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.