Religion and Spirituality in Older Adults - Geriatrics - Merck Manuals Professional Edition (2023)

Religion and spirituality are similar but not identical concepts. Religion is often viewed as more institutionally based, more structured, and involving more traditional activities, rituals and practices. Spirituality refers to the intangible and immaterial and thus may be considered a more general term, not associated with a particular group or organization. It can refer to feelings, thoughts, experiences, and behaviors related to the soul or to a search for the sacred.

Traditional religion involves accountability and responsibility; spirituality has fewer requirements. People may reject traditional religion but consider themselves spiritual. In the US, > 90% of older people consider themselves religious or spiritual; about 6 to 10% are atheists and do not seek meaning through religion or a spiritual life. Most research assesses religion, not spirituality, using measures such as attendance at religious services, frequency of private religious practices, use of religious coping mechanisms (eg, praying, trusting in God, turning problems over to God, receiving support from the clergy), and intrinsic religiosity (internalized religious commitment).

For most older adults in the US, religion has a major role in their life, with about half attending religious services at least weekly.

Older adults' level of religious participation is greater than that in any other age group. For older people, the religious community is the largest source of social support outside of the family, and involvement in religious organizations is the most common type of voluntary social activity—more common than all other forms of voluntary social activity combined.

Benefits of Religion and Spirituality

Religion correlates with improved physical and mental health, and religious people may propose that God's intervention facilitates these benefits. However, experts cannot determine whether participation in organized religion contributes to health or whether psychologically or physically healthier people are attracted to religious groups. If religion is helpful, the reason—whether it is the religious beliefs themselves or other factors—is not clear. Many such factors (eg, psychologic benefits, encouragement of healthful practices, social support from the religious community) have been proposed.

Psychologic benefits

Religion may provide the following psychologic benefits:

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Many older people report that religion is the most important factor enabling them to cope with physical health problems and life stresses (eg, declining financial resources, loss of a spouse or partner). In one study, > 90% of older patients relied on religion, at least to a moderate degree, when coping with health problems and difficult social circumstances. For example, having a hopeful, positive attitude about the future helps people with physical problems remain motivated to recover.

People who use religious coping mechanisms are less likely to develop depression and anxiety than those who do not; this inverse association is strongest among people with greater physical disability. Even the perception of disability appears to be altered by the degree of religiousness. Of older women with hip fractures, the most religious had the lowest rates of depression and were able to walk significantly further when discharged from the hospital than those who were less religious. Religious people also tend to recover from depression more quickly.

Health-promoting practices

In older adults, active involvement in a religious community correlates with better maintained physical functioning and health. Some religious groups (eg, Mormons, Seventh-Day Adventists) advocate behaviors that enhance health, such as avoidance of tobacco and heavy alcohol use. Members of these groups are less likely to develop substance-related disorders, and they live longer than the general population.

Social benefits

Religious beliefs and practices often foster the development of community and broad social support networks. Increased social contact for older adults increases the likelihood that disease will be detected early and that older people will comply with treatment regimens because members of their community interact with them and ask them questions about their health and medical care. Older people who have such community networks are less likely to neglect themselves.

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Religious faith also benefits caregivers. In a study of caregivers of patients with Alzheimer disease or terminal cancer, caregivers with a strong personal religious faith and many social contacts were better able to cope with the stresses of caregiving during a 2-year period.

Harmful Effects of Religion and Spirituality

Religion is not always beneficial to older adults. Religious devotion may promote excessive guilt, inflexibility, and anxiety. Religious preoccupations and delusions may develop in patients with obsessive-compulsive disorder, bipolar disorder, schizophrenia, or psychoses.

Certain religious groups discourage mental and physical health care, including potentially lifesaving therapies (eg, blood transfusions, treatment of life-threatening infections, insulin therapy), and may substitute religious rituals (eg, praying, chanting, lighting candles). Some more rigid religious groups may isolate and alienate older people from nonparticipating family members and the broader social community.

