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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A Hospice Nurse on Embracing the Grace of Dying

Hadley Vlahos

By David Marchese

A decade ago, Hadley Vlahos was lost. She was a young single mother, searching for meaning and struggling to make ends meet while she navigated nursing school. After earning her degree, working in immediate care, she made the switch to hospice nursing and changed the path of her life. Vlahos, who is 31, found herself drawn to the uncanny, intense and often unexplainable emotional, physical and intellectual gray zones that come along with caring for those at the end of their lives, areas of uncertainty that she calls “the in-between.” That’s also the title of her first book, which was published this summer. “The In-Between: Unforgettable Encounters During Life’s Final Moments” is structured around her experiences — tragic, graceful, earthy and, at times, apparently supernatural — with 11 of her hospice patients, as well as her mother-in-law, who was also dying. The book has so far spent 13 weeks on the New York Times best-seller list. “It’s all been very surprising,” says Vlahos, who despite her newfound success as an author and her two-million-plus followers on social media, still works as a hospice nurse outside New Orleans. “But I think that people are seeing their loved ones in these stories.”

What should more people know about death? I think they should know what they want. I’ve been in more situations than you could imagine where people just don’t know. Do they want to be in a nursing home at the end or at home? Organ donation? Do you want to be buried or cremated? The issue is a little deeper here: Someone gets diagnosed with a terminal illness, and we have a culture where you have to “fight.” That’s the terminology we use: “Fight against it.” So the family won’t say, “Do you want to be buried or cremated?” because those are not fighting words. I have had situations where someone has had terminal cancer for three years, and they die, and I say: “Do they want to be buried or cremated? Because I’ve told the funeral home I’d call.” And the family goes, “I don’t know what they wanted.” I’m like, We’ve known about this for three years! But no one wants to say: “You are going to die. What do you want us to do?” It’s against that culture of “You’re going to beat this.”

Is it hard to let go of other people’s sadness and grief at the end of a day at work? Yeah. There’s this moment, especially when I’ve taken care of someone for a while, where I’ll walk outside and I’ll go fill up my gas tank and it’s like: Wow, all these other people have no idea that we just lost someone great. The world lost somebody great, and they’re getting a sandwich. It is this strange feeling. I take some time, and mentally I say: “Thank you for allowing me to take care of you. I really enjoyed taking care of you.” Because I think that they can hear me.

The idea in your book of “the in-between” is applied so starkly: It’s the time in a person’s life when they’re alive, but death is right there. But we’re all living in the in-between every single moment of our lives. We are.

So how might people be able to hold on to appreciation for that reality, even if we’re not medically near the end? It’s hard. I think it’s important to remind ourselves of it. It’s like, you read a book and you highlight it, but you have to pick it back up. You have to keep reading it. You have to. Until it really becomes a habit to think about it and acknowledge it.

I was reading these articles recently about how scientists are pursuing breakthroughs that could extend the human life span to one hundred twenty.1

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Examples of which could include devising drug cocktails that get rid of senescent cells and filtering old blood to remove molecules that inhibit healing.

There’s some part of people that thinks they can cheat death — and, of course, you can’t. But what do you think about the prospect of extending the human life span? I don’t want to live to be 120. I have spent enough time around people who are close to 100, over 100, to know that once you start burying your children, you’re ready. Personally, I’ve never met someone 100 or older who still wants to be alive. I have this analogy that I did a TikTok2

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Vlahos has 1.7 million followers on TikTok, where she posts about her experience as a hospice nurse and often responds to questions about death and dying.

on. This is from having a conversation with someone over 100, and her feeling is that you start with your Earth room when you’re born: You have your parents, your grandparents, your siblings. As you get older, your Earth room starts to have more people: You start making friends and college roommates and relationships. Then you start having kids. And at some point, people start exiting and going to the next room: the afterlife. From what she told me, it’s like you get to a point when you’re older that you start looking at what that other room would be, the afterlife room,3

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According to a 2021 Pew Research survey, 73 percent of American adults say they believe in heaven.

and being like, I miss those people. It’s not because you don’t love the people on Earth, but the people you built your life with are no longer here. I have been around so many people who are that age, and a majority of them — they’re ready to go see those people again.

“The In-Between” also has to do with the experience of being in between uncertainty and knowing. But how much uncertainty is there for you? Because in the book you write about things that you can’t explain, like people who are close to death telling you that they’re seeing their dead loved ones again. But then you write, “I do believe that our loved ones come to get us when we pass.”4

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From Vlahos’s book: “I don’t think that we can explain everything that happens here on Earth, much less whatever comes after we physically leave our bodies. I do believe that our loved ones come to get us when we pass, and I don’t believe that’s the result of a chemical reaction in our brain in those final hours.”

