Abstract
BACKGROUND: Spiritual well-being enhances older persons' health status. Factors that optimize their spiritual well-being are not well-established. OBJECTIVE: To describe spiritual needs attainment and identify factors associated with such attainment among community-dwelling older persons. DESIGN: Cross-sectional. SETTING: Sixty-five U.S. continuing care retirement communities or independent housing facilities. SUBJECTS: 4077 persons entering the facilities between January 1, 2007 and November 30, 2016. METHODS: Standardized Community Health Assessment and Wellness Survey instruments were used to determine the proportion of subjects reporting their spiritual needs were met. Multivariate logistic regression identified characteristics independently associated with this outcome. RESULTS: Among the 4077 subjects (mean age 81.6 ± 7.5; male, 28.8%; and White race, 70.7%), 93.4% stated their spiritual needs were met. Factors independently associated with a greater likelihood of spiritual needs attainment were: satisfaction with life (adjusted odds ratio (AOR) 2.81, 95% confidence interval (CI) 2.00, 3.96; p < 0.001), feeling valued (AOR 2.51, 95% CI 1.61, 3.92; p < 0.001), strong and supportive family relationship (AOR 1.99, 95% CI 1.20, 3.29; p = 0.008), sufficient sleep (AOR 1.59, 95% CI 1.15, 2.19; p = 0.005), no pain (AOR 1.35, 95% CI 1.01, 1.82; p = 0.046), and having someone to talk to about death among those interested in doing so (AOR 0.39, 95% CI 0.29, 0.54; p < 0.001). CONCLUSIONS: The majority of community-dwelling older persons reported their spiritual needs were met. Adequate sleep, pain relief, and having a person with whom to discuss death are potentially modifiable factors that may promote spiritual needs attainment in this population, which in turn, may improve their health outcomes.