Straight From The Patient’s Mouth

Videos Can Clearly State Your End-Of-Life Wishes

[F]or years, Wendy Forman, considered how to make her wishes known if she became horribly ill and couldn’t speak for herself.

She prepared a living will refusing cardiopulmonary resuscitation.

She assembled orders instructing medical personnel to refrain from putting in a feeding tube or placing her on mechanical ventilation.

She told her husband and her daughters “no lifesaving measures” under any circumstances if she were unconscious and incapacitated.

“I was terrified of losing control,” this 70-year-old Philadelphia therapist said.

Then, earlier this year, Forman heard of a Pennsylvania physician who was helping people prepare “video advance directives” — videotaped statements expressing their preferences for end-of-life care.

“I was like ‘Oh my God, it’s like someone was reading my diary — this is exactly what I want,’” she recalled.

Only a few U.S. organizations offer people the chance to create video testimonials, which are meant to supplement and expand upon written living wills and Physician Orders for Life Sustaining Treatment (POLST), now available in 26 states. Do-it-yourself videos are also a convenient option.

One organization doing pioneering work in this field is the Institute on HealthCare Directives, founded by Dr. Ferdinando Mirarchi, the Pennsylvania physician whose work Forman heard about. Others include MyDirectives, a Texas company that helps people create digital advance directives, including personal video and audio statements; Life Messages Media of Wisconsin, which also creates video memoirs and ethical wills, a way to share your values with your family; and In My Own Words, launched by a geriatric psychologist in California.

These organizations hope the videos will help physicians and families interpret and follow written advance directives. About one-third of adults have such end-of-life documents.

“It can give everyone confidence that Mom was competent and knew what she was signing and that no one tricked her by sticking a document in front of her and asking her to sign,” said Thaddeus Pope, director of the Health Law Institute at Mitchell Hamline School of Law in St. Paul, Minn.

Similarly, videos have the potential to ease some of the emotional angst that surrounds end-of-life decision-making. “A family gets to hear Mom saying, in her own words, what she wants, which can be profoundly reassuring,” said Dr. Monica Murphy, medical director of advance-care planning and end-of-life education for Huntsville Hospital System in Alabama.

Formats vary. The Institute on Healthcare Directives’ videos are carefully scripted and usually last 45 to 90 seconds. The goal is to convey essential information to physicians making crucial decisions (perform manual chest compressions? insert a breathing tube?) in time-pressed emergency medical situations.

Mirarchi helps draft scripts after taking a careful medical history, explaining various types of medical situations that might arise, and discussing clients’ goals and values in considerable depth. The cost: a one-time fee of $350, which covers 10 years of follow-up consultations and maintenance, or a setup fee of $50 to $100 accompanied by an annual fee of $35 to $50.

After consulting with the doctor, Forman realized her “do nothing” instructions could prevent her from being treated for medical crises that she might recover from. Now, her video states that if someone witnesses her having heart attack and she can receive medical attention within 15 minutes, resuscitation should be tried.

“I came to see that in my zeal to have my wishes known and respected, I was going to an extreme that didn’t really make much sense,” she said.

Easy accessibility to the videos is essential but may not be practical, yet. The institute houses videos on a server; they can be called up on digital devices via QR codes, or hyperlinked bar codes, that are printed on cards given to clients. (Forman carries hers in her wallet, next to her insurance card.) Passwords are discouraged because these might be a barrier in an emergency. Still, medical personnel aren’t accustomed to searching for cards of this sort.

Videos by MyDirectives clients also tend to be short — between 15 seconds and a minute. The service is free to consumers; the company’s business model relies on partnerships with health care organizations. “The consumer deserves to have their voice heard in electronic health records” that these organizations maintain, said Jeff Zucker, MyDirectives chief executive officer, who hopes that health systems will eventually embed patient videos in those records.

