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Choosing a dignified death

— Stratford woman shares medical assistance in dying journey

Stratford resident and journalist Diane Sims, who is living with end-stage multiple sclerosis, recently received approval for medical assistance in dying (MAiD). She spoke with the Beacon Herald about that process and why she is choosing to end her life.

Approved for medical assistance in dying last year, Stratford’s Diane Sims recently spoke with the Beacon Herald about her journey and her choice to die with dignity.

By Galen Simmons

In making the decision on how and when she will die, Diane Sims is also choosing how she will live the rest of her life.Last year, the Stratford journalist and writer, who was diagnosed with multiple sclerosis in 1975 when she was just 17 and declared palliative two years ago, qualified and was approved for medical assistance in dying (MAiD).

“I never want to end up in a nursing home, especially after what we saw coming out of COVID,” Sims told the Beacon Herald in a recent interview. “My whole experience with nursing homes is they’re just places where you’re waiting for God. It was the lack of independence and privacy, and I worried about care because my care needs are high. I never wanted that.“And I’m a communicator, so when my hands stop working completely and my voice stops working, I don’t feel I have myself left anymore. MAiD is such a dignified way to go,MAiD and there’s no purchase in people giving me lectures about God because the divine and I are at peace with this.”

A nuanced decision

In Canada, qualifying and being approved for medical assistance in dying is a strictly regulated, yet nuanced, process. Dr. Stefanie Green, a MAiD practitioner and founding president of the Canadian Association of MAiD Assessors and Providers, said there are five criteria a patient must meet to qualify as eligible.

The patient must be 18 years of age or older and eligible for government-funded health care in Canada. The patient also needs to make a voluntary, written request free of any kind of coercion. The patient must have the capacity to make that decision, which means they understand what’s wrong with them, as well as their pros and cons of their treatment options. Finally, the patient must understand that an assisted death is irreversible.

Finally, the patient needs to have what Canadian law refers to as a grievous and irremediable condition.

“A grievous and irremediable condition is a term that is defined in the Criminal Code of Canada,” Green said. “It is the only medical practice I’m aware of that’s defined in the Criminal Code … so we know exactly what the law says about it. … It means there are three things that need to be true all at the same time. … The patient needs to have a serious, incurable illness, disease or disability. The patient needs to be in an advanced state of decline and capability. Capability really means function, so they’re no longer functioning the way they were before they had their serious and incurable illness, disease or disability.

“The third and final thing that needs to be true is that the patient has intolerable and unendurable suffering that cannot be relieved in any way they find acceptable, and that is a subjective criteria that the patient really gets to decide. It’s not for me to decide how much someone is suffering or how much they can endure.”

Once a patient meets those criteria as determined by two independent clinician assessors, there are two paths their MAiD journey can follow, Green said. The first is more straightforward. If doctors determine the patient’s natural death is reasonably foreseeable, meaning the patient is on a trajectory toward death based on their illness, disease or disability, and not that they will die within a specific time period, they are put on track one.

“The procedural safeguards (for track one patients) are some of the things I already mentioned,” Green said. “There needs to be a written request. It needs to be signed and dated. It needs to be witnessed. The patient needs to give consent at the time of their request and also immediately prior to administration of medications.

“A track two patient,” Green added, “is someone whose natural death is not reasonably foreseeable. Typically, they’re people with chronic pain syndromes that are less understood and more complex, or a patient who a clinician is just not comfortable saying their death is reasonably foreseeable. Track two patients have to meet all the track one eligibility requirements and procedural safeguards … and they have five extra procedural safeguards on top of that, (including) there has to be the input of someone with expertise in the condition that’s causing the patient’s suffering … (and) patients need to be made aware of all the reasonable and available means to reduce their suffering. … They need to be offered those means of reducing their suffering and they need to give serious consideration to accepting those means of reducing their suffering.”

A considered decision

Sims said she and her husband spent the year between her prognosis as palliative and her decision to apply for MAiD considering these alternatives and evaluating her quality of life.

While she was still getting some enjoyment out of life, her disease has confined her to an electric wheelchair and severely restricted the food she can eat. In recent years, she’s endured numerous hospitalizations and invasive surgeries, required round-the-clock care, and has suffered chronic pain, declining speech, jerky arms, spastic legs, shaky hands, a compressed lung and a dying colon.