So where is the uncertainty? The uncertainty I have is what after this life looks like. People ask me for those answers, and I don’t have them. No one does. I feel like there is something beyond, but I don’t know what it is. When people are having these in-between experiences of seeing deceased loved ones, sometimes it is OK to ask what they’re seeing. I find that they’ll say, “Oh, I’m going on a trip,” or they can’t seem to find the words to explain it. So the conclusion I’ve come to is whatever is next cannot be explained with the language and the knowledge that we have here on Earth.

An image from Hadley Vlahos’s TikTok account, where she often posts role-playing scenes and video tutorials. She has more than two million followers across social media.

Do these experiences feel religious to you? No, and that was one of the most convincing things for me. It does not matter what their background is — if they believe in nothing, if they are the most religious person, if they grew up in a different country, rich or poor. They all tell me the same things. And it’s not like a dream, which is what I think a lot of people think it is. Like, Oh, I went to sleep, and I had a dream. What it is instead is this overwhelming sense of peace. People feel this peace, and they will talk to me, just like you and I are talking, and then they will also talk to their deceased loved ones. I see that over and over again: They are not confused; there’s no change in their medications. Other hospice nurses, people who have been doing this longer than me, or physicians, we all believe in this.

Do you have a sense of whether emergency-room nurses5

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Who, because of the nature of their jobs, are more likely than hospice nurses to see violent, painful deaths.

report similar things? I interned in the E.R., and the nurse I was shadowing said that no one who works in the E.R. believes in an afterlife. I asked myself: Well, how do I know who’s correct? How am I supposed to know? Are the people in the church that I was raised with6

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Vlahos was raised in an Episcopalian family. She now refers to herself, as so many do, as spiritual rather than religious

more correct than all these people? How are you supposed to know what’s right and what’s not?

But you’ve made a choice about what you believe. So what makes you believe it? I totally get it: People are like, I don’t know what you’re talking about. So, OK, medically someone’s at the end of their life. Many times — not all the time — there will be up to a minute between breaths. That can go on for hours. A lot of times there will be family there, and you’re pretty much just staring at someone being like, When is the last breath going to come? It’s stressful. What is so interesting to me is that almost everyone will know exactly when it is someone’s last breath. That moment. Not one minute later. We are somehow aware that a certain energy is not there. I’ve looked for different explanations, and a lot of the explanations do not match my experiences.

That reminds me of how people say someone just gives off a bad vibe. Oh, I totally believe in bad vibes.

But I think there must be subconscious cues that we’re picking up that we don’t know how to measure scientifically. That’s different from saying it’s supernatural. We might not know why, but there’s nothing magic going on. You don’t have any kind of doubts?

None. Really? That’s so interesting. You know, I read your article with the atheist.7

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“How to Live a Happy Life, From a Leading Atheist,” an interview with the philosopher Daniel C. Dennett, published in August.

I feel like you pushed back on him.

There are so many things in our lives, both on the small and the big scale, that we don’t understand. But I don’t think that means they’re beyond understanding. OK, you know what you would like? Because I know that you’re like, “I believe this,” but you seem to me very interested; you’re not just set in your ways. Have you ever heard that little story about two twins in a womb?8

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Known as the parable of the twins, this story was popularized by the self-help author Dr. Wayne W. Dyer in his 1995 book “Your Sacred Self: Making the Decision to Be Free.”

I’m going to totally butcher it, but essentially it’s two twins who can talk in the womb. One twin is like, “I don’t think that there is any life after birth.” And the other is like, “I don’t know; I believe that there is something after we’re born.” “Well, no one’s ever come back after birth to tell us that there is.” “I think that there’s going to be a world where we can live without the umbilical cord and there’s light.” “What are you talking about? You’re crazy.” I think about it a lot. Do we just not have enough perspective here to see what could come next? I think you’ll like that story.

For the dying people who don’t experience what you describe — and especially their loved ones — is your book maybe setting them up to think, like: Did I do something wrong? Was my faith not strong enough? When I’m in the home, I will always prepare people for the worst-case scenario, which is that sometimes it looks like people might be close to going into a coma, and they haven’t seen anyone, and the family is extremely religious. I will talk to them and say, “In my own experience, only 30 percent of people can even communicate to us that they are seeing people.” So I try to be with my families and really prepare them for the worst-case scenario. But that is something I had to learn over time.

