Category: Spirituality

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Confronting Death and Dharma at Brooklyn’s Green-Wood Cemetery

Can we shift our perspective on the reality of loss?

By Lauren Krauze

[W]hen I arrived at the main gate of Brooklyn’s Green-Wood Cemetery, I was greeted by two talkative green birds hopping and flapping about in the grass. I was surprised; the birds seemed bright and exotic compared with the pigeons, jays, and sparrows I normally see. I later learned that these playful birds are monk parakeets—a very fitting name given that I was attending an event called Death and Dharma, a lecture and meditation series co-presented by the Brooklyn Zen Center and Green-Wood Cemetery.

Green-Wood’s high, rolling hills and shady lawns offered a cool and quiet respite from the heat and hum of downtown Brooklyn. A group of about 40 people gathered on the grass near the cemetery’s Modern Chapel, a serene space for meditating and contemplating death and dying.

“Death is a fundamental question. It’s sometimes called ‘the big question,’” said Rev. Francisco (Paco) Genkoji Lugoviña, the founder and guiding teacher at the Hudson River Peacemaker Center. “There are lots of questions, actually, and no real answers. However, at age 78, I try to live each day with as much involvement and obedience to what emerges and go with it.”

Joining Lugoviña was Rev. Daiken Nelson, the founder and guiding teacher at the Pamsula Zen Center in Harlem. Nelson and Lugoviña are both teachers and priests in the White Plum Lineage of Taizan Maezumi Roshi and the Zen Peacemaker Order. As a pair that often teaches together, they were invited to share their insights with the Brooklyn Zen Center community.

“In the West, and particularly in the U.S., people don’t deal with death until they have to,” Nelson said. “They don’t think about it until someone they know passes away. I think it’s important to at least think about it before that happens and try to realize that it’s everyone’s fate.”

While the discussion was rich with teachings, stories, and koans from the Zen tradition, Nelson and Lugoviña also created space for people to briefly talk about their own relationships with death and dying. At the start of the discussion, they asked individuals to share one or two words that reflected their thoughts on the topic. While many people expressed a cautious wonder and curiosity about the topic, others shared words like “fear,” “uncertainty,” and “dark.”

Lugoviña didn’t seem very surprised. As a Zen teacher, he said that he often ventures into this very territory, especially in his conversations with people struggling with anxiety, depression, and suicidal thoughts. He also relayed a poignant story about his grandson, who passed away at age 23 after a methadone overdose. That experience taught him to reevaluate his intellectual understanding about death and shift toward a deep experience of gratitude.

“A friend of mine once told me she that she used to count her life by the number of summers she had left,” he said. “I think that’s a very poetic way to look at what we value in our lives and cherish what’s important to us.”

In a short work titled “Vulnerability,” acclaimed poet David Whyte writes, “The only choice we have as we mature is how we inhabit our vulnerability, how we become larger and more courageous and more compassionate through our intimacy with disappearance.” Nelson echoed this by imparting a teaching about impermanence and what can come of embracing the transient nature of experience.

“What I’ve been working with in my own practice is accepting whatever is arising,” he said. “We can learn to accept our inevitable passing, the passing of others, and the passing of this moment. Realizing something is just how it is—that it’s ‘just this,’ without it having to be any different—can give rise to freedom.”

At Green-Wood, humble gravestones and elaborate mausoleums dot the landscape, crowding some of the hills and valleys. The root of the word monument is the Latin word monere, which means “to remind.” These markers remind the living of the deceased’s name, life, and family, but for Nelson, the monuments reflect a more complicated reality that attempts to honor both the teachings of impermanence and the reality of human connection and loss.

“Once we are born, we exist, and then we spend our lives going to great lengths to express that in the world,” he said. “We spend a great deal of time and energy thinking about this self, or the ideas we have about awareness, consciousness, our connections with others, acceptance, and impermanence. Then people die, and afterwards, we want to live in the memory of them, whether it’s through their accomplishments, their stories, or things we build to honor them.”