Though she still finds enjoyment when she writes and paints, Sims knows there will soon be a time when that enjoyment will only be a memory.

“I know what’s coming and yet I look around at all this colour and I think, ‘How am I going to leave all this colour and close my eyes for the last time,’” she said. “I’m not there yet because I’m still working. I can’t keyboard very well anymore – my hands are really going – so that worries me. I notice it day by day almost.

“It is scary.”

Not everyone in her life understands or is willing to confront Sims’ decision. In a piece she wrote for Maclean’s magazine at the end of June, ‘How I Plan to Die’, Sims said her husband, Dennis, was initially horrified by the notion his wife was considering ending her life.

“Dennis was absolutely against it. I remember being outside on the terrace last summer telling him that’s what I wanted to do, and I knew his reaction because I’d known what it would be all along. He hated the idea. He felt it was a cop out. He felt it was suicide,” Sims said.

That summer, Sims and Dennis worked their way through a bucket list of day trips close to home before travel became too burdensome and painful for her. After seeing his wife struggle with pain and discomfort on those trips, Dennis finally accepted his wife’s decision.

“All of the sudden in the car he said, ‘I understand.’ I was sort of shocked into silence and had to ask him to repeat what he meant. He said, ‘I understand why you want to do it now,’ so now he understands and is supportive. All my friends have been supportive. I’ve had some family members … tell me that it’s basically suicide and I should wait for God’s timing to take me, and I’ve said, ‘You want me to suffer?’  … It’s not just the communication. It’s when the pain reaches a certain point where I won’t want to carry on with it anymore.”

A conversation with the patient

Ultimately, control over when, where and how she dies remains firmly in Sims’ hands. When she reaches the point where she knows she simply can’t carry on, she will call her MAiD practitioner and they will be ready to carry out the final stage of her journey within 48 hours. Even on the day of her planned death, Sims has the right to back out of the process until that point of no return when the medications are administered.

According to Green, a patient and their practitioner have that conversation about how the medically assisted death will be carried out as soon as it is approved.

“It’s a conversation with the patient about what’s meaningful to you. What would be a meaningful event for you? Who do you want there? The word that we tend to use … is choreograph. We choreograph their event,” Green said. “Do they want music? Do they want people there? Do they not want any of those things? Do they want a spiritual guide? Do they want prayer? Basically, anything we can accommodate, we will. Any sort of ceremony or ritual that they wish, we can do.”

For Sims, she will be surrounded by her friends when she decides to go.

“And they’ll be there to support (my husband) Dennis. … I plan to have friends and bubbly and music – all the things that I love,” Sims said. “You have to explore your soul and be at peace with yourself first (before considering MAiD). You can’t put too much purchase in what other people say because those that love you and understand what you’re going through should support you. … Don’t be afraid of the process. … You’re in the driver’s seat. Nobody is pushing you as to the time. It’s totally up to you.

“You are making the choice and it’s your last act of independence.”

According to the most recent data published by Statistics Canada, there were 12,689 written requests for MAiD in 2021,  a 31 per cent jump from 2020. These requests resulted in 10,029 medically assisted deaths in Canada in 2021, an increase of 34.7 per cent from the year before. MAiD accounted for 3.3 per cent of all deaths in Canada in 2021, up from 2.4 per cent of all reported deaths in the previous year. In 2021, slightly more than half of those receiving MAiD were men, and the small percentage difference between men and women had not changed significantly since 2020.

Complete Article ↪HERE↩!

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Does Someone Know When They’re About To Die?

By Jennifer Anandanayagam

Death is an uncomfortable topic for most of us but it is also one of the few universal experiences everyone will have. Scientists and doctors have long been investigating what happens to someone as they slowly slip away from this world, and while we don’t have all the answers, there are a few physical and behavioral changes you might be able to observe in someone who’s dying.

