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How to Assist a Person During Their Time of Death-Hospice Care and Other Cultural Practices

Updated on July 19, 2012

Discovering Serenity in Surrendering to Death

Peace at the time of death is strived for.
Peace at the time of death is strived for. | Source

Ways to support the dying

On April 1st, 2011, I received news that one of my friends from my spiritual group died. While he was being treated for cancer, several members of the group formed a committee for death and dying, led by one of our teachers. As my friend’s time of transition grew closer a tight community of support was formed.

During our March retreat we received word that our friend and his wife would not be making the trip, but arrangements were made to have them join us through skyping. His condition had deteriorated. We supported him across the distance and in our hearts. For some of us it would be our last live encounter with him.

The support committee attended to both him and his wife with prayers, company, food, and any other tasks that was needed. In the days that followed the retreat many of the group members attended prayer groups in their home. As I attended to my meditation, holding my friend, his wife, and the group in my awareness, I contemplated how different his experience was from so many people in our country.

There is a vast difference between being ‘prepared’ for death and being in denial of it. With the first, you are making choices, including gathering a support group to aid in the transition, resulting in peace, love and calm. In the final process of transitioning between life and death we know we are not alone.

In the second, where denial and resistance prevail, our fears override the peace that arrives when surrender to the inevitable occurs. In the United States people do not like to talk about death, although it is the natural end of our life cycle. There is much fear and taboo in discussing death.

What is Hospice care?

Hospice, which offers care for the terminally ill, has been practiced as early as the 11th century during the Crusades, but no formal hospice house was established until 1967, when Dame Cicely Saunders, and English born woman who held professions first as a nurse, then as a medical social worker, and finally as a physician and writer, established St. Christopher’s Hospice. It was the first hospice home built with the intention to serve the terminally ill and it was based on the holistic model which is still implemented today. The holistic model incorporates care for the physical, emotional, psychological and spiritual needs of the patient.

It was not until 1974, however, before the first American Hospice facility would be established in Connecticut as Connecticut Hospice. In the meantime, Dr. Elisabeth, Kubler-Ross, a Swiss born psychiatrist, who had moved to the United States to continue her studies, was bringing the topic of death into the public awareness, advocating for the terminally ill to have as pain free a death as possible and changing the techniques of doctors delivering this news to their patients.

In her book, On Death and Dying, Dr. Kubler-Ross explained that there was a similar pattern that occurred in all patients who were given the prognosis of a terminal illness. These stages, now known as the Five Stages of Grief, are denial, anger, bargaining, depression and acceptance. Ideally a patient reaches acceptance before his death.

As a former hospice nurse, I always maintained that my position was one of privilege. It was a privilege to be fully present for the dying individual, holding her in my thoughts, my heart and in the light of love. Keeping a calm presence at the bedside can make the difference between relaxed last moments, or creating a concern that ‘something is wrong’, resulting in increased restlessness. If we are open to discussing the patient’s beliefs, including his fears, we are given the opportunity to make his journey out of this earthly world more comforting for him.

All religions offer support to the dying.

All religions have a practice that honors the dying and deceased.
All religions have a practice that honors the dying and deceased. | Source

Cultural and Religious Practices about Death

Although we are all going to die alone, it is not death itself, but the fear of the unknown, that causes much anxiety in the terminally ill, especially in the last days of their lives. In my own experience, I’ve been more curious about ‘what is next’, rather than afraid, and my spiritual practice supports investigating this mystery.

So, I wondered how other cultures and religions viewed death. I am most familiar with the Christian practices and belief in an afterlife-a heaven and hell, a redemption and resurrection for those who are worthy of sitting in God’s presence, and the ritual of a burial or cremation. As I researched this subject I was amazed at how religions had similar themes and practices.

Several religions conceptualize an afterlife with a God in a ‘heaven’ of some sort, if they live good lives. These include: Christianity, Judaism, and Islamic religions. Several more religions believe that there is a reincarnation process, returning to life before final enlightenment. These religions include: Buddhism, Hinduism, and Sikhism.

There was also a similarity of the process of the transition between the earthly realm and the afterlife, which the soul had to travel, and which caused trepidation for those left behind that the soul would lose her way navigating the unknown territory. Therefore a ‘guide’ was developed and used by the individuals at the bedside of the dying.

Guides to help in the transition toward death

Prayer, Scripture, Mantra, Chants-all are part of the support at the time of death.
Prayer, Scripture, Mantra, Chants-all are part of the support at the time of death. | Source

Historical references of death and religious writings

One of the earliest cultures, in which this information was discovered, was the Ancient Egyptians who wrote a series of books. The oldest one is the Pyramid Texts that guided the soul, or ‘akh’ to the ‘Hall of Judgment’. There, the heart would be weighed against a feather. If it was lighter than the feather it was allowed to move into the afterlife.