Role of the Health Care Practitioner

Talking to older patients about their religious beliefs and practices helps health care practitioners provide care because these beliefs can affect the patients’ mental and physical health. Inquiring about religious issues during a medical visit is appropriate under certain circumstances, including the following:

  • When patients are severely ill, under substantial stress, or near death and ask or suggest that a practitioner talk about religious issues

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  • When patients tell a practitioner that they are religious and that religion helps them cope with illness

  • When religious needs are evident and may be affecting patients’ health or health behaviors

Older adults often have distinct spiritual needs that may overlap with but are not the same as psychologic needs. Ascertaining a patient’s spiritual needs can help mobilize the necessary resources (eg, spiritual counseling or support groups, participation in religious activities, social contacts from members of a religious community).

Spiritual history

Taking a spiritual history shows older patients that the health care practitioner is willing to discuss spiritual topics. Practitioners may ask patients whether their spiritual beliefs are an important part of their life, how these beliefs influence the way they take care of themselves, whether they are a part of a religious or spiritual community, and how they would like the health care practitioner to handle their spiritual needs.

Alternatively, a practitioner may ask patients to describe their most important coping mechanism. If the response is not a religious one, patients may be asked whether religious or spiritual resources are of any help. If the response is no, patients may be sensitively asked about barriers to those activities (eg, transportation problems, hearing difficulties, lack of financial resources, depression, lack of motivation, unresolved conflicts) to determine whether the reason is circumstances or their choice. However, practitioners should not force religious beliefs or opinions on patients or intrude if patients do not want help.

Referral to clergy

Many clergy members provide counseling services to older adults at home and in the hospital, often free of charge. Many older patients prefer such counseling to that from a mental health care practitioner because they are more satisfied with the results and because they believe such counseling does not have the stigma that mental health care does. However, many clergy members in the community do not have extensive training in mental health counseling and may not recognize when older patients need professional mental health care. In contrast, many hospital clergy have extensive training in the mental, social, and spiritual needs of older people. Thus, including hospital clergy as part of the health care team can be helpful. They can often bridge the gap between hospital care and care in the community by communicating with clergy in the community. For example, when a patient is discharged from the hospital, the hospital clergy may call the patient’s clergy so that support teams in the patient’s religious community can be mobilized to help during the patient’s convalescence (eg, by providing housekeeping services, meals, or transportation, by visiting the patient or caregiver).

Support of patients’ religious beliefs and practices

Patients seek medical care for health-related reasons, not religious ones. However, health care practitioners should not discourage a patient’s religious involvement as long as it does not interfere with necessary medical care, because such involvement may contribute to good health. People who are actively involved in religious groups, particularly those in major religious traditions, tend to be healthier.

If patients are not already involved in religious activities, suggesting such activities requires sensitivity. However, health care practitioners may suggest that patients consider religious activities if patients seem receptive and may benefit from such activities, which can provide social contact, reduce alienation and isolation, and increase a sense of belonging, of meaning, and of life purpose. These activities may also help older people focus on positive activities rather than on their own problems. However, some activities are appropriate only for more religious patients.

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What is the role of religion and spirituality with older adults? ›

Practicing a religion can help slow cognitive decline and reduce or stabilize cognitive disorders, according to International Psychogeriatrics. The use of spirituality in daily life enables those with dementia to preserve relationships, maintain hope and find meaning.

What are some characteristics of religion spirituality in older adults? ›

Religion, spirituality and/or belief were also found to provide social support, connectedness to others and a sense of belonging to a community for older adults in general [27], older adults with physical health conditions [5,38,41], and older adults with mental health conditions including anxiety and depression [42] ...

What is the difference between religion and spirituality in professional ethics? ›

Religion involves large groups of people holding the same belief and worshipping the same God, and it is the communal belief authenticated by religious scriptures. On the other hand, spirituality is a personal journey that someone may guide you, or you may take the path unguided.

What is the importance of spirituality in older adults? ›

Research shows that spirituality can play a part in helping seniors with healthy, positive aging by providing a sense of structure and understanding in our lives. Connecting to something larger than ourselves, serving others, and thinking beyond our own situation can truly improve the quality of our days.

What is the relationship between religion and spirituality? ›

Spirituality and religion are often used interchangeably, but the two concepts are different. Some authors contend that spirituality involves a personal quest for meaning in life, while religion involves an organized entity with rituals and practices focusing on a higher power or God.

How does spirituality and religion affect the health of a person? ›

Some research shows a connection between your beliefs and your sense of well being. Positive beliefs, comfort, and strength gained from religion, meditation, and prayer can contribute to well being. It may even promote healing. Improving your spiritual health may not cure an illness, but it may help you feel better.