What weight video testimonials will carry in legal conflicts has yet to be determined. Only Maryland allows advance directives to be conveyed in a video format, while New Jersey explicitly recognizes video or audiotapes as supplements to written documents, according to the American Bar Association’s Commission on Law and Aging.

Multimedia advance directives likely will be taken into account in end-of-life disputes, just as a daughter’s statement that “Mom told me this is what she wanted last week” is given consideration, Pope said.

“Since the only thing that constitutes clear and convincing evidence under the law is the written advanced directive, make sure your video is consistent with what’s expressed in these documents,” he advised.

Physicians seem receptive to the videos. According to a study published this year, doctors were more likely to agree about recommended treatments for patients in difficult circumstances after viewing patient videos, as well as evaluating written advance directives.

“Doctors always question whether we’re doing the right thing when it’s just the paper document,” Mirarchi explained. “When you can see a patient expressing what their true intended wishes are, in their own voice, looking into a camera, that’s a very powerful tool.”

For their part, patients seem comfortable speaking before a camera, according to unpublished research conducted by Dr. Angelo Volandes, an internal medicine doctor at Massachusetts General Hospital and a pioneer in creating videos that help patients understand the pros and cons of end-of-life interventions.

Complete Article HERE!

They Comfort Strangers, So No One Dies Alone

David Wynn, 62, and Carolyn Lyon, 74, in Santa Ana, Calif., volunteer at a hospital where they accompany patients who are near death and don’t have loved ones to be with them in their final hours.

By Liyna Anwar

[W]hen patients are near death, and don’t have loved ones to be with them, David Wynn and Carolyn Lyon rush to the hospital.

“They have no one for various reasons, you know, they’ve outlived family, they’ve never married,” Lyon says.

For about six years, Lyon has been comforting patients in their final hours at St. Joseph Hospital in Orange, Calif.; for Wynn, it’s been about nine years.

“For some reason I always wonder about the person’s mother,” David Wynn says. “She saw him first, and I saw him last. It was her and me that are the bookends of this person’s life. So each time that I leave a patient who has died, there is this element of sadness.”

But this kind of work also has its rewards. Wynn remembers one man who was estranged from his family.

“I was sitting there with him and I heard somebody at the door. Turns out it’s his son,” Wynn says. “And he, I guess, felt a little bit uncomfortable, and so he asked me to stay.”

Then, the patient’s daughter came in. “These are people who hadn’t seen each other in maybe 10 or 20 years,” Wynn says.

While the family members exchanged apologies, Wynn recalls the daughter saying, “I don’t even know why I was angry at you, I don’t even remember.”

“And they said, ‘We’re going to try to be a family again,’ ” Wynn says.

“You know, we talk about the last senses to go would be the sense of touch and hearing,” Wynn says. “And I hope that there was enough left of the dad that he had some sense that this bad situation had been healed through his death.”

Wynn says he felt honored, simply to witness that reconciliation, at the end of the man’s life.

Complete Article HERE!

Illusions While Dying

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[I]n the hospital one afternoon, after unsuccessful surgery to remove her tumor, my mother drifted in and out of sleep. I sat on a sofa in her room with light from the window streaming in as I read email. My mother began talking to someone. I looked up.

My mother was an attorney. She dealt in realities. For most of my life, I knew her as a woman with few illusions. She did not kid herself, and she did not let me kid myself. She told my sister and me, when we complained about a situation, “Life isn’t fair.” So when she was diagnosed with pancreatic cancer, my mother approached it matter-of-factly because it was a matter of fact no one disputed. She researched pancreatic cancer online, came to terms with her odds and spent the next seven months maintaining as much control as she could.

Yet illusions sometimes came to her in those months. In that hospital room, she wasn’t talking to me but to people standing on the other side of her hospital bed, people invisible to me. They weren’t there, but she saw them. I couldn’t make out my mother’s words, only that there existed a pleasant back-and-forth going on. I was the first witness to her illusions.