Have you thought about what a good death would be for you? I want to be at home. I want to have my immediate family come and go as they want, and I want a living funeral. I don’t want people to say, “This is my favorite memory of her,” when I’m gone. Come when I’m dying, and let’s talk about those memories together. There have been times when patients have shared with me that they just don’t think anyone cares about them. Then I’ll go to their funeral and listen to the most beautiful eulogies. I believe they can still hear it and are aware of it, but I’m also like, Gosh, I wish that before they died, they heard you say these things. That’s what I want.

You know, I have a really hard time with the supernatural aspects, but I think the work that you do is noble and valuable. There’s so much stuff we spend time thinking about and talking about that is less meaningful than what it means for those close to us to die. I have had so many people reach out to me who are just like you: “I don’t believe in the supernatural, but my grandfather went through this, and I appreciate getting more of an understanding. I feel like I’m not alone.” Even if they’re also like, “This is crazy,” people being able to feel not alone is valuable.

This interview has been edited and condensed for clarity from two conversations.

Complete Article HERE!

Death Is a Part of Life

— A mindfulness of death practice inspired by the Buddha’s teachings in the Maranasati Sutta

By Nikki Mirghafori

The Buddha taught mindfulness of death teachings in many different discourses. Today we will discuss the Maranasati Sutta (Anguttara Nikaya 6.19). Maranasati means death awareness—marana (death) and sati (awareness or mindfulness). At the beginning of the Maranasati Sutta, the Buddha is said to address the monks, or practitioners (we’re all practitioners), thus:

When mindfulness of death is developed and cultivated, it’s beneficial. It culminates in the deathless, and ends with the deathless—but how does one develop mindfulness of death?

I’d like to go over these benefits before talking about the specific instructions he gave the monks.

The Benefits of Practicing Mindfulness of Death

Many of us in the West might be afraid of death—we don’t want to think about it, we don’t want to talk about it—and yet, bringing death into our awareness has many benefits—benefits for ourselves and our loved ones, benefits in how we live, and benefits for how we die. This practice prepares us to have a sense of peace, not being scared and fearful, when the moment of death arises.

The moment of death is said to be a liberating moment. So doing this practice is supreme training for that important moment of transitioning. However, this practice isn’t just for the potential of liberation. It impacts the way we live and how we show up for ourselves and others—loved ones, people we don’t know, and people we have challenges with.

Living according to our values is one of the many benefits of this practice. When we know that our time in this body and in this life is finite—when we fully embrace finitude—we don’t waste time. When the scarcity of our time comes into the forefront of our consciousness, we tend not to do the unskillful actions that cause harm. When we “greet and hold death as an advisor on our shoulder all the time,” as Carlos Castaneda said, the way we live our life changes.

We live with more freedom, peace, ease, love, and care because we know there is nothing to hang on to. We are a traveler on this earth. This body is not mine. It’s for rent. This life is for rent.

When we realize this, we live differently, we live more freely. We let go of our clinging, our sense of attachment to me, me, me, mine, mine, mine. It shifts our perspective. We can live with more freedom, generosity, kindness, and forgiveness. There is nothing to take with us. There’s nothing to hang on to. So this practice is liberating, just as the Buddha says, and it has the deathless as its fruit.

What does the deathless mean?

The deathless refers to nibbana (nirvana). The deathless is another translation for nibbana, freedom, liberation, awakening. So mindfulness of death practice is a liberating practice. It leads to freedom in the way we live and in the moment that we die—the ultimate letting go.

Summarizing the Sutta

So with that as the preamble, let’s continue with the Maranasati Sutta.

So then, as I read, the Buddha asked the monks:

Do you develop mindfulness of death? How do you develop mindfulness of death, knowing how important it is?

One monk raises their hand and says:

Oh, yes, I develop mindfulness of death. If I’d only live for another day and night, I’d focus on the Buddha’s instructions and I could really achieve a lot. That’s how I develop mindfulness of death.

And then another monk raises their hand and says:

Me too, me too! I practice mindfulness of death. If I’d only live for a day, then I’d focus on Buddha’s instructions.

Another one raises their hand and says:

Me too, me too! I practice as if I’d only live as long as it takes to eat a meal of alms food.

And then the fourth one raises their hand and says:

Oh, Buddha, Buddha, I practice, thinking if I lived only as long as it takes to chew and swallow four or five morsels of food.

A fifth one raises their hand and says:

Actually, the way I practice is, if only I lived as long as it takes to chew and swallow one morsel of food.

And then the last one, the sixth one in the story, raises their hand and says:

Buddha, the way I practice is, I might live only long enough to breathe out, after breathing in, or breathe in, after breathing out. That’s how I practice mindfulness of death.

And then the Buddha says:

Okay practitioners, those of you who said, “I think I’m going to live another day or night and I have time,” or said, “I may live another day,” or said, “I may live to eat another meal,” or said, “I may live to eat three or four morsels of food,” all of you are living heedlessly. All of you are living heedlessly.

