Category: Cultural Expressions

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At 83, this patient advocate is still passionate about end-of-life care in Maine

Eddington resident Pat Eye was instrumental in starting hospice services in the Bangor area -- first at St. Joseph Hospital, then at Eastern Maine Medical Center, and finally her own New Hope Hospice in Eddington.
Eddington resident Pat Eye was instrumental in starting hospice services in the Bangor area — first at St. Joseph Hospital, then at Eastern Maine Medical Center, and finally her own New Hope Hospice in Eddington.

By Meg Haskell

EDDINGTON, Maine — Back in the 1980s — not all that long ago, really — hospice was essentially unknown in this country. Death, fearsome and mysterious, was a taboo topic in the health care setting. Doctors, trying to live up to their omnipotent reputations and avoid lawsuits, employed all possible measures to save lives, even when there was little or no hope for a cure, even at the natural end of a long life.

Patients with a terminal diagnosis often were not even told they were dying. They were hospitalized and endured painful, exhausting and expensive interventions instead of being provided with dignity, comfort and support in their final days. Because the focus was on cure, not comfort, their pain and anxiety often were poorly managed. Family members were also kept in the dark and found little support in preparing for loss or responding to grief.

Much has changed over the course of the past few decades. All over the country, hospice care is now a welcome, accepted and affordable model for providing comprehensive comfort and support to the dying and their loved ones while also cutting unproductive spending in the health care system.

While many factors have played into the rise of hospice nationally, no one has been more instrumental in bringing about this critical change in the northern half of Maine than area resident, registered nurse and passionate hospice advocate Patricia Eye.

Eye, a native of Machias who trained at Eastern Maine General Hospital School of Nursing, spent years traveling the globe in connection with her then-husband’s diplomatic career. She found ways to practice nursing wherever they were posted. She had encountered a hospice-like philosophy of care in other countries and while working at a children’s hospital in northern Virginia. It was in Virginia, too, where she first encountered the teachings of end-of-life advocate Elizabeth Kubler-Ross, whose revolutionary 1969 classic, “On Death and Dying,” sought to normalize death and outlined a five-stage process of healthy grieving.

“She was speaking my language about end-of-life issues,” Eye said during a recent conversation at her home. “That’s when I knew what I was going to do with the rest of my life.”

A patient advocate at heart

When Eye returned to the Bangor area in 1981, she encountered a health care community that had barely begun to grapple with end-of-life issues. A group calling itself COPES — no one seems to remember now what the acronym stood for — was meeting at Eastern Maine Medical Center, trying to organize a nonmedical, all-volunteer system of home-based support for dying patients. Beyond that, there was silence on the issue of hospice.

But by the time Eye semi-retired last year, there were at least five agencies delivering Medicare reimbursable hospice services in the Bangor area, helping thousands of residents of all ages live out their days and die peacefully in their homes. Eye has been a persuasive presence throughout this growth period, providing direct patient care, helping organize several of the agencies, working toward all-important Medicare certification and, in 1994, establishing her own agency, New Hope Hospice in Eddington.

“Some people’s personalities just resonate at a level that is deep and reflective,” Kandyce Powell, the longtime director of the Hospice Council of Maine, said. She’s known Eye professionally “for so long I can’t even remember,” she said. “Pat’s heart and soul have always been sensitive to the deepest needs of the people she cares for.”

Despite Eye’s soft-spoken ways and gentle demeanor, Powell said, she has been a determined advocate for the business-side growth of hospice, from the all-volunteer COPES model to a more structured and regulated system that is now paid for and supported by Medicare, Medicaid, veterans benefits and most private insurances. That transition has been critical to the expansion and consistency of hospice care across Maine, Powell said, and its availability to all Mainers regardless of ability to pay.

At the bedside, in the conference room and in policy debates, Powell said, “Pat has always been an advocate, ethically and morally, for the right to die. She has always done what was best for her patients.”

What is hospice?

Hospice, a longtime option in Great Britain and some European countries, is an end-of-life model that promotes the comfort and dignity of terminally ill patients over the possibility of cure. Originally considered an alternative for the very elderly and individuals with incurable cancer, hospice care is now available in this country for patients of all ages with any kind of untreatable, terminal illness.

Hospice provides highly individualized medical, emotional, spiritual and practical support for patients with six months or less to live and for their families and loved ones. Services, both paid and volunteer, are coordinated by the providing agency and delivered in the home, in a residential facility such as a nursing home or in a specialized hospice residence. Additionally, some hospitals set aside space for the delivery of hospice services to inpatients who cannot be adequately cared for at home.