The person’s level of activity and movements might decrease significantly, noted the Hospice Foundation of America. They might spend most of their time sleeping. You might also observe that they’ve detached from what’s going on around them — interests, conversations, etc. They may also experience a loss of appetite and mental confusion. Physically speaking, someone who’s dying will experience a slowing down of their breathing and a drop in their blood pressure, per Everyday Health. “The fingers may get cold or turn blue. If you feel the pulse, it will be weak, then they start to develop an irregular type of breathing, and that’s a sign that things are pretty ominous,” added the medical director of the Hebrew Home at Riverdale in New York, Dr. Zachary Palace. A person in the last stages of life may also lose control of their bodily functions like urinating and defecating.

While these are the changes you’ll see in someone who’s close to death, what about them? Do they know they’re dying? According to certified hospice nurse Penny Smith, who goes by the name Hospice Nurse Penny on YouTube, they do, mainly because of what most people say before they die.

Dying people talk of having to ‘go away’

Penny Smith, who’spassionate about end-of-life advocacy and normalization of death, thinks that people who are close to death sometimes tell us that their time on earth has come to an end. “They might say, in no uncertain terms, ‘I’m dying soon,’ but often they tell us in metaphors,” she added.

They might say things like, “‘I need to pack my things,’ ‘I’m getting ready to leave,’ ‘I’m going on a trip,’ ‘I want to go home,’ or even just, ‘I’m tired,'” shared Smith. For the loved ones who are watching the process, it’s a matter of leaning into and listening to what they’re saying. By following their cues, you’ll really have the chance to say goodbye and express your feelings before they no longer understand, explained the hospice nurse.

People on their deathbeds are often concerned with mending relationships, navigating regrets, and spending time with loved ones. In fact, according to Fellow of the American Academy of Hospice and Palliative Medicine, palliative care physician, and author, Dr. Ira Byock, the words, “Please forgive me,” “I forgive you,” “Thank you,” and “I love you,” become even more meaningful when death is near. As a loved one who’s close to someone nearing their end, facilitating these important conversations could be the biggest gift you can give them.

Someone near death may feel peace

According to a 2014 study published in Resuscitation, people close to death sense being separated from their bodies and feel peaceful. The research involved interviewing 140 cardiac arrest survivors with near death experiences from the U.S., U.K., and Austria.

Neuroanatomist and author of the book, “My Stroke of Insight,” Dr. Jill Bolte Taylor, who experienced a sense of bliss when she had a stroke, per Forbes, thinks her euphoric sensations when close to death may have had to do with what part of your brain dies first. The left brain is often credited with all that’s logical, mathematical, and factual in our thinking, while the right brain is where creativity, imagination, and feelings thrive (via Healthline). Dr. Taylor thinks that when we’re close to death, it’s the right side of our brain that endures.

“When we’re on our deathbed, the left brain begins to dissipate. We shift out of all the accumulation and the external world because it’s no longer valuable. What is valuable is who we are as human beings and what we did with our lives to help others,” she told Forbes. Perhaps this is another explanation as to why someone who is about to die is concerned with mending relationships. Even if we don’t have all the answers about what people see and hear before they die, we do know that they want to spend their last moments in peace and love. Maybe this will help us do the best we can to make the experience of their passing meaningful for them.

Complete Article ↪HERE↩!

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Why Do We Always Want To Know How Someone Died?

— Mental health experts weigh in on this common impulse to find out the cause of death.

It’s natural to feel curious about death, especially in unexpected circumstances.

By

When we learn that someone has died ― especially at an earlier age than expected ― there’s often a flood of painful emotions and difficult questions. Chief among them: How did this happen?

Whether we knew the deceased well or they were a complete stranger, some of us have a tendency to fixate on finding out the cause of death, perhaps devoting hours to internet research as we desperately search for clues that might provide an reason. Others might reach out to express condolences to their loved ones … followed by the blunt question. Though the approach to finding answers can vary, the underlying impulse is not uncommon.

“I think when we hear about someone passing away at a young age, it rocks our sense of normalcy and the way we conceptualize the world,” said Rachel Thomasian, a licensed therapist and owner of Playa Vista Counseling in Los Angeles. “We operate with the general belief that people live until they are older and, barring a major catastrophe, will die well after they retire. Believing this is our brain’s way of keeping us psychologically safe from worrying about all the bad things that actually could happen.”

She added that not knowing the cause of death can lead us to think about all the possible ways a person can die. This need to have the reason a relatively young person died is about giving us some sense of meaning as to why this could happen.