He then introduced a teaching from Bankei, a 9th century Chinese Zen master. While recovering from a serious illness as a young man, Bankei realized his existence was nothing more than a moment-by-moment experience. He framed his realization about life as “the unborn.”

“He taught us that nothing is ever born and nothing ever dies,” Nelson said. “Life is a moment-by-moment arising and falling away. So, he said, don’t get born. Don’t fall into identification as me or you, as young or old, as a woman or a man. Even our habits are not part of our original being. Everything is unborn. Why not abide in that?”

He then looked around and chuckled.

“What better place to talk about the unborn than a cemetery?”

Many of us laughed, too. Later, during meditation, I tried to focus on the sounds and sensations I was experiencing: the gentle breeze rolling off the back of my neck, the cool grass under my feet, the soft breathing of my friends around me. At one point several birds cried out, asserting their place in the world before settling in for the evening.

I began to realize that it is possible to sit in a cemetery—a place so deeply associated with death and loss—and feel very much alive. I also understood this as something I can practice on a regular basis; when I find myself sinking into mental, physical, or emotional places of decay, I can work to more directly experience my own vitality as I honor the complicated thoughts of fear and doubt swirling within me.

By the end of meditation, the sun had dipped below the Upper New York Bay. In the lingering warmth of the afternoon, I found myself wondering how many more summers I have left. In that same moment, however, I was able to shift my perspective and realize: I am here, right now, breath-filled and conscious and capable of so much. As my friends and I walked out of the cemetery, I took comfort in their singsong voices echoing in the open twilight sky. I also noticed a pigeon’s glowing red feet, the cemetery security guard’s half-smile, and the first fireflies brave enough to shine their lanterns and welcome the night.

Complete Article HERE!

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The Christian case for assisted dying

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[B]efore and after photos of Frenchwoman Chantal Sebire motivated me, in 2009, to become public in advocating, as a Christian, for the terminally ill to be shown Christian empathy, love and compassion, and to be given an additional choice when even the best palliative care cannot ease their futile suffering.

Chantal, who had an aggressive nasal cancer, that had left her blind, her jaw disintegrating and suffering “atrocious pain”, was pleading for assistance to die.

Since then my views have been reinforced by Christians far more theologically qualified than I am, and many examples of futile suffering sent to me by Christians who have watched loved ones dying inhumanely, asking how can this be compatible with Jesus’ message of love.

Catholic theologian Hans Kung, in his book A Dignified Dying states:

As a Christian and a theologian I am convinced that the all-merciful God, who has given men and women freedom and responsibility for their lives, has also left to dying people the responsibility for making a conscientious decision about the manner and time of their deaths. This is a responsibility which neither the state nor the church, neither a theologian nor a doctor, can take away.

Anglican Archbishop Emeritus Desmond Tutu has written:

I know that we will all die and that death is a part of life. Terminally ill people have control over their lives, so why should they be refused control over their deaths? Why are so many instead forced to endure terrible pain and suffering against their wishes?

Regardless of what you might choose for yourself, why should you deny others the right to make this choice? For those suffering unbearably and coming to the end of their lives, merely knowing that an assisted death is open to them can provide immeasurable comfort.

In refusing dying people the right to die with dignity, we fail to demonstrate the compassion that lies at the heart of Christian values. I pray that politicians, lawmakers and religious leaders have the courage to support the choices terminally ill citizens make in departing Mother Earth. The time to act is now.

Complete Article HERE!

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Dying is a Sacred Act

by Frank Ostaseski

[M]irrors reflect the truth of what strikes their surface. The eyes of a dying patient are the clearest mirrors I have ever known. In their gaze, there is simply no place to hide. Over the years, the habits of my life have been reflected in those eyes.