I knew that, as a child, my mother had spent many days in the hospital for surgeries to correct bilateral club foot so she could walk. Her memories of that time included an imaginary friend whom she named after the model of hospital bed in which she had lain. As I watched her that day, I wondered whether John Standard had returned to her after all those years.

A few minutes later, my mother turned to me, fully alert. I asked whether she remembered the conversation she’d just had. Friends she hadn’t seen in a long time, she said, without going into detail. Then she tilted her head and added, “But they weren’t really here, were they?” I admitted that, no, they hadn’t been here. She said, “Well, it was a good conversation.”

My mother’s illusions were not delusions. She was not misled. The word “illusion” comes from the Latin “ludere” meaning “to play.” The word has longstanding negative connotations, as in a deception. But my mother’s illusions were her mind at play.

How different that was from my father’s delusions years earlier, when he was in the hospital undergoing cancer treatment. His gift balloon had become a spaceship, and he described to my mother a terrible war around him. He was caught up in it, afraid. One of the medications he’d been prescribed caused the delusions, and they subsided once it was stopped. But he said the scene had been so real that he couldn’t not believe it at the time. It still felt real after he knew it wasn’t. My mother could deal with anything in the physical world but couldn’t imagine how she would manage if my father lost his mind. By that, she meant his mind losing touch with reality. And she meant that his physical deterioration was enough for her to bear.

Later in her illness, at home, my mother began seeing medieval people on a hillside in her own bedroom. She enjoyed watching them, robed in their dresses and breeches, and she especially enjoyed the music they played. Flutes and mandolins. They even brushed large ostrich feathers and long veils over her skin. She didn’t know when these musicians would show up, but she welcomed them whenever it happened. She knew no one else saw these people or heard this music, and she didn’t care that it wasn’t real. I had some concerns but didn’t know what to do with them. I didn’t talk about these illusions in my book “Tumor” because I didn’t yet know how. There are so many concerns when someone is dying of cancer.

My mother and I talked with her oncologist about this new development, wondering whether such a thing was common in patients with cancer, perhaps the result of wasting or dehydration, two serious physical concerns at that point, or perhaps a side effect of one of the medications or chemo drugs. The oncologist asked several questions.

“No,” my mother said. “I’m not afraid of them. No, they don’t try to harm me. No, they don’t make me do things.”

The midsummer-night’s-dream people never talked to her and she never talked to them. She explained this arrangement as if such conversation would be crazy. Then, she said, “The music makes me happy.”

The three of us — my mother, her oncologist and I — decided this illusion was the least of our worries, that, in fact, medieval singers on a hillside were no worry at all. She had nothing to lose by listening, as long as she could hear the rest of us too. I was surprisingly relieved the oncologist did not want to treat this cognitive symptom because often physicians want to correct what deviates from the norm. He considered the larger context, the limited time, and told my mother to let him know if she stopped enjoying these visions.

This illusion, of course, might be considered a hallucination. The word “hallucination” comes from the Latin meaning “to wander in the mind,” originally akin to dreaming or allowing one’s thoughts to ramble. Hallucinations are now considered deceptions, not merely stray thoughts or daydreaming. To be sure, they can result from serious illness such as schizophrenia, dementia, epilepsy, Parkinson’s disease or migraines and make it difficult to function day to day. So hallucinations also came to be defined medically as distortions of sensory perceptions that the person experiencing them takes as real experiences. My mother, then, wasn’t really hallucinating because, though she accepted her experiences as real in her mind, she knew the people she saw and heard were not real in the world. She liked the touch of ostrich feather on her skin but didn’t think it existed in the world beyond her imagination.

Here was a woman who’d always shopped for a new outfit by picking what was paired on the rack because she was unable to imagine original combinations on her own. When my mother’s body weakened, when her body betrayed her, her mind said, “Let loose and enjoy the music.”