“People have a natural fear of their own death, so when they hear of an untimely death, it might give them a sense of control to know how they died so they can try to prevent that,” Thomasian said. “So when we hear about someone who dies at a young age, it reminds us not only of our own mortality but that we too are not immune from dying much sooner than our 100th birthday.”

Because most of us don’t enjoy actively thinking about our own mortality, we tend to counter such thoughts with the assumption or hope that we’ll die peacefully in our sleep of old age, as will our loved ones.

“So when we have to confront the reality that someone died young, it creates a conflict with this assumption and we try to resolve it by getting more information,” said Zainab Delawalla, a clinical psychologist in Atlanta, Georgia. “Ultimately, we want to reinforce for ourselves the idea ‘that [dying young] won’t happen to me.’”

This impulse to want to know the cause of death also stems from our natural curiosity as people. In the age of the internet and social media, those in younger generations particularly pride themselves on their ability to quickly find information about other people. So not knowing how someone died can feel like a frustratingly incomplete puzzle, which compounds the difficult emotions surrounding a tragic and shocking loss.

“This neurological need to understand how and why someone died relates to a concept that social psychologists call ‘cognitive closure,’ which refers to the motivation to find answers to ambiguous situations,” said Becky Stuempfig, a Southern California-based therapist. “All of us have different levels of need for cognitive closure, and this need often increases during stressful events such as a death. Our brains struggle with the unknown, and it brings us peace when we can answer the ‘why’ and dispel the mystery surrounding the loss. Even if we do not have accurate information, our minds may hold on to any answers we can gather.”

Is this impulse a bad thing?

“Generally speaking, I think trying to resolve internal conflicts by seeking more information is not a bad thing,” Delawalla said. “The impulse to figure out the exact cause of death when someone dies at a young age is likely rooted in us trying to desperately hold on to the assumption that we might still die peacefully of old age. More information on one specific case would allow us to figure out why these circumstances are different and how they don’t apply to us.”

There’s nothing inherently wrong with wanting details that allow us to put order to things that feel chaotic, and the unknown process of death and what happens after we die certainly fall into that category.

“For some, the attempt to understand how and why someone died stems from a desire to delay the frightening concept of death by prolonging life and avoiding whatever caused the death,” Stuempfig said. “This is often seen when children pass away. The loss of a child feels so unnatural and traumatic that others sometimes feel a desperate need to understand the cause of death in an attempt to avoid a similar loss and to place some kind of reason to a situation that feels like it should never happen.”

However, this impulse can become problematic in certain situations, she added. For example, you might need to take a step back if your desire to learn the cause of someone’s death becomes obsessive and interferes with your daily functioning. Don’t let it impact your sleep or ability to complete work or other tasks.

“On the extreme alternative end, those who fixate on all the alternative ways one could die young are usually dealing with some form of anxiety,” Thomasian noted.

Ask yourself if your desire for this information is related to a deeper problem you should work through with a professional therapist.

“I think the impulse can be bad if it influences you to cross boundaries or disrespect what a person or family has lost,” added Racine Henry, a licensed marriage and family therapist in New York City. “It’s not always appropriate to ask ‘what happened?’ ― especially when the loss is new and people are trying to figure out how to grieve.”

Show respect for the deceased person’s loved ones and their desire for privacy.

How can you avoid feeling consumed by your need to know?

If you’re feeling consumed by your need to know someone’s cause of death, try to shift your mindset. Examine the source of your frustration and ask what you see as the benefits to gain from knowing how they died and harms from not knowing.

“If the desire stems from concern over personal health or wanting to safeguard family members from potentially dangerous situations, open discussions and proactive steps can empower the individual to regain a sense of control,” Stuempfig said.

“For example, if someone feels preoccupied by a death that they suspect was caused by suicide, it could be therapeutic to have open discussions with people in their lives about how they can take care of their mental health. This can help give people a sense of control, counteracting the prevailing feelings of helplessness.”

Try to determine whether your feelings around wanting this information are related to something in your own life.

“Most often there’s a judgment attached to a manner of death ― i.e., if someone died from an overdose, you may feel they deserve less empathy vs. someone who died from a car accident or plane crash,” Henry said. “What does that judgment say about you, and why is it necessary to attach meaning to how someone passes away? Spend time thinking about how that informs the way you treat others.”