Those of you who are practicing while thinking, “I might only live long enough to chew this bite of food,” or “I might only live long enough to eat this bite of food,” or “I might only live long enough for the duration of this in-breath or the duration of this out-breath, that I might die after this in-breath or after this out-breath”—you are practicing heedfully.

So as practitioners, how do we heedfully practice the instructions of the Buddha? The invitation is not to think, Oh I’ll have time, I have another year, or another month, or another week.

Heedlessly was considered thinking I have another day, another few bites of food. The Buddha is inviting us to consider that we could die in this moment, at the end of this in-breath or this out-breath, at the end of this bite of food, right here, right now. The Buddha is inviting us to bring death intimately into each breath.

The Practice of Mindfulness of Death

So with this, I would like to lead a guided meditation for us to practice with these instructions. I would like to invite you to close your eyes, if that’s comfortable for you. To feel yourself sitting or lying down, whatever posture is comfortable for you. Feel yourself having a sense of integrity, a sense of uprightness, letting the body be relaxed while rooted to this earth, to your sit bones, to your feet. Feeling your hands and yet the sense of uprightness, dignity.

Let us begin by bringing our awareness, our attention, into this body. This long fathom body, breathing in this moment. Feeling the breath where it’s comfortable for you, or in your abdomen, sensing the life force moving through.

This body is alive in this moment and breathing. Let’s connect with the sense of aliveness in this body. Breathing, pulsating, this amazing piece of nature. Through this in-breath, through this out-breath.

After we connect with the living, pulsating, alive nature of this body, let us connect to the fact that this body too shall die. This body is nature. It’s not a mistake. It’s not an aberration. It’s not a problem. Death is a part of life. Everything that is born also dies, and this body too.

Letting the awareness connect with the in-breath, with the out-breath. Settling, calming, and appreciating that death is so close. It’s always close. I might only live as long as it takes to breathe in, that’s all. Or I might live as long as it takes to breathe out after breathing in.

Death is so close and intimate. Can we bring it close and intimate, like a friend who advises us, on how to live, how to practice, how to be in this moment attending to the Buddha’s teachings on love, compassion, letting go, and generosity.

What if I only have the length of this in-breath to live? The length of this out-breath to live? Can we open our hearts to relax and embrace this liberating truth of impermanence?

For some of us, this practice can bring up a sense of agitation. It’s okay. You’re not doing it wrong. If agitation arises, let yourself relax with the out-breath. Connect with the sensations in the body in a spacious way, making space for the agitation or the fear that may have arisen. It’s not a mistake. As we allow ourselves to make space and be with what is difficult, arising in this moment. As expand our capacity for peace. To be with what is challenging, we extend our capacity and we cultivate fearlessness, another synonym for nibbana.

So as you do this practice on your own, bring in this contemplation: Death is so close, I might only live as long as it takes to breathe this in-breath or out-breath.

At the end of this morsel of food, how do you want to live? How do you want to show up? How do you want to cultivate your heart and mind in this short flash that is our life?

Remember that this practice of mindfulness of mortality is a liberating practice. It ends in the deathless. In nibbana, in freedom, awakening.

Complete Article HERE!

Losing a loved one to suicide can cause immense grief and anger.

— But the truth can set you free

‘Love is never wasted, it bears all things; even a terrible death and deep grief,’ the Rev Sharon Hollis writes.

When my husband died I questioned my purpose in life. But my faith offered me tools to help navigate the worst days

By Sharon Hollis

When a loved family member dies unexpectedly we experience immense grief and sadness. It can cause us to ask questions about our meaning and purpose in life. This is even more so when the death is sudden or traumatic.

I found myself asking these questions when my husband Michael died suddenly by suicide 10 years ago. As a minister in the Uniting church, I turned to my faith to give me some guidance. What I discovered was that Christianity offered many tools to help me navigate the worst days of grief (along with good counselling and fabulous friends). And they can be used by anyone, regardless of faith.

Be compassionate

For much of the history of the Christian church, suicide has been considered a sin so grievous that a Christian funeral couldn’t be offered and a burial couldn’t take place in church graveyards. This represented a failure to understand mental illness as an illness that deserves our compassion in the same way any other illness does. There is no love in the historic position of the church. It is not a “love that bears all things”, including death by suicide.

Michael battled deep depression, spent time in a psychiatric ward and clung to life for as long as he could. I choose to continue to love Michael, notwithstanding what he did. One of the things my counsellor said many times was that none of us wants to be judged by our worst moment. I choose not to judge Michael by his worst decision, as I believe God chooses not to judge us by our worst moments.

