Spiritual care for dying patients is an integral part of Japanese hospice care, irrespective of faith. However, overcoming feelings of meaninglessness and anxiety about death is impossible unless both patients and their caregivers are able to discern a meaning that transcends everyday life and death. In his faith development theory, James Fowler considers faith as a human universal, and development in faith to be a result of life crises. Faith for him is not just believing in God, but seeing " the ultimate environment, " which provides a comprehensive frame of meaning for our daily lives and relationships with others. We start from Fowler' s idea of " the ultimate environment," and discuss Fowler' s theological foundation based on H. Richard Niebuhr' s " interpersonal faith." We suggest that spirituality can be understood as faith in what transcends life and death. This may help hospice workers to overcome their own feelings of meaninglessness and fear of death.