Tibetans view death as an opportunity for spiritual growth. Following their own guide: The Tibetan Book of the Dead , a spiritual lama may whisper instructions in the person’s ear to guide the deceased through the ‘Bardo’-that place between the human form and the next place.

Sacred scriptures and Vedic guidance describing the reason for death’s existence, and the destinations of the soul after it leaves the body, are also part of the practices of the Hindu culture. Cremation releases the soul from its earthly existence. The ashes are then thrown into a river, preferably the Ganges.

Part of the Christian burial prayers also refers to the concept of the body disintegrating into ashes: ‘ashes to ashes, dust to dust’. It also has sacred scriptures that are read from the bible as part of a ceremony or ritual to pray for the ‘souls of the departed’.

Meet death before it meets you

If there is anything that I would wish for the reader to understand, more than the historical aspects or similarities between various religious groups, it is the wish for the exploration of their own beliefs about death.

Comparison of how major religions view death

After Life Belief 
Book or 'Guide' 
Soul / Heaven / God
Bible / Scripture / Prayer
Soul / Heaven / God
Torah / Scripture / Prayer 
Soul / Paradise / Allah 
Koran / Prayer 
Soul / Reincarnation
The Tibetan Book of the Dead
Soul / Reincarnation
The Vedic Guide / Scripture


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    • Denise Handlon profile imageAUTHOR

      Denise Handlon 

      5 years ago from North Carolina

      Hi Linda, you are welcome-I believe so strongly in Hospice care, I could become a marketing agent for them!

      Hello ChitrangaSharan, Yes, I am aware of the importance of a peaceful transition to the other world. There are many beautiful prayers and rituals in many religions, including Hinduism. My deep respect for this ancient culture and religion. We can learn much from its wisdom. Thank you for your votes :)

    • ChitrangadaSharan profile image

      Chitrangada Sharan 

      5 years ago from New Delhi, India

      This is a wonderfully written hub on a unique topic.

      It is very important that the dying person should be peaceful in mind and at heart. That person should be calmed down by the relatives, so that there is no anxiety or fear about the this World or 'that World.'

      In Hinduism also recitation of spiritual or religious epics is done to calm down the dying person so that the death becomes peaceful.

      Voted up as awesome and thanks for sharing!

    • Sunshine625 profile image

      Linda Bilyeu 

      5 years ago from Orlando, FL

      Hospice was good to my mother during her final days and moments...also in my cancer support group, hospice has helped many of the family members, my best friends mom is now in hospice care. I know one day I'll need to call hospice for my husband...I never imagined that hospice would become part of every day conversation for me and I'm not in the medical field! Not too long ago I Googled a hospice center and OMG the ads were popping up on every site I went to for over a month, I know I totally went off track with my last comment :) Anyway thank you soooo much for publishing this informative article. Much appreciated!

    • Denise Handlon profile imageAUTHOR

      Denise Handlon 

      8 years ago from North Carolina

      ChatKath-forgive the lack of response to your comment prior to this...not sure how I hit the 'approve' button w/o following it up with a comment from me. Thank you for taking the time to read and share about your experiences with the deaths of your mother and grandmother. It isn't easy to be available to a loved one at the time of their death, yet it is a sacred privelage. My heart goes out to you and I hope that you are moving on.

      Hi Jean-thank you for reading this hub. It is a topic dear to my heart. I can only imagine the experience that has left such an impact on you when your dad died. I agree that the Celebration of Life is a beautiful experience and many people are opting for Memorial services.

    • Jean Bakula profile image

      Jean Bakula 

      8 years ago from New Jersey


      Thank you for tackling a very complex subject. Many people still won't speak of death. I find things different and like the idea of being in a hospice, having time for the person and their loved ones to face the inevitable in a calmer fashion. Many are opting to have Celebration of Life ceremonies, as far as a month or a year after the death. That way, everyone can find pictures and tell stories about the loved one that passed on, but later, when they are not grief stricken. I have nighmares about my Dad lying in an open coffin when I am upset, and he died 27 years ago. It was awful, my Mom wouldn't bury him. I want to be cremated, since the spirit which is me will be gone. I don't want my loved ones feeling sad at my grave. I know they will be sad, but the whole system of staring at a dead body for days, and throwing dirt on a coffin over a whole in the ground seems almost cruel. I am glad customs are changing.

