Development of the GERO-6, a Quantifiable Assessment of Spiritual Concerns of Older Adults Living in Long-Term Care

OBJECTIVES: Caring for the religious and spiritual (R/S) needs of older adults in long-term care (LTC) is an important part of whole-person care. One of the primary roles of the chaplain is to complete a comprehensive assessment of older adults' R/S needs and resources. A model for spiritual assessment designed for older adults in LTC does not exist. The aim of this work was to develop and test the reliability of an evidence-based, quantifiable model for the assessment of R/S concerns in LTC. DESIGN: The GERO-6 was developed by a team of LTC chaplains. The team relied on the literature and their clinical expertise to identify and develop themes and descriptors of the central R/S concerns of older adults. Team members refined these themes and descriptors and the reliability of their ratings through the discussion of LTC case studies. SETTING AND PARTICIPANTS: Nine experienced LTC chaplains in the United States met online between 2024 and 2025. METHODS: There were 3 phases in the development of the GERO-6. The first 2 included a literature review and identifying the key R/S issues and related indicators of older adults living in LTC. The third phase focused on developing inter-rater reliability of chaplains' assessments of residents' R/S concerns. RESULTS: The key themes of the model include Identity, Legacy, Connection, Autonomy, Death/Dying, and R/S needs. At a workshop at a professional conference, the GERO-6 was introduced to 26 chaplains. They used the model to score a case study, and a high level of reliability was achieved. Using the GERO-6 allows chaplains to assess and quantify the R/S concerns of older adults in LTC. CONCLUSIONS AND IMPLICATIONS: Further research is needed to determine the reliability and validity of the GERO-6 and to assess the prevalence of unmet R/S concerns in older adults living in LTC.