In Maine, approximately 25 agencies deliver home hospice services, including medical and nursing care, clergy visits, social services, nutritional advice, visiting companions and more. Agencies also deliver equipment such as hospital beds, walkers and bedside commodes. Most agencies in Maine are nonprofit. Many are affiliated with larger health care systems; a few, such as New Hope Hospice, are independent.

In addition, there are four residential hospice “homes,” in Auburn, Scarborough, Rockland and at the Togus VA Medical Center near Augusta. A fifth hospice home will soon be built in Presque Isle. Greater Bangor doesn’t have one.

The artist's rendering of a building where Eddington resident Pat Eye is hoping to continue offering hospice services in Eddington.
The artist’s rendering of a building where Eddington resident Pat Eye is hoping to continue offering hospice services in Eddington.

An ‘evangelist for hospice’

It was not always like this, according to Sr. Mary Norberta, the former president and CEO of St. Joseph Healthcare in Bangor. Now retired and living in Connecticut, Norberta recalled that the Catholic organization in the early 1980s investigated the possibility of establishing an inpatient hospice unit at St. Joseph Hospital. Without a reliable funding source, it couldn’t work.

“We decided a home-based volunteer program would be more financially feasible and reach more people,” she said. Eye, who had been working on the cancer unit at EMMC and meeting with the COPES group there, moved over to St. Joseph to help set up the home hospice program.

“Pat and [social worker] Sr. Mary Romuald were the pioneers,” Norberta said. “They would trade off night shifts to sit with patients in their final moments.” In addition, the two recruited and trained a dedicated cadre of volunteers to help support patients and their families.

In those early days, Eye was persistent in telling patients the hard news of their terminal status, sometimes against doctors’ wishes. Patients must understand their condition in order to enter hospice care.

“She had tremendous compassion and she was never pushy about it,” Norberta said, “But she was always able to tell people the tough things they needed to hear.”

Dr. Toby Atkins, a primary care provider in Bangor for about 40 years, was also part of the hospice startup at St. Joseph Hospital. He recalled that there was early confusion about the role of hospice workers, who, unlike home health nurses, aimed to keep patients home instead of sending them back to the hospital when their conditions worsened.

“The whole idea of the ‘do not resuscitate’ order was just getting developed,” he said, and some health workers, including visiting nurses and ambulance crews, refused to honor it. Atkins, who now serves as the medical director at Community Health and Counseling Services in Bangor, said Eye was key in educating doctors, nurses and other providers about the intent and the importance of the DNR order, which allows terminal patients to die naturally without the trauma of medical interventions aimed at “saving” them.

“Pat was a real evangelist for hospice,” Atkins said. “She got right into her patients’ lives and provided lots of support, lots of services.”

Still looking ahead at 83

In 1984, Congress directed the federal Medicare program to pay for hospice care. With guaranteed funding — and no small amount of regulation and oversight — provider agencies have since blossomed across the country. Hospice, not long ago a controversial, hard-scrabble, grass-roots effort, is now a well-established and respected player in the national healthcare system.

These days, Eye lives with her son John, 52, and a menagerie of geriatric dogs and cats in a comfortable old farmhouse in Eddington. At 83, she remains active in her chosen field, providing community outreach and clinical support for New Hope Hospice.

She has weathered some deep sorrows. She lost her 58-year-old daughter, Connie, to cancer last year. Another child, her son Lance, suffered with mental illness and took his own life, years ago, at age 28. Her marriage ended in divorce in 1985.

But she has blessings, too. She had a leaky heart valve repaired recently but is otherwise in good health. She is close with her other daughter, Kitty, a nurse who works locally in long-term care.

She enjoys her life, her family, her home and all the pets — “They’re all rescues and strays,” she said — who share it with her.

And she continues to love her work. “To do this work, you cannot help but be close to God,” she said.

Thanks to all the traveling she did in the first half of her life, she feels at ease with many world religions. “It doesn’t matter. We all have the same god,” she said. “Religion really just gets in the way.”

If she has a burning wish, it is this: to see New Hope Hospice build the residential care facility she envisioned when it first opened for business.

“My theory is that every community should have a small, inpatient hospice home,” she said firmly, “even if it’s just two beds.”