Focus on showing empathy for how their loved ones might feel about the cause of death as well.

“Remember that many times the cause of death is not revealed openly because of the family members’ fears about how others will respond and judge them,” Steumpfig said. “In the case of substance abuse overdose or death by suicide, family members are often reluctant to share the cause of death out of fear of judgment or blame.”

Give yourself grace as you process the uncertainty and difficulty of death as well. Stop the “what if” questions from turning into intrusive thoughts and feelings by labeling them without self-judgment.

“Instead of feeling shame for wanting to know the cause of death, recognize the need as a natural function of the human brain,” Stuempfig said. “It can be useful to alter our inner dialogue from ‘What’s wrong with me? Why am I so morbidly obsessed with finding out how this person died?’ to ‘OK, I’m having an intrusive thought about wanting to know the cause of death and that’s just my brain doing its job.’”

Shifting our negative self-talk helps reduce judgment, anxiety and shame ― which thereby decreases the frequency of potentially harmful impulses. So rather than judging yourself for having them (and thus helping them grow stronger), focus on awareness to avoid feeling consumed by intrusive thoughts.

“Discussing these impulses with trusted family and friends can also help reduce isolation and self-criticism as it is a universal human need to seek answers in such situations,” Stuempfig added.

If you didn’t know the person who died well, consider how you might channel your fixation into something more positive.

“Try to refocus on how you can honor what those who are impacted are going through,” she said. “Maybe you can drop off a meal or help with the funeral arrangements. How can that energy be used to benefit those grieving?”

The finality of death can prompt serious anxiety and fear, but no piece of information will make it feel less uncertain.

“Instead of frantically looking for information to confirm ‘that won’t happen to me,’ let us work on accepting that none of us knows how or when we will confront death,” Delawalla emphasized. “We do, however, know and have many more choices around how we confront life. Let us spend more energy on that.”

Complete Article ↪HERE↩!

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Dia de los Muertos (Day Of The Dead) 2023

More than 500 years ago, when the Spanish Conquistadors landed in what is now Mexico, they encountered natives practicing a ritual that seemed to mock death.

It was a ritual the indigenous people had been practicing at least 3,000 years. A ritual the Spaniards would try unsuccessfully to eradicate.

A ritual known today as Dia de los Muertos, or Day of the Dead.

The ritual is celebrated in Mexico and certain parts of the United States. Although the ritual has since been merged with Catholic theology, it still maintains the basic principles of the Aztec ritual, such as the use of skulls.

Today, people don wooden skull masks called calacas and dance in honor of their deceased relatives. The wooden skulls are also placed on altars that are dedicated to the dead. Sugar skulls, made with the names of the dead person on the forehead, are eaten by a relative or friend, according to Mary J. Adrade, who has written three books on the ritual.

The Aztecs and other Meso-American civilizations kept skulls as trophies and displayed them during the ritual. The skulls were used to symbolize death and rebirth.

The skulls were used to honor the dead, whom the Aztecs and other Meso-American civilizations believed came back to visit during the monthlong ritual.

Unlike the Spaniards, who viewed death as the end of life, the natives viewed it as the continuation of life. Instead of fearing death, they embraced it. To them, life was a dream and only in death did they become truly awake.

“The pre-Hispanic people honored duality as being dynamic,” said Christina Gonzalez, senior lecturer on Hispanic issues at Arizona State University. “They didn’t separate death from pain, wealth from poverty like they did in Western cultures.”

However, the Spaniards considered the ritual to be sacrilegious. They perceived the indigenous people to be barbaric and pagan.

In their attempts to convert them to Catholicism, the Spaniards tried to kill the ritual.

But like the old Aztec spirits, the ritual refused to die.

To make the ritual more Christian, the Spaniards moved it so it coincided with All Saints’ Day and All Souls’ Day (Nov. 1 and 2), which is when it is celebrated today.

Previously it fell on the ninth month of the Aztec Solar Calendar, approximately the beginning of August, and was celebrated for the entire month. Festivities were presided over by the goddess Mictecacihuatl. The goddess, known as “Lady of the Dead,” was believed to have died at birth, Andrade said.

Today, Day of the Dead is celebrated in Mexico and in certain parts of the United States and Central America.