Choose love

I loved Michael in life, and my love for him endures. Love is never wasted, it bears all things; even a terrible death and deep grief. Not everyone understood my capacity to keep loving Michael. Yes, I’ve had times when I’ve been furious with him. I’ve been sad for him and what he is missing, and so sad for the loss of his presence in my life and the life our daughters. But I continue to love him. I know not everyone can do this but I find strength in the enduring nature of our love. It is one of the ways Michael continues to be present in our lives, even in his absence.

The Christian story is not one of a God who doesn’t know or experience suffering. I take great comfort from this. Some time after Michael died, I wondered: where was God when Michael made his decision to die? Where was God when Michael died? An image came to me of Jesus holding Michael in that moment, catching him and holding him.

Speak the truth

One of the things I was most clear about almost as soon as I knew Michael had died was that I would be honest about how he died. I never wanted to feel ashamed of him. I never wanted to feel ashamed of our relationship. I never wanted my children to feel they couldn’t talk about their father or feel ashamed of him. I didn’t want to use what precious energy I had in the depth of my grief worrying about who knew what.

I told the truth about his death to our daughters, to our family and friends. We told the truth at his funeral. I have continued to tell the truth. Speaking the truth of Michael’s death has been a gift in so many ways. I have had wonderful conversations with people who have found it hard to speak about mental illness or the death by suicide of a family member or friend. Jesus said the truth will set you free and I have found this to be so.

The Christian story teaches us that death does not have the last word, and that we can find new life and new hope even where there has been great sadness. I have found it to be true. In the wake of Michael’s death I have found the courage to live again; to notice joy, small moments at first, now days, weeks months of joy; a new life of love and family and friends. This has brought me back to a fullness of life.

If you have lost someone close to you, particularly by suicide, I hope these tools can help you navigate the next stage of your life, and bring you back to a fullness of life.

Complete Article HERE!

Spiritual care for hospice patients

— For patients in hospice, spiritual care plays an important role in offering comfort to them and their loved ones. Just like with physical or emotional pain, spiritual pain can cause hospice patients to have anxiety or concerns as they near the end of their lives. Thankfully, hospice chaplains are available to help patients and their families find spiritual healing and comfort.

What is a chaplain’s role?

A chaplain is a part of the hospice patient’s multi-disciplinary care team that also includes physicians, nurses, LPNs, CNAs, social workers and more. A chaplain’s job is to walk alongside patients as they navigate their spiritual journeys at the end of life. Because chaplains aren’t tied to a particular church or religious background, they are focused on meeting patients where they are spiritually and providing the type of comfort and care each patient needs.

This typically involves performing an initial assessment with each patient that helps the chaplain understand their beliefs, church background, faith background and more. This allows the chaplain to find out what is important to the patient and how they can best support them, no matter their religious beliefs or denomination. It also allows them to connect the patient with other religious leaders, such as priests or ministers, who can provide religious-specific support.

Chaplains as listeners

One of the most important parts of a chaplain’s job is listening. They will often spend a lot of time with their patients going through a “life review” — which involves listening to the patient as they talk about their past, memories, accomplishments, interests, etc. This life review allows the chaplain to enter the patient’s world and gives the patient the often-therapeutic experience of sharing stories about their lives.

Through the life review, the chaplain builds a trusting relationship with the patient that gives them the foundation they need to better provide spiritual support. It also gives the chaplain an idea of things in the patient’s past that they may be able to help with and relieve any lingering negativity.

Chaplains as comforters

Providing comfort and easing any anxieties a patient may have as they near the end of their life is a big part of a chaplain’s role — and it looks differently for every person.

Religious patients may find comfort in scripture, prayer or sacraments such as baptism or communion. Other patients may have questions about spirituality if they haven’t been religious before but are looking for peace. Patients who are not faith-connected may want non-religious support to ease their minds in their final days, such as being reminded that their loved ones are being taken care of. Chaplains also often care for the family members of hospice patients, helping spouses, parents, grandparents, etc., find peace and hope in saying goodbye to their loved one.

For chaplains, it’s all about looking for signs of spiritual pain or distress and finding ways to relieve that anxiety and help someone find comfort in their hospice journey.

Chaplains as planners

One way chaplains can help patients and their family members find peace and comfort is by aiding in the funeral process. Often, chaplains are brought in to help with planning or even officiating the funeral.

For many patients who are able, speaking with a chaplain about their wishes offers them a chance to request specific poems, scriptures, songs or prayers that they would like to be read or played at their funeral. It also offers the chaplain an opportunity to gather information about the patient to ensure it’s a personal event that honors them in an appropriate way. Speaking about and planning their funeral ahead of time gives the patient peace of mind in knowing the funeral is taken care of — which can help relieve a lot of stress later in the hospice journey.