She produced an architect’s drawing of an eight-bed, bungalow-style home. “We already own a lovely piece of land for it,” she said, brushing off the dust. “ And there’s such a need in this area. It’s just a matter of finding the money.”

And with that, it’s clear that nurse Pat Eye is still advocating for her patients, still intent on identifying and serving the end-of-life needs of Eastern Maine.

Complete Article HERE!

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Festival of dying: is your ‘death literacy’ lacking?

Lying in a satin-lined coffin or wearing a bondage hood may help you face up to your inevitable demise

 

The Sydney Festival of Death and Dying aimed to spark conversations about mortality.
The Sydney Festival of Death and Dying aimed to spark conversations about mortality.

By

[N]othing could evoke more gut-wrenching melancholy than Syrian musician Adnan Baraké playing the oud in a dimly lit boat shed at a festival of death. At least, that’s what I’m thinking right up until the moment a foghorn bellows ominously from some distant ocean liner, swamping us entirely in a sombre aura of doom.

It’s the opening ceremony at the inaugural Sydney Festival of Death and Dying – and it’s only going to get more macabre.

Held this past weekend, the festival was billed as three days of workshops, lectures, and performances that “do justice to the full spectrum of what is at stake in mortality”. Presented by Dr Peter Banki, he has compiled a line-up of peers such as anti-death-phobia advocate Stephen Jenkinson, designer of posthumous fashion Pia Interlandi, and president of Dying with Dignity NSW, Dr Sarah Edelman.

Together, they aim to illuminate all angles of death and dying: living with grief, dying at home, the afterlife, visions, suicide, and voluntary assisted dying, among others.

Nobody close to me has died, and my “death literacy” is lacking – I have a lot to gain from a weekend like this. In curatorial advisor Victoria Spence’s terms, I’m here to “build muscles in relation to mortality”.

Death is and perhaps always will be taboo, but it’s something we need a lot of help preparing for. Before we become a parent, we have months to get ready: we read books, we go to classes, we shop, we see a counsellor. When someone dies though, it’s often unexpected – but there are ways we can make the process easier, and they usually begin with a conversation. Or in this case, a festival.

Victoria Spence is a civil celebrant, consultant and former thespian. She begins her session – Developing Your Mortality Muscle – by explaining her objectives: to help us be aware of, and understand, our physiological responses to loss.

Death may cause us to fight, flee, freeze or submit, she says, but one response is pretty much guaranteed: shock. We react to death by abruptly drawing in breath; and in the rituals that surround death, we metaphorically hold it in. But if we’re prepared, if we learn to breathe, we can be properly present.

“When somebody dies, you put the kettle on,” she says. “That’s how you be with your dead.”

Having physical proximity with the deceased – being privy to their new smells, witnessing physical changes – activates a physiological response, changing the way we view our dead and encouraging the grieving process.

The Sydney Festival of Death and Dying allowed participants to get up close and personal with the accoutrements of death.
The Sydney Festival of Death and Dying allowed participants to get up close and personal with the accoutrements of death.

Victoria says being physically intimate with death can be crucial: bathing your dead person, or clothing them. Another way to be intimate is through language. We sit in groups to exercise our vocabulary of condolence: “I’m sorry”, “You’ll get through this”, “You will heal in time” – my phrases seem to avoid the moment, while others engage with it: “How does her death make you feel?”

Next we’re given the chance to get up close and personal with the accoutrements of death. I slink into a satin-lined coffin, and as the lid is repositioned I imagine the sound of dirt raining down on me. This experience builds no bridge to death, the same way being wrapped in toilet paper for Halloween brings me no closer to the experience of mummification. But it does make me wonder about alternative burial rites.

In another session, Dr Sebastian Job creates a simulation where participants “face the worst” ahead of time. By inflating a balloon until it bursts we experience a symbolic death, he says, allowing us the opportunity to process death anxiety and life regret. He hopes this jolts us from social paralysis into affirmative action.

Have you ever thought about what song you want played at your deathbed? Peter Roberts is a music thanatologist; he plays music for people who are at the end of their life. In this session he discusses how music can help dying people to let go – and several have during his service.

Tempo tempers breathing, and tone and timbre can quell fear, he explains; his use of vowel sounds, not words, can offer uncomplicated companionship, and provide the dying an opportunity to abandon their pain-riddled bodies and follow with their mind, travelling peacefully with the harp’s melody.

