or pharmaceutical manufacturers to offer treatment for the bereavements of the residents. Given that, there would need be consent from the residents that places trust in the knowledge of the trained, care givers. Consent is given through an informed and knowing intention that is voluntary for both parties. The spiritual reasoning behind this specific question and its effects on intervention and/or therapy plans are as follows: a) it supports the empowered patient, and b) it is a hallmark of the specialized care offered with abundance here.
Question 5: Do you have any special talents or favorite past times you would like to see developed during your stay here?
“Activity theory (of adult development) states that successful aging depends on remaining active, productive, and involved. Those who disengage after retirement are less likely to be positive and are more likely to suffer the consequences that go along with a negative outlook. Those who have optimism, faith, hope, perseverance, and look to the future generally remain happy, content, and have positive attitudes” (Seligman & Csikszentmihalyi, 2000). “Several researchers have found that cognitive training, specifically in abstract reasoning, can reduce cognitive losses” (Ball, Berch, & Helmers, 2002; Boron, Turiano, Willis, & Schaie, 2007). Therefore, investment into helping the residents use the skills they have previously acquired and interactively exposing the residents to other residents’ unique abilities can be a method for keeping minds and bodies sharp.
Question 6: You are able, are you willing to declare sovereignty and obtain world citizenship?
This question would reveal the spiritual aptitude of residents. Being a privately-funded facility, we are advocating that “freedom to worship God as the individuals’ conscience dictates, within the dominion where the sovereign has the power to make civil law over both religious and secular matters, can ‘be granted without prejudice to the public peace, for without such peace, piety cannot flourish, nor the public peace be secure” (Prokhovnik, 2008). “Patriotism is defined in terms of a kind of loyalty to a particular nation which only those possessing that particular nationality can exhibit” (MacIntyre, 1984). Since this unsubstantiated sense of pride is not universally applicable to all, it does not support a peaceful environment. Therefore, the application of this answer would assess the individual’s measure of altruism, which is more spiritually sound than egoism. As Sri Swami Vishnu said, “The time has come that this idea of nationalism, of patriotism must disappear, and only one unity should exist.” The expectations of success, the thriving peace of residents, and the potential expansion of this facility has a goal of detaching this community from the structural violence that plagues the world for the sake of which we all will have remembered dying.
Question 7: What are some of your greatest fears?
Many elderly adults will fear things that add no self-concerns to younger populations. “Fear of falling (FOF) is a major health problem among community-dwelling older persons both in older persons who have experienced a fall and those who have not” (Scheffer et al. 2008). Two FOF interventions utilized at this facility would be “Tai-Chi exercise and cognitive-behavioral (CB) intervention. Tai Chi focused on improving lower extremity muscular strength and balance. The CB intervention concentrated on improving awareness of environmental hazards and medically related risk factors, changing faulty thinking tied to FOF experiences, and selecting useful management strategies and resources and improving confidence” (Tzu-Ting, Lin-Hui, & Chai-Yih, 2011). Another fear that many aged people face is the fear of death and dying. With this particular fear, uncertainty is prevalent among the individuals and their families. Resulting from the awareness of their own mortality “people seek to reduce anxiety related to their mortality by attaching or investing themselves in something that will outlast their short existence (e.g., a cultural worldview)” (Benton, 2007). For the individual, a therapeutic methodology might be exploring the inner dimensions of the sacred texts that discuss the afterlife. For their families, the uncertainty could be resolved with appreciation, open, honest discussions with their loved ones, and preparing them to do honor to the memories of the deceased.
Question 8: What is your definition of belief?
The word belief is defined as the following: a) acceptance of the truth of something: acceptance by the mind that something is true or real, often underpinned by an emotional or spiritual sense of certainty, b) trust: confidence that somebody or something is good or will be effective, and c) something that somebody believes in: a statement, principle, or doctrine that a person or group accepts as true. Belief alone does not constitute knowledge. It may imply knowledge, but it does not mean that we possess knowledge. “Attribution
of first-person belief is most importantly attribution to the believer of a view of intentional reality from a vantage point that is epistemically special
in ways connected with introspection” (Martens, 2010). The information that the answer to this question contributes to planning intervention and therapy for the resident is an important revelation for explaining and thereby improving their behavior at the roots.
Question 9: Have you experienced any physical or emotional trauma that left its impressions on you?
The older a person becomes, the more likely they will have experienced a debilitating, traumatic event. “Much has been written about Post Traumatic Stress Disorder (PTSD) since it was first included in The Diagnostic and Statistical Manual of Mental Disorders in 1980. According to the pyschiatrist Bessel van der Kolk, a leading authority in this field, it is the second most commonly diagnosed psychiatric disorder” (McBride, Armstrong, 1995). The purpose of this question and how it relates to residents’ interventions and therapy is addressing any special care that may be required for victims of war or assault.
Question 10: Do you pray?
“In religion a person believes in a God, who is in control, and that there are events that happen or may happen to him or her that are felt as either good or bad. If they think that something bad is happening they start praying, and ask that god change his attitude and instead be kind and take away or prevent the bad event and make it good. In fact, this isn’t prayer at all; it’s a kind of bribery, but to no affect” (Perceiving Reality: Prayer, n.d.). At this facility, we want each resident to understand and be able to see the true will of the Creator in every circumstance they face. It is said that God is unchangeable and that His actions are only for good. By this understanding, our goal is to alter our inner nature so that we can live and perceive a very different world. This perspective is akin to that which begets sovereignty as mentioned in Question 6; it allows for it and immediately manifests the like.
“When culturally diverse patients are admitted to an acute care settings, their families need to feel comfortable with the access that is available to them” (Cioffi, 2006). “Family members have a right to support their hospitalized relatives” (Johnson, 1988). These are reasons that the facility will be accessible 24 hours a day, 7 days a week. The family, who will most likely live in much more uncomfortable conditions, may bring various amenities at the request of their loved ones now enjoying independence. Being jealous of the freedom might be more of an issue than cultural differences and personal preferences.
“Religion and spirituality potentially can mediate quality of life by enhancing patient subjective well-being through social support and stress and coping strategies. Theoretically, religious and spiritual beliefs may enhance subjective well-being in 4 ways: promoting a salubrious personal lifestyle that is congruent with religious or personal faith traditions, providing systems of meaning and existential coherence, establishing personal relationships with a divine other, and ensuring social support and integration within a community” (Daaleman, VandeCreek, Dmin, 2000). This potential in an individual’s religion and/or spirituality would only be enhanced by the universality of the well educated staff at this facility. “In the development of treatment goals and care plans, patient autonomy can be threatened when physicians' religious convictions are dissonant with those of patients and family members” (Daaleman, VandeCreek, Dmin, 2000). Compatibility would not be an issue with the omnium-gatherums appearing disorderly being restored to order by the reckoning of collective grace.
In conclusion, the variety of religious, spiritual, or secular backgrounds would be amalgamated into a peaceful, true, absolute unity in this revolutionary, assisted-living facility. Special diets, rituals, or sacraments, as long as they are peaceable, will all be provided and allowed when requested. “Spiritual concerns in later life are often driven by the paradoxes of growth/loss and weakness/strength. In the face of these paradoxes, aging individuals can find wisdom, reflection, strength, a sense of purpose, inner peace, and transcendence in their spiritual beliefs” (Young & Koopsen, 2011). Through a new but familiar paradigm the residents will attain tacit, holistic wellness in a welcoming community of World Citizens.
References:
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