Even in that first observation of my mother’s conversation with friends who were not there, I was not upset that my mother was losing touch with reality or becoming less herself because she seemed at ease. Though they were unexpected and out of the ordinary, I became grateful for the odd joy my mother’s illusions gave her. What a practical thing for her mind to have done. I wish I knew how she did it. Any of us may someday face a similar illness. How fortunate my mother was able to conjure up happiness all on her own without denying the harsh reality of her condition. May we each find or conjure some music in our minds when we need most to hear it.

Complete Article HERE!

Ashes to Ashes, Stardust to Stardust

Delivering cremated remains to the stratosphere joins a growing list of new ways to memorialize the dead.

By Marina Koren

[M]ark Harris says funeral directors talk about it all the time. More and more people are growing tired of traditional funeral services and opting for something a little more creative. “It’s getting more difficult to offer the cookie-cutter send-off,” explains Harris, the author of Grave Matters, which examines how people have started to think, er, outside the box about death.

And so, Harris wasn’t surprised to hear that a new British company is offering to send cremated remains to the stratosphere. High-altitude latex balloons will float to 100,000 feet above the surface of the Earth, where the curvature of the planet appears against the darkness of space, and then release the ashes into the cold, creating a glittering display. “Scatter your loved one’s ashes in space,” Ascension Flights says on its website. “We are all made of stardust.” The stratosphere is not technically space, but for their purposes, it’s close enough.

Ascension Flights, run by funeral directors and a near-space launch firm, will soon offer its high-altitude funerals, with the cheapest package starting at £795, or about $1,040. For more money, customers can choose the launch site and have the scattering photographed and filmed

The near-space funeral is, at first glance, a contrast to “green” burials, which return remains to the soil in biodegradable coffins or urns. In this way, the deceased can meet “the green reaper,” as a Guardian article in 2014 colorfully put it, and contribute to the physical processes of the Earth. Blasting ashes into the stratosphere sure sounds like the opposite of that, but Ascension Flights promises some kind of return to the planet. “As the particles eventually return to Earth, precipitation will form around them, creating raindrops and snowflakes,” its website explains. “Small amounts of nutritious chemicals will stimulate plant growth wherever it lands.”

Harris, who favors going the natural route, said this promise seems considerably less certain than that of green burials, where at least “I wouldn’t have to worry about having my loved one’s ashes raining down from space on some random location like a landfill or a Superfund site or a nuclear power plant,” he said.

Both kinds of memorials are part of the same growing trend in end-of-life affairs, Harris said. People are becoming increasingly interested in how their physical remains, and the remains of their loved ones, will be handled. They want something more personal and more personalized.

These days, people can forgo metal caskets and be buried in bamboo or recycled cardboard instead, or have their remains wrapped in banana leaf, cotton, or wool. A company called Eternal Reefs will fashion an environmentally friendly artificial reef out of cremains—cremated remains—and drop it into the ocean for nearby marine life to populate. Cremains can be pressed into diamonds, incorporated into paint, and ejected as fireworks. The variety of options for the dead reflects the consumer culture of the living, says Phil Olson, a Virginia Tech professor who studies funeral practices, like the home-burial movement. “There are at least seven kinds of Coke, 500 kinds of cigarettes—options, options, options,” Olson said. Consumers want just as many choices in death as in life.

The option to send a loved one’s ashes to actual space has existed for several years already, for a steeper price than Ascension Flights charges. Since 1997, the company Celestis has flown missions into space delivering the cremains of dozens of people, including Star Trek creator Gene Roddenberry. The payload is launched inside a capsule to more than 300,000 feet, beyond the boundary of space, and eventually falls back to Earth.

While the concept of commemorating life’s final frontier in the final frontier may seem incredibly high-tech, the emotion behind it is no different than run-of-the-mill funerals on Earth. Funeral services can be, in the end, more for the benefit of those who are left behind than those who’ve passed away. They are about processing grief, and grief is personal. For some, the thought of sending their loved one’s ashes into the stratosphere is, simply, very fitting, and it’s difficult to pin down the exact reasons why.