Once while washing the back of a hospice patient named Joe he turned toward me and said, “I never thought it would be like this.” I asked what he had thought it might be like. He answered, “I guess I never really thought about it.” Death had taken him by surprise. Perhaps we are not so different.

In the sacred, Hindu epic poem the Mahabharata there is a question that speaks to this tendency. “In all of the worlds what is most wondrous?” The answer that is given is; “That no man no woman though they see people dying all around them believes it will happen to them.”

We make an enormous effort to keep death at arms-length. We spend more than 50% of our healthcare dollars in the final six months of life, literally throwing money at death. We shut away our elders in nursing homes to avoid confronting their pain and our destiny. We have a multi-billion-dollar cosmetics industry that tries to keep us all looking young. We even put rouge on people in the coffin.

Death is the fulcrum issue of our life and yet we can barely use the word. People don’t die they “pass away” or they “expire” like credit cards. We make plans for all sorts of activities; when to get married, the number of children we will have, where to go on vacation, which career moves to make or how we will spend our retirement—all of which may never happen. But death, the one event that is certain to occur, barely receives a sidelong glance.

Dying is at its heart a sacred act; it is itself a time, a space, and process of surrender and transformation. The sacred is not separate or different from all things, but rather hidden in all things. Dying is an opportunity to uncover what is hidden.

Walking the gauntlet of thirty beds on the long single hospice ward at Laguna Honda Hospital, I noticed Isaiah out of the corner of my eye. An African-American man raised in Mississippi, Isaiah was actively dying. His breathing was labored, and he was sweating up a storm. I sat down next to him.

     “You look like you’re working really hard,” I said.

     Isaiah raised his arm, pointed to the distance, and said, “Just gotta get there.”

     “I forgot my glasses. I can’t see that far in the distance. Tell me what you see.”

     Isaiah described a bright green pasture and a long hill leading to a grassy plateau.

     I asked, “If I promise to keep up, can I come?”

He grabbed my hand tight, and Isaiah and I started climbing together. His breathing got shorter, and he perspired more with every step. It was a long walk. Not an easy one.

     “What else do you see?” I asked.

He described a one-room red schoolhouse with three steps leading up to a door.

My training informed me that Isaiah was disoriented to time and location. I could have told the old man that his visions were likely being caused by brain metastasis and morphine. I could have reminded him that we were in a ward at Laguna Honda Hospital. But that was only true on the most superficial level.

The deeper truth was that we were walking to a little red schoolhouse.

     I asked, “Do you want to go in?”

     Isaiah sighed. “Yeah. I’ve been waitin’.”

     “Can I go with you?” I asked.

     “Nope.”

     “Okay, then, you go,” I said.

A few minutes later, Isaiah died quite peacefully.

The great spiritual and religious traditions have any number of names for the unnamable: the Absolute, God, Buddha Nature, True Self. All these names are too small. In fact, all names are too small. They are fingers pointing at the moon. I invite you to connect with what you know and trust most in your heart of hearts.

I use the simple term Being to point at that which is deeper and more expansive than our personalities. At the heart of all spiritual teachings is the understanding that this Being is our most fundamental and benevolent nature. Our normal sense of self, our usual way of experiencing life, is learned. The conditioning that occurs as we grow and develop can obscure our innate goodness.

Some part of us, deep in our hearts has known this truth. If not, we would not long for a return to it. And this part of our being knows that we will never be satisfied until our whole being is immersed in this oneness.

Complete Article HERE!

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A Quaker Approach to Living with Dying

By Katherine Jaramillo 

[I]’ve been present with hundreds of people as they’ve died, hundreds more who were already dead by the time I was paged, and hundreds more who were in their dying process. I’ve accompanied spouses, parents, children, friends and family members as they’ve experienced the horror and sorrow of grief. For the past 20 years, I’ve been a chaplain, mostly in hospitals, a few with hospice. In doing this work, I’ve crossed death’s path more often than I can count as I’ve zigzagged my way through the hospital corridors and in the homes of folks experiencing the last days, weeks, months of life. Those of us on the interdisciplinary healthcare team struggle, as best we can, to provide our dying patients with a “good death,” however they and their families define such. There’s a saying in healthcare, “People die as they have lived.” Sometimes that is not the case, but, more often than not, that’s the way it goes.