What are the four main themes of spirituality? ›

Spirituality involves exploring certain universal themes – love, compassion, altruism, life after death, wisdom and truth, with the knowledge that some people such as saints or enlightened individuals have achieved and manifested higher levels of development than the ordinary person.

How would you characterize the difference between spirituality and religion? ›

There are some pretty clear ways in which religion and spirituality differ. Religion: This is a specific set of organised beliefs and practices, usually shared by a community or group. Spirituality: This is more of an individual practice, and has to do with having a sense of peace and purpose.

What are the characteristics of religion and spirituality? ›

Spiritual beliefs include the relationship to a superior being and are related to an existential perspective on life, death, and the nature of reality. Religious beliefs include practices/rituals such as prayer or meditation and engagement with religious community members.

What is spirituality in professional ethics? ›

spirituality. According to McLaughlin (2005), for some, spirituality simply means. incorporating the personal values of integrity, morality, good quality work. For others, it means. treating colleagues in an affectionate and responsible way.

What is the similarities between religion and spirituality? ›

Religion and spirituality are both rooted in trying to understand the meaning of life and, in some cases, how a relationship with a higher power may influence that meaning.

How does religion affect the well being of older adults? ›

Religion is not always beneficial to older adults. Religious devotion may promote excessive guilt, inflexibility, and anxiety. Religious preoccupations and delusions may develop in patients with obsessive-compulsive disorder, bipolar disorder, schizophrenia, or psychoses.

How does age affect spirituality? ›

There is evidence that religiosity and spirituality are among such factors. Older people tend to have high rates of involvement in religious and/or spiritual endeavors and it is possible that population aging will be associated with increasing prevalence of religious and spiritual activity worldwide.

What is the functions of religion in developing the spiritual life? ›

Religion ideally serves several functions. It gives meaning and purpose to life, reinforces social unity and stability, serves as an agent of social control, promotes psychological and physical well-being, and may motivate people to work for positive social change.

Why is spirituality and religion important in healthcare? ›

When healthcare professionals respect their religious preferences, patients can enter into a state of peace before a procedure or before they die. Chaplains embody the positive connection between religion and healthcare and demonstrate how religion can benefit patients when they are in emotional and physical pain.

Does religion affect spirituality? ›

Spirituality and religion are linked. But spirituality can be more general and include many other things. Spirituality can mean different things to different people or you can follow a common spiritual belief. You can be spiritual without being religious.

What is your new understanding on the concept of religion and spirituality? ›

Religion serves the important purpose of facilitating spirituality itself, but it serves other functions as well, including those that are psychological, social, and physical. In contrast, spirituality focuses on the search for one particular significant destination, the sacred.

What are the three pillars of spirituality? ›

If you take a moment to revisit the three pillars of spiritual well-being—relationships, values, and a meaningful purpose in life—you will see that these aspects are interwoven through the passages of each season (Seaward, 2007).

What are the four pillars of spirituality? ›

The 4 Pillars of Spiritual Living
  • Practice: Wake Up to Wellness. Without a regular spiritual practice, I don't believe it's possible to live a fulfilled spiritual life. ...
  • Service: Bring Altruism into Your Life. ...
  • Community: Nurture a Strong Social Support System. ...
  • Remembrance: Remember the New Golden Rule.

What are the 3 types of spirituality? ›

The shamans, healers, sages, and wisdom keepers of all times, all continents, and all peoples, in their ageless wisdom, say that human spirituality is composed of three aspects: relationships, values, and life purpose.

What is the difference between religious but not spiritual and spiritual but not religious? ›

Meanwhile, “religious” often means belonging to a group with specific doctrines and rituals. The spiritual but not religious are independent seekers, many of whom pray, meditate, do yoga and other spiritual practices outside the confines of a particular tradition.

What are the 7 characteristics of religion? ›

According to Smart, a religious framework is composed of seven dimensions: narrative/mythological, doctrinal, ethical, institutional, material, ritual, and experiential (Smart, 1999). These dimensions capture the broad and encompassing nature of religion.

What are the three basic concepts of religion? ›

As this paper shows, three main uses are currently dominant: religion as belief/meaning, religion as identity, and religion as structured social relations.

