Whole-Person End-of-Life Care / 身心社灵照护

Definition

Whole-person end-of-life care is a hospice and nursing model that addresses physical symptoms, psychological distress, social relationships and support, and spiritual or meaning-related needs as interacting parts of the patient’s and family’s experience.

Current Synthesis

The source expands 安宁疗护 beyond pain medication or treatment limitation. Physical care includes breathlessness, nutrition, elimination, hygiene, positioning, and comfort; psychological care includes fear, anxiety, embarrassment, sensory reassurance, and supported expression; social care includes family, friends, staff, pets, and care networks; spiritual care includes belief, ritual, meaning, unfinished wishes, and farewell. These domains do not form a universal checklist. Their value comes from asking what matters to this person, in this state, and helping family participate without assuming that every patient wants the same contact, setting, or ritual.

Key Claims

• Physical comfort remains active clinical and nursing work even when cure is no longer the leading aim.
• Psychological support can use conversation, music, movement, touch, familiar sensory cues, and calm presence when they fit the patient.
• Social support includes relationships, caregiver guidance, professional networks, familiar animals, and opportunities for farewell.
• Spiritual care can involve religion, ritual, meaning, hope, or unfinished wishes without assuming a particular faith.
• Family support is both a resource for the patient and a care need in its own right.
• Home or another familiar environment may support security and connection, but setting choice depends on symptoms, services, preference, and caregiver capacity.

Evidence

• Physical domain: VOL.44献礼护士节｜与协和医院护师对谈临终关怀中的“身、心、社、灵” connects nursing with pain, breathing, nutrition, elimination, hygiene, comfort, and dignity.
• Psychological and sensory domain: VOL.44献礼护士节｜与协和医院护师对谈临终关怀中的“身、心、社、灵” describes movement, music, touch, hearing, smell, memory, reassurance, and goodbye.
• Social and spiritual domain: VOL.44献礼护士节｜与协和医院护师对谈临终关怀中的“身、心、社、灵” uses family, friends, pets, social workers, familiar places, faith settings, and religious practices as individualized support examples.

Counterevidence & Qualifications

The source offers practice examples and a conceptual model, not comparative evidence that a particular sensory, movement, music, pet, religious, or home intervention benefits every patient. Consciousness, consent, culture, symptoms, infection control, safety, caregiver burden, service access, and personal preference determine what is appropriate. Whole-person language should not conceal inadequate medical symptom control or shift professional responsibilities onto families.

What Changed

• Established a four-domain end-of-life model with explicit nursing and family roles.
• Added setting, consent, culture, service access, and caregiver capacity as limits on individualized support.

Related Concepts

• 安宁疗护 / Hospice Care - broader end-of-life care framework that this model makes operational and relational.
• Subject-Led Care - person-centered principle for selecting meaningful support rather than applying a fixed checklist.
• Family Ethics At End Of Life - family participation and burden boundary within whole-person care.
• Public Illness Writing - public language that can make bodily decline, fear, and dignity discussable.
• Death Normalization Practice / 死亡日常化练习 - preparation and farewell practices that connect end-of-life care to ordinary relationships.