Often, Quakerism is defined as a way of life. Some questions that I have carried for years in the ministry of chaplaincy include the following:

  • What does our Quaker faith and spirituality offer us as we face decline, diminishment, and death?
  • What can we say, as Quakers, with regard to dying and death as a personal and spiritual experience?
  • Is there a Quaker way of dying? How do we, as Quakers, do this?

My formative experience with regard to the Quaker way of dying was by accompanying a Friend through her decline and death. Her final illness, dying process, and death were Quaker community and meeting experiences. Her experience wasn’t a private or family-only affair. When she couldn’t come to meeting, small groups of Friends were dispatched to her home, hospital, or nursing facility to have meeting for worship with her. Friends from meeting stayed with her overnight in the hospital when she had to be on the breathing machine and was so uncomfortable and scared. She had a committee of trusted Friends who arranged for her practical needs when she was still able to live independently, including staying with her 24/7 when just home from the hospital and at times of extreme debility. These Friends helped with discernment regarding transition from independent living to a skilled nursing facility. In what turned out to be her final hospitalization, these Friends helped her discern her choice to decline heroic life-sustaining treatment and allow herself a natural death. Friends reflected with her about her desire for integrity and living in alignment with the testimonies, her beliefs about an afterlife. She was afforded the opportunity, though her Quaker way of living, to proceed to a Quaker way of dying. One First Day, as we knew death was approaching, our meeting of about 80 Friends decided to meet in a hospital conference room for worship. About halfway into the worship hour, a Friend came downstairs to announce our Friend’s death. It was a gathered meeting. Our Friend died the way she had lived.

Last year, desiring conversation on these questions, I facilitated an interest group I called “The Quaker Art of Dying” at the Pacific Northwest Quaker Women’s Theology Conference. The conference brings women together from the divergent Friends traditions in the Pacific Northwest, primarily from Canadian, North Pacific, and Northwest Yearly Meetings, as well as other independent meetings and churches, to articulate our faith and to learn from each other. The group was well attended and diverse. I presented three queries to the group for discussion. We broke into small groups each taking one of the queries, then reconvened into the large group to get the bigger picture.

What is a Quaker approach to declining health, dying, and death?

[F]riends reported their understanding that all life is sacred and Spirit informs all life. A Quaker approach would be a mindful, conscious, and prepared approach, with an excitement—or at least a willingness—to enter the mystery of death. It was agreed that a Quaker approach would involve less denial that someone is dying or that death is imminent. There is a value for listening, hearing one another’s experiences, and entering new situations with curiosity, not offering answers. Especially for Liberal Friends, but for some Evangelical Friends as well, there was less focus on an afterlife. A Quaker approach would be a well-ordered approach, with orderly records, legal documents, and final letters and lists of wishes. Friends agreed that cremation was customary and in alignment with Quaker values. The writing of a memorial minute was another Quaker tradition to document the passing of a Quaker life. As one Friend stated, “The Quaker approach is portable; you can take the heart of the Quaker way wherever it needs to go.”

How do our beliefs, testimonies, and values inform our approach to the end of life?

[F]riends agreed in their understandings that we have a direct connection with the Divine. Some Friends voiced a lack of fear about death. Others voiced fears about the decline of physical and cognitive abilities and the actual process of dying, such as the possibility of pain, loss of competence, being a curmudgeon, or depleting family resources. One Friend likened the burdens of dying to birthing: “Both are hard work.” Friends agreed that upholding the dying person in community benefits the community as well as dying person. Friends voiced an intention to allow support and presence of others as we approach the end of life, as well as taking all the alone time we need.