“It’s celebrated different depending on where you go,” Gonzalez said.

In rural Mexico, people visit the cemetery where their loved ones are buried. They decorate gravesites with marigold flowers and candles. They bring toys for dead children and bottles of tequila to adults. They sit on picnic blankets next to gravesites and eat the favorite food of their loved ones.

In Guadalupe, the ritual is celebrated much like it is in rural Mexico.

“Here the people spend the day in the cemetery,” said Esther Cota, the parish secretary at the Our Lady of Guadalupe Church. “The graves are decorated real pretty by the people.”

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It’s Never Too Soon to Start End-of-Life Conversations

— Patients can make their preferences known away from the pressures of acute illness

By Fred Pelzman, MD

There are the things that matter, and then there are the things that really matter.

As I’ve often written, through the course of a primary care office visit, and over the course of a long-term relationship between a patient and their primary care doctor, there are so many things we need to attend to.

So many acute issues, so many chronic medical problems, so many unmet health needs, so many social determinants of health that our patients struggle with, the massive issues of mental health, and the healthcare inequities and disparities that exist across the spectrum of our society.

I’ve written before about how much time it would take to take care of everything — to go through all the patient’s issues, all the vaccines and other healthcare maintenance items, all the screenings mandated by insurance companies, and all the questionnaires that bombard our patients (and us) from before their visit even starts through the time they leave the practice.

But of course, there are often things that get left unsaid, unattended to, or put off for another day.

Apart from the moment a decision is finally required, we oftentimes put off end-of-life discussions and other issues surrounding these complicated topics.

Things like signing a healthcare proxyopens in a new tab or window, having a discussion with their family about what they would want done at their end-of-lifeopens in a new tab or window, whether they want to donateopens in a new tab or window their organs, whether they want an autopsy when they pass.

Each of these topics could take a day, a week, a month, a year, a lifetime.

Patients’ ideas about each of these things change over time, change with their circumstances, change in the moment.

What we think we want when we’re young and healthy and seemingly immortal sometimes changes in the heat of a critical moment, a catastrophic illness, a tipping point, a time to decide.

How many times have each of us had a patient who got to this point and both doctors and the patient’s family wished we’d had more time to talk to them to understand what their loved one really wanted.

As part of my initial visit with patients, I tell them I’m there to be an advocate for their health, to help them navigate through our incredibly challenging healthcare system, and to try and be there for them as much as I can.

Our practice used to hand out paper copies of the New York State healthcare proxy and living wills forms.

But somewhere along the line — perhaps due to the cost of printing all those paper forms — the hospital decided we wouldn’t be doing that anymore.

Now when I meet a new patient, I send them a link to those forms in the electronic after-visit summary once we’ve wrapped up for the day, and they can print them out at home. I am hopeful the forms will help them make these decisions in a calm manner, away from the pressures of an acute illness, talking it all over with those that matter most in their lives.

Whenever time allows, I tell my patients — from the youngest to the oldest, the incredibly healthy to the terribly sick — that I have these conversations with everybody, that everyone should make their family and other loved ones know what they would want done in these difficult situations.

I know there is a lot of debate about how much this can change, how the decision to do nothing and pass peacefully can be interrupted by a critical illness when maybe, just maybe, if we only do just a little more, just a few more days, then things might turn around.

But for all of us this is a good place to start: to find out what a patient’s wishes are, to help make things easier for them, for the team of healthcare providers taking care of them, and for everyone who’s close to them who will ultimately be so deeply affected by what happens next.

Perhaps someday we’ll be a mature enough society where, instead of having to convince someone to be an organ donor, the default would be to donate any of our viable organs for the benefit of others (like it is for much of the rest of the world).

Perhaps someday we can use the idea of an autopsy to help advance medical knowledge, to help understand the process of living and dying, to help the next person in line who might benefit from what we learn.

And maybe even someday the issues of a dignified death, of maximizing the use of hospice and palliative care, of helping our loved ones get the peace they desire, will no longer raise such societal ire and create so much resistance.

I know this is a lot, I know that each of these topics comes with an enormous amount of charged societal and emotional baggage, and there are strong opinions on all sides.