For hospice patients, navigating their spirituality is a big part of end-of-life care. Hospice chaplains play an important role in helping each individual patient and family member find the comfort they need, no matter their religious belief or background.

Complete Article HERE!

Methodist bishop offers meditation on death

By Terry Mattingly

There was nothing unusual, in the early 1970s, about a student hearing one of his professors preach during chapel.

But one sermon — “How Would You Like to Die?” — impressed the seminarian who would later become United Methodist Bishop Timothy Whitaker of Florida. Theologian Claude H. Thompson had terminal cancer and, a few months later, his funeral was held in the same sanctuary at the Candler School of Theology in Atlanta.

“What hit me was that he calmly preached on that subject — even while facing his own death,” Whitaker said. “It hit me that that, if death is one of the great mysteries of life, then that needs to be something that the church openly discusses. …

“Yes, we live in a culture that is reluctant to talk about death. But I decided that it’s important for us to hear from our elders who is facing this issue, head on.”

Thus, soon after doctors informed him that his own cancer is terminal, Whitaker wrote a lengthy online meditation, “Learning to Die.” The 74-year-old bishop is retired and receiving hospice care, while living in Keller, a small town near the Virginia coast.

“Being a pastor, I considered it a privilege and also an education to linger beside many deathbeds. I have tried to never forget that, unless I die abruptly in an accident or with a heart attack or stroke, sooner or later the subject of death will feel very personal to me,” he wrote. Now, “in the time that remains for me I have one more thing to learn in life, which is to die. … I had always hoped that I would be aware of the imminence of my death so that I could face it consciously, and I am grateful that I have the knowledge that I am going to die soon.”

Certainly, Whitaker noted, the Orthodox theologian Father Thomas Hopko was correct when he quipped, while facing a terminal disease: “This dying is interesting.”

Dying is also complicated — raising myriad theological questions about eternity, salvation and the mysteries of the life to come, he noted. The Bible, from cover to cover, is packed with relevant stories, passages and images. The same is true of the writings of early church leaders who preached eternal hope, even when suffering persecution and martyrdom. Over and over, the saints proclaimed their belief in the resurrection of Jesus.

Whitaker noted that Methodists can ponder this quote from their pioneer John Wesley: “But what is the essential part of heaven? Undoubtedly it is to see God, to know God, to love God. We shall then know both His nature, and His works of creation and providence, and of redemption. Even in paradise, in the intermediate state between death and resurrection, we shall learn more concerning these in an hour, than we could in an age, during our stay in the body.”

But what about the big questions that modern believers might struggle to ask? What about their fears of living with a terminal disease and the complicated questions surrounding death itself?

Early Methodists believed that preparing for death was simply part of life, and outsiders noted that “Methodists die well,” Whitaker said. The problem in churches today is that dying is often viewed as “a counseling issue,” or merely a “therapeutic challenge” for busy clergy.

For centuries, Christians developed rites linked to what they called the “good death,” or even the “happy death,” he noted. While millions now shudder at the thought of dying alone in a hospital, clergy should teach — especially in the age of hospice — how believers can plan to die surrounded by family and their fellow believers.

Yet many clergy are reluctant to discuss these subjects from the pulpit or in educational events addressing modern realities, as well as centuries of rituals and prayers.

“I can understand this reluctance — because they’re going to have many parishioners who will be alarmed or upset by any open discussions of these topics that our culture wants to ignore,” Whitaker said.

“But the church is supposed to help us prepare for death. And this isn’t just about someone receiving a terrible diagnosis. Death is something that can strike at any moment. … The church can’t be silent, in the face of death.”

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‘It was cruel’

— Dying patient denied assisted dying in Catholic-run hospital

Jane Morris says her friend, who had motor neurone disease, ‘had a terrible experience and she had to seek help outside of the hospital system’ in order to die via voluntary assisted dying.

Sally wanted to die on her own terms. But despite voluntary assisted dying being legal in Victoria, her advocates say a Catholic palliative care facility obstructed access

By and

When 60-year-old Sally* told her neurologist that she wanted to choose when to die, she was dismissed. Diagnosed with motor neurone disease, Sally knew her condition was incurable and that her rapid decline could include respiratory failure, difficulty swallowing and cognitive decline.

She wanted to die on her own terms, before her symptoms became unbearable. But Sally was receiving treatment at a Catholic palliative care hospital.