How can we prepare for death? Our own and that of our loved ones? A list emerged.

[W]e need to:

  • Pray.
  • Think about what we want.
  • Talk about what we want, even though it is difficult, especially with our children.
  • Talk about what others want.
  • Talk with our families about our wishes.
  • Pray some more.
  • Deal with unfinished business—either finishing it or leaving it unfinished, but dealing with it intentionally.
  • Educate ourselves about health decline and the dying process by reading books like Atul Gawande’s Being Mortal.
  • Talk with our spouses or significant others, about things we’ll need to know if they can’t tell us themselves for whatever reason.
  • Prepare for the process:
    • Who do we want involved? Who do we not want involved? Do we want a care committee or not?
    • How do we want our remains disposed? Do we prefer cremation or burial? If we want to be cremated, do we want our remains to be scattered, interred, or buried?
    • What do we want for a memorial or funeral?
    • Do we want an obituary; a eulogy? What would we want said in our memorial minute?
  • We need to help meetings and churches be prepared for the decline, debility and deaths of their members and attenders.
  • Keep praying.

This conversation continues. In a recent meeting of our Quaker women’s discussion group, I facilitated a robust discussion about a Quaker approach to end-of-life issues and posed similar queries to the group. Evangelical Friends spoke of the “continuum of life” that transcends death, the need for “being right with God,” and the peace that “being with Jesus” will bring. Liberal Friends spoke of “entering the mystery” and “going into the Light.” There seemed to be agreement and assurance that “all will be well” at the end of physical life. Some women focused on the need to enter this time of life with their “affairs in order.” Other women spoke of their experiences accompanying a dying person in their meeting or church or in their own families. All seemed to enjoy the discussion of “things we don’t usually get to talk about” and voiced an intention to encourage further discussion in our churches and meetings. Later this month, I will attend my own meeting’s retreat where the topic will be “Spirituality As We Age.” No doubt, we will be continuing the discussion of how we Quakers intend to die as we have lived.

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Deconstructing Death as a Dying Woman

by Mackenzie E. Rockcastle

[N]ext week, I have my second scan since being diagnosed with terminal cancer.

 
The thought of the little white masses glowing brightly on my doctor’s computer monitor leaves my stomach unsettled—leaves my mind unsettled.

As my “scanxiety” builds, I find myself leaning on my own advice to approach my fears of dying. A few weeks ago, I gave my therapist a breakdown of what I thought were my general fears surrounding death. She was surprisingly thankful for my analysis of such an enormous concept and fear that is shared by so many. She told me many of her patients held an irrational fear of dying. Breaking death down into the smaller fears that truly comprise the overall terror for the word makes it a little less intimidating.

She believed this mindset could help some of her other patients get to the root of their obsessions. So I thought to myself, perhaps my breakdown of death—one that has helped me unveil my true fears, befriend my own death, and enhance my life—could help others do the same.

To start the process of grasping my fears surrounding death, I first had to ask: Is it possible to create a good relationship with death? And in order to create a good relationship with it, well, perhaps we need to understand why we have such a bad relationship with it.

I personally see four major reasons to feel uncomfortable about death. All of them associate with fear. Fear of the dying itself, fear of what lays beyond death, fear of the life we will never live, and fear for those we leave behind.

At this point, I believe I’ve come to peace with three out of the four. But I had to ask (and continuously have to ask) myself the following questions:

1. What is dying?

Dying is a physical action. It is momentary. Physical pain may be associated, but it is temporary, not eternal. Dying is generally defined as “to stop living.” This definition causes death to be associated with the opposite of life. I don’t like this association, and I don’t believe it properly does justice to the word death.

As a young child in school, I specifically remember doing worksheets to understand opposites: on/off, black/white, night/day, life/death. Looking at a lot of ancient cultures, many have a book of the dead: The Egyptian Book of the Dead, The Celtic Book of the Dead, The Tibetan Book of the Dead, and so on. The way that most of them describe death is not as the opposite of life, but the opposite of birth. I think this shift in language—this shift in the juxtaposition of life and death—is important.

