Die Würde im Alter erkennen, anerkennen, lebendig werden lassen – eine Aufgabe von Individuum, Gesellschaft und Kultur

This article presents a model for research and practice that expands on the biopsychosocial model to include the spiritual concerns of patients. Literature review and philosophical inquiry were used. The healing professions should serve the needs of patients as whole persons. Persons can be considered beings-in-relationship, and illness can be considered a disruption in biological relationships that in turn affects all the other relational aspects of a person. Spirituality concerns a person's relationship with transcendence. Therefore, genuinely holistic health care must address the totality of the patient's relational existence-physical, psychological, social, and spiritual. The literature suggests that many patients would like health professionals to attend to their spiritual needs, but health professionals must be morally cautious and eschew proselytizing in any form. Four general domains for measuring various aspects of spirituality are distinguished: religiosity, religious coping and support, spiritual well-being, and spiritual need. A framework for understanding the interactions between these domains is presented. Available instruments are reviewed and critiqued. An agenda for research in the spiritual aspects of illness and care at the end of life is proposed. Spiritual concerns are important to many patients, particularly at the end of life. Much work remains to be done in understanding the spiritual aspects of patient care and how to address spirituality in research and practice.

The effects of the physical-spatial-technical environment on aging well have been overlooked both conceptually and empirically. In the spirit of M. Powell Lawton's seminal work on aging and environment, this article attempts to rectify this situation by suggesting a new model of how older people interact with their environment. Goals of the paper include (a) integration of the essential elements of the ecology and aging literature, particularly in regard to Lawton's research, (b) development of connections between traditional theories of ecology of aging and life span developmental models of aging well, (c) acknowledgment of the pronounced historical and cohort-related changes affecting the interactions of older people with their environment, and (d) discussion of the implications of this analysis for concepts and theories of aging well. The model builds on a pair of concepts: environment as related to agency and belonging, founded in motivational psychology, and developmental science. After describing the model's key components, we discuss its heuristic potential in four propositions for future gerontological research and identify implications of the model for future empirical research.