Sally lived in Victoria, where legislation allows those with neurodegenerative conditions such as motor neurone disease access to voluntary assisted dying. But her advocates say none of the doctors who diagnosed and treated her would provide the necessary paperwork for her to access euthanasia, nor would they refer her to someone who would.

Sally’s calls and emails to the hospital, an institution that objected to euthanasia, elicited promises of a response at a later date that never came.

“She had a terrible experience and she had to seek help outside of the hospital system,” says Jane Morris, the vice-president of Dying with Dignity Victoria. “She was one of the most lovely people I’ve ever met and it was cruel she was ignored or met with empty platitudes.”

By the time Morris met Sally, she couldn’t write and was communicating with a sight board. “She kept asking me to write down her story and tell it one day for her,” Morris says. “She told me that she wants voluntary assisted dying to be discussed openly, to be destigmatised and not subject to the religious doctrine of faith-based health facilities.”

Doctors and legal experts who spoke to Guardian Australia have called for voluntary assisted dying laws, which differ between the states and territories, to be nationalised and made more humane so that institutional objection does not lead to delays in care, or to patients dying in places they do not feel comfortable.

Depending on where someone lives, the catchment area they fall into may mean that the only local palliative care service is run by a Catholic organisation, which all have different policies about how they treat euthanasia. Under Catholic Health Australia’s code of ethics, any action or omission that “causes death with the purpose of eliminating all suffering” is not permissible.

Sally’s condition declines

The months of delays by the hospital would prove devastating for Sally. Her pain increased as her condition progressed, making it difficult to eat, speak and swallow. It meant taking the euthanasia medication orally was no longer an option, even if she was approved.

Desperate, Sally went outside the hospital system to a GP and asked for help. She was referred to the Victorian Voluntary Assisted Dying Statewide Care Navigator service, who helped her find a specialist and get the paperwork she needed, and she was put in contact with a voluntary assisted dying doctor trained to deliver euthanasia intravenously.

The doctor was not comfortable administering the medication outside a hospital and by the time she was approved, Sally was no longer well enough to travel to a health facility.

Plus, she wanted to die in her home.

When specialist doctor and voluntary assisted dying provider Eleanor* heard about Sally’s plight, she offered to help without hesitation. Eleanor assisted in getting approvals, travelled to Sally’s home and administered euthanasia drugs to her intravenously.

“I was sad and angry that she was delayed from accessing a service she had a right to,” Eleanor tells Guardian Australia.

“No one would write the letter that gave her access to voluntary assisted dying. She deteriorated very quickly and she lost the window in which she was well enough to comfortably go through the process in terms of going to doctor’s visits to get the approvals. So she needed to find doctors willing to come to her home. Unfortunately, cases like this are not rare.”

Sally’s situation was further complicated by federal legislation that prevents anyone seeking information or advice about voluntary assisted dying from a health professional over an electronic carriage service, ruling out telehealth consults for assistance. It is one of the reasons experts say uniform national legislation is needed.

Eleanor believes public funding for hospitals and aged care homes should come with a responsibility to provide a full suite of health services, including voluntary assisted dying.

“The alternative is sometimes to watch someone slowly suffocate to death, or die of a bowel obstruction, or starve to death because they can’t access a more humane way of dying,” she says. “We need national legislation to make the process more humane by taking the best of the legislation in each state and adopting it everywhere.”

It can also be difficult to find a doctor to administer or approve euthanasia drugs, with a shortage of trained voluntary assisted dying doctors, which Eleanor says is partly due to stigma and confusing legislation.

“Most doctors agree with voluntary assisted dying, but feel it is too hard to become a practitioner themselves.”

‘A huge power imbalance’

Victoria was the first state to pass voluntary assisted dying laws in 2017 and since then the other states have followed. In December 2022, commonwealth laws that stopped Australian territories from making new laws on voluntary assisted dying were repealed.

Three states – Queensland, South Australia and New South Wales – include institutional objection provisions in their legislation. Ben White, a professor of end-of-life law at Queensland University of Technology, says it means in those states, people are able to access voluntary assisted dying if they are a resident of an aged care or palliative care facility, even if the facility objects, because it is considered the patient’s home.

While conscientious objection by individual health professionals is protected by the Victorian legislation, objections by institutions are governed by their own policies, which White says aren’t always transparent. The Victorian health department has guidelines for how institutions can manage objections, but this is not binding. Health professionals are also barred in Victoria from raising voluntary assisted dying with their patients – the patient must bring it up first.

“I think we should be able to explain to people all the options they have,” says a health professional who has worked in end-of-life care for decades and did not want to be named. “I just believe in people being able to make informed choices – we’re talking about competent … people who already have a terminal illness.”