For now, I’ll keep telling my patients to think about it, to think about how they’d feel, how they want their family to feel, how much better it will be if everyone is on the same page.

Far too often we’ve seen families torn apart by these decisions during the last days of a patient’s life. And none of us want to see that happen.

Complete Article ↪HERE↩!

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Supernatural Festivals

— A Cross-Cultural Look at the Celebration of Death

Candles placed on the river to carry intentions

By Dr. Ahriana Platten

Halloween, with its eerie costumes, spooky decorations, and a sense of playful fright, is a widely celebrated holiday in many parts of the world. It’s interesting to note that various faiths around the globe have their own festivals that share similarities with Halloween, a great example of the universal need to acknowledge our ancestors, the time of death, and our desire for life beyond our mortal walk. These celebrations may not always align perfectly with the modern commercialized version of Halloween, but they embrace themes of the supernatural, remembrance of the deceased, and the triumph of light over darkness.

Here are a few examples:

Dia de los Muertos – Mexico

In Mexico, Dia de los Muertos, or the Day of the Dead, is a vibrant and colorful festival that coincides with Halloween. Celebrated from October 31st to November 2nd, this holiday honors deceased loved ones. Families create elaborate altars adorned with sugar skulls, marigold flowers, and the favorite foods and beverages of the departed. People dress in skeleton costumes, and parades and festivals take place across the country to celebrate the cycle of life and death.

Pitru Paksha – Hinduism

In Hinduism, Pitru Paksha is a 16-day period when Hindus pay homage to their ancestors. It is believed that during this time, the spirits of the deceased visit the realm of the living. Families perform rituals, offer food, and conduct tarpana (libations) to honor their ancestors and seek blessings for their well-being in the afterlife. The festival is marked by a sense of solemnity and reflection, akin to Halloween’s connection with the supernatural.

Obon – Buddhism

Obon, or the Festival of the Dead, is a Buddhist tradition celebrated in Japan in July or August, depending on the region. During this time, families honor deceased relatives by lighting lanterns and setting them afloat on rivers and other bodies of water. It is believed that these lanterns guide the spirits of the deceased back to the world of the living. Bon Odori dances are also performed, and grave sites are cleaned and decorated to welcome back the spirits.

Samhain – Celtic Paganism

Samhain, originating from Celtic pagan traditions, is considered the precursor to modern Halloween. Celebrated on October 31st, it marks the end of the harvest season and the onset of winter. It is believed that during Samhain, the veil between the world of the living and the world of the dead is at its thinnest, allowing spirits to cross over. People would light bonfires, don masks, and leave offerings to appease the spirits. Many elements of Samhain have been incorporated into contemporary Halloween celebrations.

Chuseok – Korean Buddhism

Chuseok, also known as Korean Thanksgiving Day, is a major harvest festival celebrated in Korea. While it is not directly related to Halloween, it shares some thematic similarities. Families gather to pay respect to their ancestors by visiting their ancestral graves, offering food, and performing ancestral rites. Chuseok emphasizes the importance of family and the connection between the living and the deceased, similar to Halloween’s focus on remembering the departed.

Qingming Festival – Chinese Traditions

The Qingming Festival, also known as Tomb-Sweeping Day, is a Chinese tradition that occurs around April 4th or 5th. During this time, families visit the graves of their ancestors to clean the tombstones, make offerings, and burn incense. It is a day of remembrance and reflection, where people pay their respects to their ancestors and ensure their well-being in the afterlife. While not directly tied to Halloween, Qingming shares the theme of honoring the deceased and maintaining a connection with the spirit world.

Regardless of the specific rituals and customs, these traditions serve as a reminder of the enigmatic and unexplained aspects of life and death, making them captivating parallels to the Halloween festivities we know and cherish. the value of exploring the rites, rituals, and sacred ceremonies of faiths other than our own is that we begin to identify aspects of life that are universally important to all human beings — and, in the process, we come to a better understanding of our interconnection. This serves the pursuit of peace — something much of the world is actively seeking now.

Complete Article ↪HERE↩!

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Do end-of-life conversations make you nervous?

by Chris Brinneman, MSW, LCSW

If your family is like mine, you enjoy coming together to talk about living your best lives, planning vacations and making sure you are incorporating the activities and people you love into your calendar. But my family, perhaps unlike your family, also appreciates opportunities to discuss plans and preferences pertaining to potential health issues and scenarios, what we want our final days to look like, death and dying. We recognize that particularly given my profession, this might make us the exception to the norm. But it doesn’t have to be.