 


 
Palliative care physician Dr Michael Barbato has devoted a significant part of his life to the exploration of dreams and visions at the end of life. He believes that we overlook the mystic elements of death and dying simply because they appear too “fringy”.

He quotes a study that found up to 50% of respondents believed their dying loved one was experiencing unusual visions. The study quoted was his own – the Palliative Medical Journal refused to publish it because, he says, it was too fringy. His talk is entertaining and peppered with emotive stories, but it lacks the scientific substance I require to get into the moment.

Dr Peter Banki, the festival director, believes proximity to death can make us feel alive. He says we often use words such as pain, fear and submission when describing death. One of his workshops, Thresholds and Lust, is an intersection of both his festivals – this Festival of Death and Dying, and his prior Festival of Really Good Sex. It is designed to playfully evoke death-related emotions from willing participants.

A bondage hood is placed on my head, suffocating my senses. My partner manipulates my head and body, she runs her hands over my arms and head (submission). I can’t help but wonder what everyone else around me is doing – are they watching (fear)? The heat bakes my gimp head like a potato jacket, while my body is uncomfortably contorted on the pungent floorboards (pain). I tap out.

I’m not yet ready to yield to the vagaries of dying, whether real or imagined, by the festival’s end – but I do notice I’ve begun cultivating a relationship with death that I’m thankful for. Perhaps more importantly, I’ve also observed friendships forming, information exchanged, and future plans being made – the festival of death has facilitated the birth of a community. We are all dying, after all.

Complete Article HERE!

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A 9,000-year-old axe sheds light on burial practices

Ireland’s earliest burial site gives up the secrets of our hunter-gatherer ancestors

By Fiona Gartland

Situated on the banks of the river Shannon at Hermitage, Castleconnell, the burial site
Situated on the banks of the river Shannon at Hermitage, Castleconnell, the burial site

[A]nalysis of an axe that is more than 9,000 years old, found at Ireland’s earliest burial site, in Co Limerick, has shed light on the ancient burial practices of our hunter-gatherer ancestors.

Archaeologists believe the highly-polished stone axe, known as an adze, was made especially for the funeral of a very important person, whose remains were cremated and then buried at the site.

Microscopic analysis has revealed the shale tool, believed to be the earliest fully polished adze in Europe, was only used for a short time, and then deliberately blunted.

Situated on the banks of the river Shannon at Hermitage, Castleconnell, the burial site, dating back to between 7,530 and 7,320 BC, is twice as old as Newgrange.

It was discovered 15 years ago, and contained burial pits holding the remains of individuals who had been cremated.

Artefacts recovered from the earliest pit were recently analysed by a team from the Department of Archaeology at the University of York, led by Dr Aimée Little. Their paper on the subject has been published in the Cambridge Archaeological Journal.

Speaking to The Irish Times, Dr Little said the discovery showed the general perception that people living in Ireland during the Mesolithic period were “just hunter-gatherers roaming around the island, chipping away at bits of stone” is completely incorrect.

Very complex behaviour

“You have really, very complex behaviour at play here, in terms of the making and treatment of the adze as part of the funerary rights,” she said.

“We make the argument it was probably commissioned for the burial and was probably used as part of the funerary rights, possibly to cut the wood for the pyre for the cremation, or to cut the tree used as the grave post marker.”

Dr Little said there were examples of other adzes partly polished in Europe which date from earlier, but nothing completely polished to such a high degree and with such a high finish.

Highly polished stone axe, known as an adze, especially made for the funeral of a very important person.
Highly polished stone axe, known as an adze, especially made for the funeral of a very important person.

“It is found on an island, which is incredible in itself . . . and it is actually found in a burial, which is even more remarkable,” she said.

She said it offered a rare and intimate glimpse into the complex funerary rituals taking place on the banks of the Shannon and how people were grieving their dead at this time.

Dr Little also highlighted the skill involved in the cremation itself, which would require temperatures of between 645 and 1,200 degrees.

“To achieve that level of cremation takes a lot of fuel and a lot of understanding of how to actually perform a cremation,” she said.

“A lot of time, and care, and effort went into collecting every single fragment of bone to put into the burial.”

Complete Article HERE!

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Dia de los Muertos (Day Of The Dead) 2016

[M]ore 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.”

Complete Article HERE!

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African version of assisted dying is forgiveness

To fully appreciate the concept of assisted dying among African cultures requires that we decolonise death and dying, writes Sibonginkosi Mazibuko.

