How to Assist a Person During Their Time of Death-Hospice Care and Other Cultural Practices
Discovering Serenity in Surrendering to Death
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.
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
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