What are the 8 aspects of religion? ›

These aspects are: beliefs, myths and other stories, sacred texts and other religious writings (such as formal creeds), rituals, symbols, social structures, ethical principles and oral or written codes of behaviour, and religious experience and spirituality.

What is the relationship between religion spirituality and morality? ›

On the one hand, morality can refer to matters of truth in moral life that shape character formation in relation to fellow human beings. On the other hand, spirituality can refer to matters of belief about the transcendent that influence the formation of holiness in relation to God.

Is spirituality important in work why and how will we use it as professional? ›

Organizational performance is positively affected by workplace spirituality. A significant relationship exists between organizational performance and organizational spirituality. Workplace spirituality leads to higher individual performance. Team performance is positively associated with workplace spirituality.

What are religious ethical issues in healthcare? ›

Religious Bioethics Websites

Religious aspects of medical ethics include refusal of treatment, reproduction, organ transplants, and rituals relevant to dying/death/burial, among others. It is not possible to include links to all religious groups.

How does religion affect the well-being of older adults? ›

Religion is not always beneficial to older adults. Religious devotion may promote excessive guilt, inflexibility, and anxiety. Religious preoccupations and delusions may develop in patients with obsessive-compulsive disorder, bipolar disorder, schizophrenia, or psychoses.

What role do religion and spirituality play in mental health? ›

People may struggle spiritually with their understanding of God, with inner conflicts or with other people. A growing body of research has linked these spiritual struggles to higher levels of psychological distress, declines in physical health and even greater risk of mortality.

What is the role of spiritual and religious values in counseling and why might they be important in the counseling environment? ›

It can help us get in touch with our own powers of thinking, feeling, deciding, willing, and acting. Spirituality and religion are critical sources of strength for many clients, are the bedrock for finding meaning in life, and can be instrumental in promoting healing and well-being.

What are the three facets of human spirituality? ›

A consensus among wisdom keepers from all the world's traditions suggest that human spirituality is a tightly woven integration of three facets: an insightful relationship with oneself and others, a strong personal value system, and the fulfillment of a meaningful purpose to one's life (Kubler-Ross, 1981).

What are some examples of ethical dilemmas encountered among older adults? ›

Some of these parallel those among children, but issues occurring more often among older adults include self-neglect and financial abuse. Second, self-harm among older adults could involve severe self-neglect as well as suicide risk.

What is the difference between spirituality and religion? ›

Religion: This is a specific set of organised beliefs and practices, usually shared by a community or group. Spirituality: This is more of an individual practice, and has to do with having a sense of peace and purpose.

Is religion spirituality essential to the practice of health care? ›

For many patients, spirituality is important and influences key outcomes in illness, such as quality of life and medical care decisions.

What are 3 positive effects of religion? ›

The practice of religion is good for individuals, families, states, and the nation. It improves health, learning, economic well-being, self-control, self-esteem, and empathy.

How do you integrate religion and spirituality into clinical practice? ›

Integration and Involvement in a spiritual community. Ritualised practices and Restrictions.
  1. sources of Hope, meaning, comfort, strength, peace, love and connection.
  2. Organised religion.
  3. Personal spirituality and Practices.
  4. Effects on medical (psychiatric) care and End of life issues.
Jan 2, 2018

How do you integrate spirituality into counseling? ›

Integrating religious and spiritual themes into psychotherapy may range from asking the questions about a client's beliefs, values, and practices to making specific values based recommendations and recommendations for engaging in particular religious activities and practices such as meditation or prayer.

What are the 9 competencies for integrating spirituality into counseling? ›

  • Culture and worldview.
  • Counselor self-awareness.
  • Human and spiritual development.
  • Communication.
  • Assessment.
  • Diagnosis and treatment.
Jun 1, 2020

What is spiritual distress in older adults? ›

defined spiritual distress of the elderly as a disturbance in seven structures of the individual's spirituality: connection, religious belief and faith system, value system, meaning and purpose of life, self-transcendence, internal peace and coordination and internal power and energy.

What are the negative effects of spirituality? ›

Negative impacts of spirituality.

Some people may take advantage of emotionally vulnerable people while pretending to support their spirituality. If you're emotionally vulnerable, you can be more easily convinced to take part in unhealthy activities.


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