In a video released earlier this month, Archbishop Emeritus Desmond Tutu stated that he supports the right of individuals to an assisted death. The writer says the African version of assisted death ensures the individual who lived wickedly is forgiven and can join their ancestors.
In a video released earlier this month, Archbishop Emeritus Desmond Tutu stated that he supports the right of individuals to an assisted death. The writer says the African version of assisted death ensures the individual who lived wickedly is forgiven and can join their ancestors.

Johannesburg – The burning question of euthanasia (assisted dying) has recently been in the spotlight again, but sadly the whole debate appears to ignore other cultural perspectives.

The concept of assisted dying is not really foreign to other cultures. To fully appreciate its essence among the cultures of African people – in South Africa in particular – requires that we decolonise death and dying.

Colonial teachings on death and dying revolve around the concepts of heaven and hell. Heaven and hell represent the Western epistemology of understanding dying and death.

The pain the sick endure is understood through Western thinking while ignoring and undermining other forms of knowledge.

Some African people believe that all dead people join their ancestors. It is believed that dead people are actually not dead. They live in another world where they give guidance to those still living on Earth.

However, access and acceptance in the place of the dead are not automatic. They are dependent upon one’s conduct on Earth. People who behaved in unacceptable ways, especially murderers and witches, are believed to struggle to meet their ancestors and, prior to confessing to their evil deeds, to find dying difficult. It’s submitted that such people suffer grave illness and pain to the extent that they wish for an early death to relieve the pain. Which is where the question of euthanasia comes in. There is a school of thought agitating for the laws of the country to be altered to allow such people to be assisted to reach death.

Their families must make the decision, with the elders calling the meeting to reach consensus. Then the sick can be assisted to die peacefully without euthanasing them at all.

It is also believed in some cultures that people who struggle to die are likely to be murderers and witches. The evil wishes and thoughts we hold for others also qualify us as such. Betraying your brethren to your enemies is an act as wicked as murder and witchcraft. The majority of traitors live with shame all their lives because they are rewarded by the enemy for betraying their own. But the wealth they get to “enjoy” grates on their consciences. They appear to be happy but they are bleeding from shame on the inside for evil acts they find it difficult to confess to. So they live heavily conflicted lives.

Think of a traitor whose hands are bloodied because they sold out their own to the enemy. They live luxuriously at the expense of others. In South Africa, for example, people betrayed the liberation struggle in many ways. They accepted money from those that killed their own. That is why it’s believed the ancestors should be angry with these people.

To be freed from the burden of a heavy conscience requires that the person confesses and sometimes this will involve physical cleansing. Otherwise these people die long and painful deaths. No medicine works until they confess to their evil deeds.

Such people usually have difficulties when they are supposed to die. Some African cultures resolve this by asking the person to confess. During the confession, only the close family is allowed near the dying person to hear their secrets. The dying person may also request that people they wronged be called in so they can apologise to them. If they refuse, they become the guilty ones while the evil-doer departs with a clean conscience.

At another level, the dying person may be required to apologise to the ancestors for actions that may have been unacceptable to the dead. The family slaughter an animal to appease the ancestors and the elders conduct the ceremony and plead for forgiveness of the sick person, requesting that the ancestors allow the person to join them in the after-death world. Usually the sick person does not live another day.

For me, then, such conversations’ with death assist a sick person to die peacefully. There is no poisoning. The dying individual only has to confess to their evil deeds to depart with a clean conscience. Those left behind are required to let go of any wrongdoing the dying person committed in their lives.

In these terms, euthanasia is not necessarily a strange thing. It may be that we only need to embrace our cultures and bring back good practices and beliefs colonialism made us discard. In fact, many African people still practise them.

The African version of assisted death ensures the individual who lived wickedly is forgiven and can join their ancestors. Otherwise it’s believed they become bad spirits wandering on Earth without a place to rest. We call them ghosts.

Complete Article HERE!

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Things not to say to mourners (and some things you can do instead)

by Esther D. Kustanowitz

black-and-white-person-woman

When friends announce on Facebook that a loved one needs prayers, or is in the hospital, or that they’re going through a hard time, I get a sinking feeling. And while recovery sometimes happens, sometimes, it doesn’t. So when I read, “I am heartbroken to announce …,” my heart breaks, and the pain of my own loss reawakens, in sympathy for the end of a life and for what is to follow for those still with us — a year mourning the loss through text, ritual and the communal embrace that is vital, but stands in contrast with grief’s frequent companion: a stark and searing sense of solitude.