    • Chatkath profile image


      9 years ago from California

      Denise this was a fabulous Hub, I was with both my Grandmas and my Mother during their death and Hospice was so incredible. Especially with my Mom, I needed a bit more support, trying to make sense of everything and they were always there for me and my siblings! Thank you for dealing with a difficult topic in a very positive and healing way!

    • Denise Handlon profile imageAUTHOR

      Denise Handlon 

      9 years ago from North Carolina

      Hi Genna-I'm sorry for your loss. I actually finished the hub and realized the next morning that, although I gave a lot of information, I didn't really offer the suggesetions that relate to the hub title. But, rather than change it (it is long) I decided to allow it to just be. There is a reason for everything. So, I'm glad that you found it helpful.

    • Genna East profile image

      Genna East 

      9 years ago from Massachusetts, USA

      Having recently lost someone I loved dearly, this hub meant a lot to me. I have dealt with such a loss before, but there is always more we can learn in both dealing with this tragedy and in helping those who pass beyond our world into the next. Thank you.

    • Denise Handlon profile imageAUTHOR

      Denise Handlon 

      9 years ago from North Carolina

      Thanks Simone, I have great respect for hospice and all of the caregivers who are involved in hospice care. Thanks for your comments.

    • Simone Smith profile image

      Simone Haruko Smith 

      9 years ago from San Francisco

      Great guide. My family just lost two very loved people and Hospice was right there with us. I'm glad you wrote this Hub!

    • Denise Handlon profile imageAUTHOR

      Denise Handlon 

      9 years ago from North Carolina

      Kathi-I know you and I have talked about how similar our situations have been. I can't encourage people to use hospice more. I'm a huge advocate for spreading the word. Thanks for reading and commenting.

      Danette-great comment. Didn't think about those 'area influences' from one place to the other, but it makes sense. Thanks for the positive feedback.

      2 down, only 28 more to go...LOL

    • Denise Handlon profile imageAUTHOR

      Denise Handlon 

      9 years ago from North Carolina

      Fay-thanks for reading. Death is a subject we can all wonder about and know we will all face. My spiritual work, including my meditation practice, allows me to explore this now, before it happens, and face what fears I may have. One does not need a religion to explore the fears of death, just quiet, uninterrupted moments. Feel free to contact me if you would like to discuss this further. Thanks for your comments.

      Cara-thanks for the read and comment, esp acknowledging the table. Thanks for the tips on using the Table. :)

      Sue-I understand your situation. I was with my mother until 6 a.m. the morning she died. I left, on her urging, to go home and fill the Christmas stockings for my dad and nephew. 8 a.m. we got a call she had died. I felt guilty for leaving her side for a very long time. Take care and thanks for the comment.

    • Danette Watt profile image

      Danette Watt 

      9 years ago from Illinois

      Excellent hub. A friend's husband has been battling cancer for about 8 years and went into hospice several days ago.

      I'm not surprised that Christianity, Judaism and Islam all share a heaven/hell concept of an afterlife, since they all come from the same area of the world and Judeo/Christian/Islamic ideas (one only has to compare their holy books to see all they share). Just as I'm not surprised that Buddhism and Hinduism share beliefs of reincarnation.

      I voted this up and awesome - I believe this was a very well written hub, written from the heart. I also appreciated the chart that put it all in a nifty table for us to quickly compare the various religions and their beliefs.

    • Fossillady profile image


      9 years ago from Saugatuck Michigan

      My husband passed away a little over a year ago and Hospice was here to guide us and keep my husband as comfortable as possible. It has been the most life changing experience of my life and I have been preoccupied with the subject of the after life ever since. God provides us the answers when we ask. Thank you for writing about this subject, very useful Denise

    • Sweetsusieg profile image


      9 years ago from Michigan

      Being with someone during their transition is one of the kindest yet most difficult thing anyone could ever do. I was with my mother as much as I could be during her months of chemo and her eventual passing. I had went away for a few days prior to her passing and didn't realize how much she was going to deteriorate in those few days. I didn't get to see her before it was over. I do regret that part, but not what came afterward. I was allowed to help prepare her for the funeral home, which helped me deal with her death.

      Thanks for sharing this.

    • cardelean profile image


      9 years ago from Michigan

      A great hub on the transition to death. Support for the dying and family is always very important. Great pics and table summarizing the religions and their beliefs.

    • fayx24 profile image


      9 years ago from Australia

      A great read, Denise! I can relate to this as my mother just recently passed away and had home carers who came in to assist on a daily basis - they were superb! So calm and yet caring. It definitely IS the fear of the unknown. I am not religious but have always been terrified of death, as I do not know what will happen. I am still worried that my mother is really at peace now.


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