It is an entirely different concept. It suggests that we walk into a room and we walk out of a room, not that the room disappears.

2. What comes after death?

Since this is the most uncertain part of the equation, this question can bring about the most fear. Do we fear an almighty man in the sky? Burning for all eternity? That, maybe, this is it? Religion, upbringing, what we’ve experienced, what we’ve watched, and what we’ve read all play into what we believe happens after death. But the reality is, no one knows for certain. Beliefs, faith, and religion aside, really no one can say without a shadow of a doubt what happens when we die.

In this thought, some people hold fear, and some people hold peace.

For me, this is the most fun part. As a nonreligious, but spiritual person, this is a playground of opportunity. I personally don’t hold a fear for this. Rather, I see the space beyond death as a a beautiful existence where our beings no longer hold their human form. I acknowledge my brain doesn’t have the capacity to understand this fully, and therefore I don’t try too hard to create an image or definition to coincide, rather just a feeling. This is the part of death I feel to be the most reassuring, warm, and whole. It’s the presence that gives full peace.

3. Are we afraid of the things you will miss out on, the things we never did, or the things we’ll never do?

This fear is actually comprised of regret. These are the things in life we always thought we’d achieve or have the time for. The places we wanted to go. The people we wanted to meet. The food we wanted to eat. The adventures we wanted to take. This is bucket-list stuff, and is constantly shifting. It’s understandable to want more time to do more things, but, in fact, more incentive to live fully while we know we are here. Carpe f*ckin’ Diem, right?

The longer we live, we assume, the more likely we are to achieve our dreams and desires. And sometimes this is true. At 21, my initial diagnosis left me thinking I’d never graduate from college. A year later, I graduated with my class. At 23, just two weeks after finding out my cancer had returned, I stood next to my beautiful sister-in-law as she married my brother. I cried a good amount, most tears were of joy, but some of the salty droplets fell from the thought that I may never live long enough to get married. A year passed, and I did.

I realize some of those things can’t always be attained. I have certainly shed a tear or two over the thought of the empty bedrooms in my home that echo with the cries of babies who are not mine, and are not there. While the thought is sad, it too passes. My perspective goes beyond that. I have a lot of dreams. But if I don’t attain them, I am at peace with that. And I think part of that acceptance is the realization that it isn’t those big “achievements” that were my favorite parts of life thus far.

It’s the nitty gritty. The naughty. The unexpected. The unconventional things that are mine. And if that’s what we enjoy about life—the little things and the uniqueness of the bonds we’ve made—then maybe we can take away the bigness of death. Maybe if we break it down into the little things about it we can start to get on the same level as it. Maybe we can start to repair this broken relationship with death.

4. Do we hold a fear for those we’ll leave behind?

Currently, this is my greatest fear associated with my own death. I fear for the pain inflicted on those who will heavily feel my void. I am trying to remedy this by reminding them that my purpose here may be just that: a reminder. A reminder and an inspiration. And whatever is happening, it’s supposed to. It’s fluid and it will make sense. If I were to die soon, I know the little things people will see and think of me for.

Little jokes that will make them laugh. Spaces, patterns, and songs that will make them smile. And that is what makes us immortal: our essence. I believe that’s what we become when we die. And if I can inspire people to pursue the things that make them smile, laugh, and feel joy—feel love—that is a gift greater than I can take credit for. It gives me peace to know I will, in some way, be with them.

But, I can stare into my mothers eyes and tell her how at peace I am over a bottle of wine at lunch. And I am. But when I swivel around that table and look through her eyes, what do I see? My baby girl dying? F*ck, I can’t imagine. Nor, probably will I ever have to (which adds into the f*cked-up-ness of the thought).