Death is part of the organic fabric of life, our liturgy tells us, arriving sometimes in a timely manner and sometimes in a shocking and unexpected instant years or decades too soon. But regardless of the individual circumstances surrounding a loss, family members and friends are left to mourn and to try to move through the grief to live their lives in a new normal.

Jewish rituals provide a year of structure for rudderless mourners, with customs that encourage communal engagement while acknowledging that the year is one in which the mourner is set apart from and different than the embracing community. While this state traditionally lasts a prescribed year, in emotional reality, it tends to linger. Five years after my mother’s death, when people check in on me, I’m grateful; Judaism says that I have been done with mourning for the span of a college education, but that doesn’t mean I’m back to the me I was before. It doesn’t mean that my mother’s absence from the world doesn’t affect me anymore. It’s just different.

I remember those first few months, and how many people, hoping to utter words of comfort, instead spewed forth words of frustration, anger, pain and even insensitivity. They were probably as appalled as I was, but I know — and I hope they know that I know — that their hearts were in the right place. I believe they were so concerned about saying the wrong thing that they often said something even less appropriate.

Each mourner is different. Each grief circumstance is different. Each person finds comfort differently, in different gestures and phrases. But here are seven things — in honor of the traditional seven days of shivah — that everyone should try to avoid saying, along with a few things you can do or say instead to express your love and concern for someone who is experiencing a loss.

Avoid awkward moments engaging the mourner, conversationally or physically. There’s a tradition to leave the conversational initiative entirely to the bereaved, to wait until he or she wants to speak. Some mourners crave the physical embrace of community, while others prefer a spiritual support and company, but not literal embraces (especially from virtual strangers). While challenging to all of us who love words and fear silence, or who are more inclined toward long and crushing hugs to convey what’s in our hearts, sitting quietly in a room next to someone who is grieving can send a powerful, wordless message of presence and support (even if you don’t touch).

“Read” the mourner and be mindful of your relationship with him or her. Are you a close friend, whose embrace the mourner may be expecting, or are you an acquaintance who hugs as an alternative to conversation? If you’re concerned about the potential awkwardness of your physical or verbal interaction, ask the rabbi or a relative what kind of support the mourner may want. You can also ask the mourners if they would like a hug, and don’t be offended if they say no — not everyone wants to be touched by everyone.

Avoid commentary about the illness or the last moments of the deceased. “At least your loved one’s suffering is over” falls into a category of things that people inside and outside the immediate family may think quietly, especially if the deceased has been through a long or public illness, but should not say. Similarly, “at least s/he didn’t suffer,” or “what a blessing that it happened so fast.” You are not the coroner, so don’t offer your opinion on the cause of death or its nature. Instead, sit quietly with the mourner for a while — if there’s an appropriate opening, gently ask the mourner to share their favorite memories or most memorable moments.

Avoid making comments about the afterlife. In some religious communities, it’s comforting to devout people to think about their loved one being “in a better place,” “taking his place at God’s side” or (as I’ve heard religious Christians say) “going to Jesus.” But, emotionally, most mourners do not find comfort in this concept (especially “God needed another angel”). Is there an afterlife? Heaven? Hell? Olam ha-ba, where you study Talmud all day? No one knows; there are too many theological and emotional potholes in grief’s road to cover over with religious speculation about the afterlife. Instead, focus on this life: “I hope the community is the right kind of supportive when you need it. And I’m always available to help you.” (More on this in the next paragraph.)

Avoid: “Is there anything I can do?” Think about the vastness of the word “anything,” and the one thing it cannot include: the return of the lost loved one. Also, offers to help are something mourners receive in abundance at funerals and at shivah, but as time goes on, the offers trickle down to nothing. A year in, people who haven’t been through a loss themselves may assume you’re “fine.” And while you probably will be functional to some degree, at least, you’re probably not “fine.” Instead, if you’re offering assistance, get specific — grocery shopping, picking up kids from school or activities, baby-sitting so that the mourner can have some personal time. Specific offers give the mourner a chance to say “yes” or “no, thanks,” but without challenging them to think deeply about what they need and what you can and cannot provide. And if you’re a friend who really wants to be supportive, offer assistance even after shivah, or during the year of mourning, or beyond, after the offers have faded away but the need for support remains.

Avoid judgmental commentary about the funeral, the shivah or about how the mourner is grieving. 

