Whole Person Care:
A Framework for Spiritual Assessment in Practice
4 MINUTE READ
From Luke’s Journal March 2026 | Vol. 31 No. 1 | God at the Bedside
Whole person care recognises the interconnected physical, emotional, and spiritual dimensions of patient wellbeing.
When aligned with culturally safe principles, this approach acknowledges the social, economic, cultural, historical, and behavioural factors that shape health across individuals, communities, and populations. It is characterised by deep respect for diverse cultures, beliefs, gender identities, sexualities, and experiences—encompassing patients, families, colleagues, and team members alike¹.
This article introduces a practical framework for exploring spiritual care with sensitivity, respect, and appropriate permission, particularly with older patients.
A Case Study: Mr CL
Consider Mr CL, a 73-year-old long-standing patient who arrives at your practice visibly distressed. He reports that a close relative is showing increasing signs of dementia.
Taking a Whole Person Approach
Embracing whole person care, attend to the interplay of physical, emotional, and spiritual concerns. Begin with a standard history, allowing CL adequate time to express his worries. Address immediate physical needs: reviewing medications for hypertension and osteoarthritis, and confirming his vaccinations are current.
CL appears unusually unsettled when discussing his relative. This could prompt further exploration through a social history:
- What support systems does the relative have?
- Is there a partner who can offer assistance?
- Are friends or family available to discuss these distressing changes?
- What community groups might provide support?
- Does the relative belong to a faith community?
The FICA Approach
Seeking permission to delve deeper, employ the FICA framework²:
- F – Faith: Do you have a faith?
- I – Importance: Is it important to you?
- C – Community: Do you belong to a faith community?
- A – Address: May I address these issues in your ongoing care?
At this point, CL discloses that he has actually been describing his own health concerns, not those of a relative.
Explain the diagnostic process ahead—various tests to clarify what’s happening and determine how best to help. Schedule a follow-up appointment for this purpose.
Addressing Emotional Distress with HOPE
Yet CL remains emotionally upset, and you’re concerned about his immediate well-being. Here, you might turn to the HOPE framework³.
The HOPE model offers four domains of inquiry:
H – Sources of Hope: Explore what provides meaning, comfort, strength, peace, love and connection. This open-ended approach works across the spiritual spectrum—accommodating patients who don’t identify as religious or spiritual, those from minority faith traditions, and those wounded by religious experiences.
O – Organised Religion: Depending on the initial conversation, you may explore the patient’s relationship with organised religion.
P – Personal Practices: Inquire about the spiritual practices most meaningful to them.
E – Effects: Finally, consider how spiritual beliefs and needs influence medical care decisions and end-of-life planning.
Ask CL: “What gives you hope?”
Building Understanding
Through this conversation, you will begin to understand what matters most to CL.
You’ve started working through multiple dimensions – physical, emotional, and spiritual. While this is just the beginning, you’re establishing a shared understanding of how CL’s spiritual journey intersects with his emotional and physical challenges.
Many steps lie ahead, but this conversation has been initiated with sensitivity, respect, and permission – the essential foundations of whole-person care. You can learn more of these skills and have a chance to practice them through Saline Process Witness Training at IHS Global.
Dr Michael Burke
Dr Michael Burke is a much-blessed member of the Christian Medical and Dental Fellowship of Australia (CMDFA). He facilitates the International Christian Medical and Dental Association (ICMDA) Creation Care and Health Training Track. He currently works at the Kilimanjaro Christian Medical Centre in Tanzania, East Africa, contributing in the areas of Family Medicine and Geriatrics. He is married to Jean and has three sons. Michael enjoys being a Saline Process trainer.
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References:
- Medical Board of Australia, Good medical practice: a code of conduct for doctors in Australia (October 2020)
- Henry NL, Gilley N. Spiritual Assessment. [Updated 2024 Jan 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK599554/
- Sleeth G, Gottlieb P, Srinivasan A, Thaddeus U, Mennillo M, Anandarajah G. Evaluation of the HOPE spiritual assessment model: a scoping review of international interest, applications and studies over 20+ years. BMC Palliat Care. 2025 Jul 7;24(1):191. doi: 10.1186/s12904-025-01809-z. PMID: 40624539; PMCID: PMC12236049.
