The concept of spirituality is a complex concept but it is a concept used in different disciplines and is defined as a sense of personal connection that allows one to search for meaning in life and in different situations the means by which the human being seeks to find peace harmony and transcendence. The elder is a human being whose advancement of age places him in situations that challenge his stability and perception of well-being so he makes use of spirituality and religiosity to find a sense of life. The objective of this work is to reflect on spirituality as nursing care for the elderly, through the review of literature and the critical opinion of the authors. It is necessary to distinguish between religiosity and spirituality the religiosity involves the practice of a creed with specific rites this is connected with the sacred; the spirituality is the understanding of the human being before his sense of life so they can exist independently. The human being in aging requires resilience to his dramatic changes these physical emotional and social changes. Self-care is essential in the elderly and care that can be promoted by the nurse. Nursing is the discipline of care and it conceives the human being as a being with multiple human responses it can intervene in a therapeutic relationship that allows to provide a spiritual care to promote the value of life, meaning and a sense of transcendence.

Keywords: Aging; Spirituality; Religiosity; Spiritual care; Nursing

Aging is a process of decline in all areas of the human being it also entails physical changes notorious over time, a series of mechanisms of adaptation to the various emotional and social crises that challenge the personal value of the elderly.

As the age progresses there is a deep connection with spirituality and religiosity perhaps due to the maturity reached by the lived experiences, or by a sense of connection with the corporal finitude that makes necessary the connection with the beliefs and values ​​more intimate Aging affects the perception of well-being, and therefore seeks strategies that allow it to have resilient mechanisms, so spirituality is a strategy that can favor personal well-being and can be manifested in different ways, depending on the concepts of the person, based on their relationship with the world and life. The objective of this work is to reflect on spirituality as nursing care for the elderly, through the review of literature and the critical opinion of the authors.

The spirituality is part of the human being it is an inherent phenomenon of its essence and is a way of understanding the situations around it The person gives it a meaning and that meaning guides it to personal maturity. The spirituality is a complex concept and is related to a universal meaning of life by which purposes are retaken and achieved that revalue that meaning and determine the self-concept of the human being.

The spirituality is an internal resource to the human being and is increased as life goes on^1-3 it is for this reason that it is considered a resource of human beings through which they connect with their inner being, nature art and human being manages to potentialize his positive life purpose.¹

The well-being and health are considered from the perception of older people about their health not only physical, but also psychic, from medical-psychological criteria that encompass lifestyle the balance and coping of their personality their well-being, and with the way they live the fulfillment of certain norms that society requires to achieve order and social control, respect for one's own and others' dignity and existing moral norms.

As the personality is more stable, the affective life is more satisfactory and the quality of life has a perception of greater well-being, and one aspect of the quality of life is spirituality this indicates that the psychic health could be educated and the correct coping of situations of adversity before reaching old age, the elderly present various changes that challenge their autonomy and their value, the elderly can perceive a better quality of life if they improve their spiritual satisfaction.⁴

A series of researches have appeared in the world of science on the effects of religion, religiosity and spirituality on the lives of human beings, being found to be protective factors that alleviate and mitigate suffering, to overcome the adversity to reach a higher degree of well-being a higher quality of life greater capacity for transcendence and a sense of fullness and self-realization.⁵

It should be remembered that for decades in science it was avoided to investigate the variables linked to religion and spirituality as non-scientific. The religion refers to a series of practices and norms according to the beliefs, but the substrate to all of them is spirituality understanding it as precisely that which nurtures religion and gives it meaning, that is, faith in God.