In many communities, there is variation in how people participate in mourning rituals. For instance, traditionally, shivah is held for seven days (shiv’ah means “seven” in Hebrew) for a close blood relative (parent, sibling or, God forbid, a child) or a spouse, and in a designated year of mourning, traditionally mourners abstain from “celebration.” But some (especially the non-Orthodox) are altering these traditions to fit their lives: sitting shivah for an aunt, uncle or grandparent, or only observing a few days of shivah. People want to connect to Jewish meaning and tradition, but not necessarily in a strictly Orthodox halachic framework. Saying things like “you’re not supposed to” or “not allowed to” grieve in a specific way is counter-supportive: The function of shivah, in particular, is to help the community gather around a mourner for support, not criticize the depth of their feelings or the minutiae of their approach to mourning. So don’t render a judgment as to whether it’s appropriate or halachic. Instead, if you’ve ever been on the inside of a year of mourning, you can offer, “If you ever want to know what helped me, I’m happy to share.” And if you haven’t been, just be there and listen.

Avoid over-empathizing with the mourner’s experience and emotional state. While this comes from a good place, saying, “I know exactly what you’re going through” minimizes the intensity of the mourner’s emotional state and shifts the conversation to being about you. For most mourners, especially at funerals and during shivah, this is not comforting; it’s a negation of their special status in that space. Occasionally, people double down on these kinds of statements, following up with an anecdote about a deceased pet or another “loss” story that isn’t equivalent — because no story of loss is ever really equivalent. Instead, saying, “I can’t imagine how hard this is for you,” or “I know it’s not the same, but I have some experience with loss if you ever want to talk,” is a better approach.

Avoid using shivah as an excuse to badmouth the community or its members. While this might seem a simple enough thing to avoid, the essential awkwardness that people feel when trying to comfort a community member may result in people blurting out things that are unintentionally hurtful. This may include criticizing the eulogies or the funeral service, or gossiping about the community’s failure to let everyone know the funeral was happening. Listen to the mourner. That’s why you’re there, to offer presence, an ear, and words of consolation when you have them. In most cases, that’s enough.

May we all know only simchas. But in the unfortunately inevitable event of a tragedy, let us focus our love and respect on the needs of those who are in the center of the grief circle, and may we as community members take seriously the sacred privilege of helping those who suffer to know that they are not alone.

Complete Article HERE!

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7 Distinctly Southern Funeral Traditions

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Most funerals follow a fairly predictable series of events. Wearing conservative, dark clothing, sending flowers and respecting family wishes are all commonplace. But when it comes to Southern funerals, you can expect to see some distinct traditions and practices that set them apart.

So much food

The second it’s announced that someone in your family has passed away, expect people to be coming by non-stop with more food than you could ever consume. Most of it will be in the form of a casserole or freezer-friendly meal. Fried chicken, deviled eggs and pies are also common. In western Mississippi, there’s a tradition of giving Tomato Aspic, a circular, gelatinous dish.

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Respecting the procession

You’ll see this in other parts of the country as well, but Southerners take it seriously. When a funeral procession of cars is following the hearse to the cemetery, all other cars on the road pull to the side until the procession has passed. This is common courtesy (and sometimes the law) to honor the grieving friends and family members of the diseased. It’s a sign of respect.

A public affair

Forget about the funerals that include just immediate family and friends. In the South, it’s not uncommon to have people from all over the community show up at the memorial and wake. Funerals are a public event of sorts, and people attend them often, even for those whom they hardly knew.

Second lines

 

Second lines are a New Orleans tradition that still take place when a popular figure from the community or a musician passes away. You may have heard of second lines for weddings, and this is essentially the same thing. The community will grab their brass instruments and play music in a procession line, following the hearse on the way to the cemetery.

Grand florals

Sending flower arrangements isn’t specific to just the South, but the scale of the arrangements certainly are. Southern funerals can get very personalized also, so you’ll often find arrangements that pay tribute to the person who has passed. You’ll often see regional flowers like camellia blooms, abelia and magnolia leaves.

Lengthy services

You’ll likely never attend a church memorial that lasts less than a couple of hours. The minister is going to do a full service, and there will be a spirited sermon aimed at getting you to come to church more often.

Sitting up with the dead

There’s also a rarely practiced, but distinctly Southern, long-standing custom referred to as ‘sitting up’ with the dead. After a loved one has passed, the body remains in the home and is never left alone. At least one family member or friend sits awake with the body at all times until they are buried.

 Complete Article HERE!