Spiritual Growth and Care in the Fourth Age of Life.
E. MacKinlay.
Jessica Kingsley Publishers, London, 2006.
ISBN-13: 978-1-84310-231-1 (pbk).
ISBN-10: 1-84310-231-5 (pbk).
$48.95.
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
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