If you’ve seen the new Barbie movie, you can appreciate that I often feel like most people are the supporting characters in that film–dancing and having a great time–and I’m the one asking, “Do you guys ever think about dying?” It can certainly cause the record to scratch and the music to stop.

I’m incredibly grateful for my family’s willingness to engage in crucial conversations. After years serving and observing as a hospice and palliative care social worker, I boldly support not waiting until it’s too late to start talking about advance care planning (ACP) and end-of-life planning. I recommend inviting the people who matter most to us to have these discussions so that we know how to advocate for them in the event of a medical crisis and they know how to do so for us. Is it as light and lovely as vacation planning? Probably not. But it is one of the greatest gifts we can give to the people we care about.

Making ACP approachable

We live in a society where people predominantly avoid the subjects of aging and death. This can make it very challenging to broach the subject of end-of-life preferences. But I tell people to start by simply opening the door, metaphorically and physically, and inviting people in to chat. This could be on your own or with the help of an ACP advocate. The important thing is just to start, because these conversations evolve over time and are best when revisited as circumstances and expectations change.

My mom used to tease, with some underpinnings of truth, that her end-of-life plan was for us to “put her on an iceberg with a polar bear.” She grew up in a home where talking about death and dying was not the norm, as their faith did not accept the reality of death. As she got older, and three of her five adult children worked in healthcare, Mom became more willing to engage in ACP discussions sans the polar bear. A big motivator for this shift was that we, as a family, began to normalize talking about sickness, dying and death. We invited her to have conversations, and over time, she was able to clearly identify the person she wanted to make healthcare decisions for her if she could not make her own and state what her treatment preferences were for future care.

Setting the stage and starting the dialogue

You, too, should begin the conversation about advance care planning with your family and friends. If that makes you anxious or triggers you to feel overwhelmed, I want to offer some suggestions for broaching the subject from a different place.

Here are some ways you can start a crucial conversation in a format that feels good for you and your family:

  • Tee up the discussion in a neutral way. You don’t have to say, “Let’s have a difficult conversation and talk about your death.” These discussions should never be framed in a negative way. Rather, try beginning a dialogue with loved ones from the truth that completing ACP early allows you (and them) to think about and reflect on what is important when health changes, even though that may be years away.
  • Set the stage or take advantage of the situation. There are times when talking about death and dying fits seamlessly into a conversation or event. For example, if you learn of a sudden medical crisis with an acquaintance or friend, use the news to spark a discussion about what you would want in a similar situation. Similarly, there are settings and scenarios that support this type of intimate conversation. When walking and talking with a loved one, for instance, you can use the dedicated private time together to communicate about your wishes.
  • Dose these conversations out over time. You don’t have to tackle the entirety of your end-of-life wishes in one sitting or conversation. Talk a bit. If you start to feel overwhelmed or like you’ve made progress, leave it. Talk again when you’re ready.  
  • Emphasize key messages. ACP is good for all adults, regardless of age or health. We have a say in our care. Treatments only work if they work for us, each individually. We can change our minds. But it’s always imperative that you make the things that are most important to you known, so that the people who will be making decisions for you can be your voice. 
  • Lighten the emotional weight of the subject matter. If you struggle with the topic of end-of-life, as many do, there are games available to help guide the dialogue with a brighter approach. The Death Deck, Hello and Morbid Curiosity are great options. There are websites that offer resources like The Conversation Project Starter Kit.

I’ll leave you with this. Last year, I dropped my car off at the dealership to have some work done. The driver of the shuttle who took me to work asked what I did for a living, and I explained my work in advance care planning. By the time we concluded our short commute together, he had my card, and I had his promise that he would speak with his wife and call to schedule an appointment. He did. And you can, too.

Invite the people you love to have the dialogue–as many times as it takes. Be open to the gifts and relief these conversations can bring. Use the resources you need to ease any apprehension. And appreciate the opportunity to make your wishes known, because, unlike in Barbie’s world, we all think about death. We just need to normalize talking about it.

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