White agrees: “I think the key issue here is there’s a huge power imbalance.

“You’ve got people who by definition are terminally ill, expected to die shortly, trying to navigate and access voluntary assisted dying in a situation where the institution holds all the cards.”

In a study published in March, White and his colleagues interviewed 32 family caregivers and one patient about their experience of seeking voluntary assisted dying, including experiences with institutional objection. The objections described generally occurred in Catholic facilities or palliative care settings, which meant some or all of the euthanasia process could not happen on site.

Most commonly, patients were not allowed to meet with a doctor to be assessed; were prevented from accepting delivery of the euthanasia medication from a pharmacy; or were barred from taking the medication or having it administered to them.

White says it can leave families scrambling to transfer their loved ones elsewhere to die, including patients with conditions that made transportation painful.

One of the study participants said: “It will always be a great sadness for me that the last few precious hours on Mum’s last day were mostly filled with stress and distress, having to scurry around moving her out of her so-called ‘home’.”

There is a strong argument to limit the power of institutions to object to voluntary assisted dying when it harms patients, White says.

What Catholic hospitals could do

Oncologist Dr Cam McLaren says a component of cancer medicine is “fighting a losing battle and sometimes all you can do is choose the terms in which you die”.

It is why he became a voluntary assisted dying provider soon after Victorian legislation was introduced. “I was, and still am, in high demand and I have been involved in the assessment of about 300 voluntary assisted dying cases,” he says.

McLaren works for a Catholic hospital and says the values of religious organisations have “allowed them to do some incredible work in palliative care out of a desire to help people”.

He has helped facilitate the transport of patients off site to administer their euthanasia medication. He says different institutions have different levels of comfort with assisted dying and support certain “tiers” of access only; some allow doctors to consult with patients about the topic, but aren’t comfortable with the death occurring on site, for example.

“I completely support the ability of religious hospitals to refuse to be involved in practitioner administration of the drugs on site – that’s completely against their codes and morals,” he says.

“But a lot of the other steps in the process don’t involve any action. It’s just a conversation with a patient or information. And a discussion should not have the capacity to violate religious boundaries.

“I think a good model is for the hospital to allow the assessment and the delivery of the medication to the patient and then give patients time to plan to go home to have the medication administered there.”

But McLaren says this isn’t enough to protect patients in an aged care facility, where the facility is already home.

“And we have seen barriers in aged care homes overtly or covertly with non-assistance and noncompliance, so we have patients asking for months or weeks to access voluntary assisted dying and by the time they’re referred to me, it’s too late because the process takes time, which they don’t have.”

In NSW, voluntary assisted dying legislation will come into effect on 28 November, but there are still unanswered questions about barriers to access for patients being treated in religious public organisations.

People wishing to end their life in the state must be assessed by two doctors as likely having less than six months to live. A document seen by Guardian Australia detailing the response of Catholic health services Calvary Health Care, St John of God and St Vincent’s Health Australia to voluntary assisted dying suggests that these organisations will not allow assessments to be undertaken on site, with patients having to be transported elsewhere for the assessment or referred on to another hospital for care.

If a person has been approved for euthanasia to be administered by a medical practitioner, the document also outlines that the patient will need to go to another health provider or be discharged home. Doctors are concerned that these transfers may unnecessarily increase pain and suffering for patients at the end of their lives.

The document says “we do not abandon our patients” – if a person is considering or actively pursuing euthanasia, “our hospitals do not change our commitments to their provision of care”.

A spokesperson for Catholic Health Australia said on behalf of all three hospitals: “Our hospitals don’t provide [voluntary assisted dying (VAD)].”

“However, we recognise that some patients may wish to explore the option of VAD while under our members’ care. In that event, our services will never block or impede a person’s access to VAD if that’s their choice. Our services will always respect patient choice.

“When it comes to end-of-life, our members choose to specialise in palliative care. Other hospital providers choose to maintain an expertise in VAD. Transferring patients to a specialist provider when a service is not available is standard practice in the public health system.”

Dr Eliana Close, a senior research fellow at the Australian Centre for Health Law Research, has analysed institutional objection to euthanasia and says it is difficult to get data on how prevalent it is.

“We need to now see research and monitoring around how legislation in different states is unfolding and working in practice and whether rights are being respected,” Close says.

“We have certainly found we need stronger national laws to address that power imbalance between institutions and individual rights.”

Close says she finds it “completely abhorrent that publicly funded institutions should be allowed to deny access to legally available healthcare”.

“Not only is that causing harm to the patients in terms of pain and suffering, it’s causing harm to their families who have to witness it – and that has lasting impacts on their bereavement.”

* Names have been changed

Complete Article HERE!