Olson points to alkaline hydrolysis as an example of the funeral industry misunderstanding its customers. Providers of alkaline hydrolysis, which reduces bodies to skeletons in a liquid solution, believed the appeal of the process came from its eco-friendliness. They later found that the primary reason people gave for choosing hydrolysis was that they perceived it to be gentler than cremation. “For some reason, people see being dissolved in caustic alkaline as being gentler than being incinerated,” Olson said.

Perhaps having more options to memorialize the dead may ease the grieving process in some way, he said, even if it’s not clear exactly how.

“We can speculate all we want for people’s motivations for doing this, but we could be dead wrong,” Olson said of the high-altitude memorial and, when I laughed in response, quickly realized his choice of words. “Sorry, pardon the pun. I didn’t even notice that.”

What Happens Inside a Dying Mind?

[W]hat makes a person believe that he visited heaven? Is there a way for science to get at what’s really going on? In the April 2015 issue of the Atlantic, Gideon Lichfield mounts an empirical investigation of near-death experiences, concluding that more rigorous research must be pursued to understand what happens in the minds of “experiencers,” as they call themselves. One thing is abundantly clear, though. Near-death experiences are pivotal events in people’s lives. “It’s a catalyst for growth on many different levels—psychologically, emotionally, maybe even physiologically,” says Mitch Liester, a psychiatrist.


 
Complete Article HERE!

What ancient cultures teach us about grief, mourning and continuity of life

By and

[A]t this time of the year, Mexican and Mexican-American communities observe “Día de los Muertos” (the Day of the Dead), a three-day celebration that welcomes the dead temporarily back into families.

Festivities begin on the evening of Oct. 31 and culminate on Nov. 2. Spirits of the departed are believed to be able to reenter the world of the living for a few brief moments during these days. Altars are created in homes, where photographs

Altar to the dead in Yucatán, Mexico

and other personal items evocative of the dead are placed. Offerings to the deceased include flowers, incense, images of saints, crucifixes and favorite foods. Family members gather in cemeteries to dine not just among the dead but with them. Similar traditions exist in different cultures with different origins.

As scholars of death and mourning rituals, we believe that Día de los Muertos traditions are most likely connected to feasts observed by the ancient Aztecs. Today, they honor the memory of the dead and celebrate the continuity of generations through loving reunion with those who came before.

As Western societies, particularly the United States, move away from the direct experience of a mourner, the rites and customs of other cultures offer valuable lessons.

Loss of rituals

Funerals were handled in the home well into the 20th century in the U.S. and throughout Europe. Sometimes, stylized and elaborate public deathbed rituals were organized by the dying person in advance of the death event itself. As French historian Philippe Ariès writes, throughout much of the Western world, such death rituals declined during the 18th and 19th centuries.

What emerged instead was a greater fear of death and the dead body. Medical advances extended control over death as the funeral industry took over management of the dead. Increasingly, death became hidden from public view. No longer familiar, death became threatening and horrific.

Today, as various scholars and morticians have observed, many in American culture lack the explicit mourning rituals that help people deal with loss.

Traditions in ancient cultures

In contrast, the mourning traditions of earlier cultures prescribed precise patterns of behavior that facilitated the public expression of grief and provided support for the bereaved. In addition, they emphasized continued maintenance of personal bonds with the dead.

As Ariès explains, during the Middle Ages in Europe, the death event was a public ritual. It involved specific preparations, the presence of family, friends and neighbors, as well as music, food, drinks and games. The social aspect of these customs kept death public and “tame” through the enactment of familiar ceremonies that comforted mourners.

Grief was expressed in an open and unrestrained way that was cathartic and communally shared, very much in contrast with the modern emphasis on controlling one’s emotions and keeping grief private.

In various cultures the outpouring of emotion was not only required but performed ceremonially, in the form of ritualized weeping accompanied by wailing and shrieking. For example, traditions of the “death wail,” which allowed people to cry their grief aloud, have been documented among the ancient Celts. They exist today among various indigenous peoples of Africa, South America, Asia and Australia.