The spirituality is related to transcendence this as a form of understanding of reality and a connection with the consciousness to reach a state of personal enlightenment.⁶ This transcendence allows the person to expand it personal limits and orientate it towards activities and goals beyond itself without denying the value of being in the present context and favoring its own maturation.²

Several studies suggest that the exercise of spiritual activities can influence through positive emotions such as hope, forgiveness, self-esteem and love which may be important for mental health through psycho neuro immunological and psycho physiological mechanisms of action.³

The spirituality also has an important influence on longevity confrontation with death and life satisfaction there is deep faith in older adults and practice of religiosity that gives them a sense of belonging and vital satisfaction; the elderly have less fear of death and have support in the disease.⁵

In some investigations it is determined that religion is an important dimension in the lives of the elderly. People with religious beliefs and practices are better able to cope with stressful situations that lead to aging, enjoy better physical and mental health, and live longer than non-practitioners.⁷ The disease and the threat of death generate a crisis about the meaning of life, determining questions about spiritual and religious beliefs. It is what is known as "spiritual stress" characterized by situations of crisis and conflict by the search for the meaning of pain, suffering, loss and death (indicators of spiritual stress).

The elderly with all their crisis of aging requires a care approach that allows them to contemplate themselves and to be clear about their goals and purposes of life as well as to deepen the meaning it has for them. For these reasons, it is necessary to take care of the promotion of spirituality from the perspective of the elderly that is considering both spirituality and religiousness in the life process.

Nursing interventions are multidimensional; they address the physical states of older adults in diverse contexts and health situations. It is also possible to provide interventions oriented to spirituality because they favor the affection trust and security. It is demonstrated that contact touching the hand and welcoming the other with positive feelings provide support and confidence to the patient and helps him or her to better face the disease crisis, in the case of the elderly crises that may affect their perception of well-being .⁸

Nursing cares the person as a total being or a holistic being, not just as a set of parts or processes. To speak of the totality of the being and the care of the person from this perspective promotes integrality. We live a cultural present in which words like affection, tenderness, love and spirituality appear from different perspectives and approaches that lead to a reflection of the daily being and routine of nursing. Spiritual suffering is one of the nursing diagnoses established by the NANDA in Domain 10 that addresses the vital principles mentioned several more diagnoses that refer to spirituality if therefore are nursing diagnoses then they are recognized as human responses of a spiritual nature necessary to attend through the care of the nurse.⁹

For nursing to attend to spiritual needs as they are an essential part of care¹⁰ it is feasible because being a nursing intervention can be explored in hospitalized older adults their spiritual perspective to be able to focus on nursing care in addition it is feasible because has access to hospitalized older adults and requires nursing care of them in this need.

Nursing care that seeks to respond to spiritual needs would be a spiritual care provided by the nurse being a relationship between the nurse and the elderly that allow them to understand the world to be present at all times with healing and healing actions favor the personal self, the sense of intuition and the exploration of personal actions that allow the elderly to find peace in their own concept of spirituality.¹¹ It is necessary for nurses to provide the elderly with the resources to meet their spiritual demands as they consider it and that can range from small manifestations of help to great moments of meditation. In this way actions that involve values such as being kind caring educated taking care of the integrity of the people when nursing techniques are carried out the ability to listen actively the ability to respond to people's questions regarding care and health status, are only some small manifestations of the spirituality perceived by the patients.¹²

It is necessary to provide this spiritual care, sometimes it is not provided due to the workload, the number of patients and the lack of training of the nursing professional to provide it¹² however an approach is necessary that allows the nurses understand that any time of contact with the elderly is a moment of care and is a transpersonal relationship. When nurses allow themselves to get to know their patients, they allow them to create a connection that makes care a moment of real health help.

Caring is the essential action of nursing to protect improve and preserve humanity. Care supports the person during the understanding of their illness, suffering and pain; care helps people to gain self-control self-knowledge and self-care.

The human being has multiple human responses these human responses not only focus on the physical, but involve social affective emotional and spiritual situations. The elderly are affected by various crises that challenge their perception of well-being a relevant aspect to address these crises is the spirituality. The spirituality is a phenomenon that increases when the age of people advances and can be confused with the religiosity. The religiosity involves the practices of a particular creed, while spirituality seeks a meaning to life. The spirituality can be favored by nursing care and this sense of life can be enhanced through various interventions between nurses and the elderly.

None.

The authors declare no conflict of interest.

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