 
In a similar way, the traditional Irish and Scottish practices of “keening,” or loudly wailing for the dead, were vocal expressions of mourning. These emotional forms of sorrow were a powerful way to give voice to the impact of individual loss on the wider community. Mourning was shared and public.

In fact, since antiquity and throughout parts of Europe until recently, professional female mourners were often hired to perform highly emotive laments at funerals.

Such customs functioned within a larger mourning tradition to separate the deceased from the world of the living and symbolize the transition to the afterlife.

Rituals of celebration

Mourning rituals also celebrated the dead through carnival-like revelry. Among the ancient Greeks and Romans, for example, the deceased were honored with lavish feasts and funeral games.

Such practices continue today in many cultures. In Ethiopia, members of the Dorze ethnic community sing and dance before, during and after funerary rites in communal ceremonies meant to defeat death and avenge the deceased.


 
In not too distant Tanzania, the burial traditions of the Nyakyusa people initially focus on wailing but then include feasts. They also require that participants dance and flirt at the funeral, confronting death with an affirmation of life.

Similar assertions of life in the midst of death are expressed in the example of the traditional Irish “merry wake,” a mixture of mourning and celebration that honors the deceased. The African-American “jazz funeral” processions in New Orleans also combine sadness and festivity, as the solemn parade for the deceased transforms into dance, music and a party-like atmosphere.


 
These lively funerals are expressions of sorrow and laughter, communal catharsis and commemoration that honor the life of the departed.

A way to deal with grief

Grief and celebration seem like strange bedfellows at first glance, but both are emotions that overflow. The ritual practices that surround death and mourning as rites of passage help individuals and their communities make sense of loss through a renewed focus on continuity.

By doing things in a culturally defined way – by performing the same acts as ancestors have done – ritual participants engage in venerated traditions to connect with something enduring and eternal. Rituals make boundaries between life and death, the sacred and the profane, memory and experience, permeable. The dead seem less far away and less forgotten. Death itself becomes more natural and familiar.

Funerary festivities such as Day of the Dead create space for this type of contemplation. As we reminisce over our own losses, that is something we could consider.

Complete Article HERE!

Here’s what traditional funerals are like in the Philippines

Blindfolded bodies and hanging coffins – the unusual funerals of the Philippines

MANILA, PHILIPPINES – OCTOBER 31: A coffin is placed on a tombstone during a funeral at the Navotas public cemetery on October 31, 2011 in Manila, Philippines. The ‘Day of the Dead (Todos Los Santos), ‘All Saints’ Day,’ and ‘All Souls Day’ are feast days celebrated on the first and second of November each year in Latin cultures around the world during which family and friends of the deceased gather around these days at cemeteries to pray and hold vigils for those who have passed. In the Philippines, family members clean the tombs, leave flowers and often spend the night at the tomb eating and celebrating with loved ones.

By

[H]ere in Blighty, we tend to stick to the same tried and tested funeral traditions.

Save for religious elements, funerals in Glasgow aren’t too different from those in Preston; funerals in Wells are largely the same as funerals in Norwich.

This is not the case in the Philippines.

The country is largely Catholic (recent estimates suggest around 80 per cent) with a smaller demographic of Filipino Muslims. But in the more remote areas, tribal traditions, passed down over centuries, dictate some seemingly unconventional funeral customs that are practiced to this day.

From under-floor burials to hanging coffins, cigarette-smoking corpses to in-tree interment, each rite has the same intent: to offer the dead safe passage to the next life.

Blindfolds and cigarettes

Benguet is a landlocked province in the southern tip of the island of Luzon.

When someone dies here, friends and relatives start to convene at the deceased person’s house.

The body is cleaned, and a few of the men are dispatched to collect bamboo, which they then fashion into a chair – and this is where the body is seated.

Once secured in place with more bamboo and strips of cloth, the body is blindfolded so that the deceased does not have to bear witness to the suffering in the world.

A fire is lit to fend off insects and act as a beacon should the deceased’s spirit wander and be unable to find its way home.

This period lasts for eight days and, as you might expect, the body begins to decay.

This holds no fear for the Benguet people – in fact, they make jokes about the smell, and happily offer alcoholic drinks to the body during the mourning feast.

The night before the funeral, elders give a chanted, oral biography of the deceased and as the body is buried, mourners hit bamboo sticks together in the belief it will help the departed find their way to heaven.

The Benguet’s near neighbours, the people of Tinguian, also seat their dead in a prominent position, with a couple of small discrepancies: the Tinguian dress their deceased in their finest clothes then place a cigarette – which is frequently lit – between their lips.

For the llongot people in the mountains the east of Luzon, being seated is integral to burial, rather than the wake.

Corpses are buried sitting up and women have their hands tied to their feet to prevent their ghosts from roaming.

Home is where the heart is

The Apayao – also referred to as the Isnegs or Isnags – inhabit the area around the north of Luzon.

They live mostly along rivers, in large airy homes that sit atop wooden posts, and when they lose relatives, the custom is to bury them under the kitchen area.

It is a unique practice thought to be a sign of love and affection for the deceased.

A natural approach

Not all Filipino tribes keep their dead at home. Further north, the Caviteño have adopted an approach that returns their loved ones to the earth.

As they near the end of life, people of the Cavite venture into the forest and select a favoured tree.

As they ail, their family builds them a small hut in which the dying person will reside for their final days.

They are not alone: relatives and friends work to hollow out the chosen tree trunk as this is where the newly deceased will be buried.

The Cavite people return the deceased to nature as nature provided for them in life: trees are a source of fruit and fire wood that sustain life, so life is given back to the tree.

Closer to heaven

view of Sagada from the rice fields , a colourful village in north of Luzon island in Philippines South east asia

The people in the Sagada region have an interment ritual that is unusual, even among the Filipino tribes.

For more than 2,000 years the people in this mountainous area have hung their coffins from cliffs – coffins that are carved out of hollow logs by the elderly person about to make imminent use of it.

The theory is that by hanging the coffins in this way, the deceased are closer to heaven.

If a person is too frail or ill, the family makes the coffin on their behalf, and after the death the coffin is taken to a cave or hung to reach aspects of the cliff face, placed close to their ancestors.

Some of the coffins are more than a century old, which makes decay inevitable; the coffins eventually fall but this is part of the fulfillment of the rite.

Tourists are advised not to walk under the coffins, and certainly not to disrespect them by touching, but they they hold a unique beauty and can be observed using binoculars from a safe distance.

Ancient superstition

It may be less intensive, but it is customary for Filipinos to adhere to superstitions, or pamahiin sa patay, most of which are rooted in long-held beliefs.

These must be observed during the wake in order to avoid further deaths and bad luck in the family – and as Filipino wakes can last anything from a few days to a few weeks, this is no easy feat.

The Cebuano people have a long list of superstitions around death. They do not sweep the floor, lest the soul of the deceased be banished from the household.

Mirrors are covered, as it is feared the dead will attempt to show themselves in the reflection.

Mourners should avoid crying onto the glass screen of the casket, in case it impedes the spirit from journeying into the afterlife.

And should you sneeze during the wake, make sure someone pinches you – sneezing invites death but a pinch is meant to ward it off.

In the event of an unjust killing, a chick is placed on top of the coffin to bring justice.

While some of these traditions may seem unusual compared with the practices we have developed in the west, family is central to life and death in the Philippines.

The elderly remain at home until the end of life, which means most die surrounded by those they love – something the UK would do well to replicate.

Funerals are a chance for families to reunite, to reconnect and reinforce familial bonds, and often wakes are extended to accommodate overseas relatives.

Togetherness, family, grief and the comfort of ritual: mountains and oceans may separate us, but maybe we aren’t so different after all.

Complete Article HERE!