I can physically feel the heaviness of my husband’s sadness as he lays his body on top of mine just to make sure I’m still there. I can run alongside my best friend and no empathy is needed, because the thought of losing her is the exact same weight as her thought of losing me. I can talk bucket-lists with my dad, who is battling Stage 3 cancer, with stipulation on both ends on how things are doing in a few months—a most unusual fate not typically shared between a father and daughter simultaneously. I can go out with my brothers or my friends and share meals, drinks, and laughs.

A big part of the problem is we continue to view death as an end—that we’ll never be able to share those same meals, drinks, and laughs again. But we wouldn’t anyways. That’s how time works. Part of making peace with death is making peace with time. Perhaps it’s the most perfect preserver of time—the relationship we had is exactly the relationship it will always be. We will always have shared that meal. We will always have shared that drink. We will always have shared that laugh. Allowing the fleeting to fleet. And letting life slip into death, in the beautiful, exact way it’s supposed to.

But, still, this is where I find sadness: in the sadness of others. I don’t like being the source of peoples’ pain. It’s the part that hurts the most. So no, this piece I am not yet at peace with. But it is a shared burden. And I believe the more at peace those I love become, the more at peace I’ll become. Which is the point of this whole thought: How do we better our relationship with death?!

I suppose a more complicated question then becomes: How do we better our relationship not only with our own death, but with the death of others? And I’m starting to think this is a full circle concept. If we better our relationship with our own death, we better our relationship with the death of others.

I think the first step is talking about it. Often the conversation is met with: “I can’t bare the thought.” But what if we did? What if we did just f*cking bear the thought? What would we do differently? How would we treat each other differently? How would we live differently? Can being friends with death make us have a better life?

I whole-heartedly believe the answer is yes.

I think as we visit and revisit each of these four major parts of death, we continue to delve deeper and deeper into a peace with it. A peace with our own death, a peace with the death of others, and a life more fully lived.

Complete Article HERE!

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Many faith leaders are unprepared to help people make peace with death

Rabbi Laura Geller addresses a room of participants at Temple Emanuel’s conference, “The Next Stage: Looking Backwards and Ahead,” on November 9, 2014.

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[C]onfronting sickness and death is part of a faith leader’s job description. Members of the clergy sit with congregants during chemotherapy treatments and pray with them in the midst of pain.

Pastors prepare for this work at seminary, spending a semester working as a hospital chaplain or volunteering at a nursing home. However, some still enter professional ministry unprepared to sit at someone’s bedside and offer advice, according to recent research on religion and end-of-life care.

Many faith leaders are uncertain of when aggressive treatments should be traded for hospice care and confused about what palliative treatments consist of, reports a study in the April issue of the Journal of Palliative Medicine.

Seven in 10 clergy members say it is “somewhat” or “quite a bit” important for them to encourage ongoing treatment for a cancer patient, even when a doctor says there is no hope for a cure, notes a new study in the Journal of Pain and Symptom Management.

This research, as well as other findings from The National Clergy Project on End-of-Life Care, points to a need for ongoing education, according to health experts.

“Poor knowledge of end-of-life care may lead clergy to passively enable congregants with serious illness to pursue … treatments that are associated with increased suffering,” wrote researchers in the Journal of Palliative Medicine.

The National Clergy Project is part of Harvard University’s Initiative on Health, Religion and Spirituality. Program leaders are working on a free end-of-life care curriculum to empower faith leaders, highlighting the important role religion often plays at the end of people’s lives.

“What clergy say — and what they do not say — can make a major difference in whether believers experience a ‘good death,'” the Association of Religion Data Archives reported in its overview of recent research.

Increasingly, palliative care, which focuses on providing pain relief rather than a cure, is seen as a key part of dying well, yet many people, including pastors, find it difficult to give up on intense or invasive treatments.

Accepting that a cure isn’t possible “may be perceived as a decision that undermines one’s faith in a God who may intervene with a miracle through medical treatment,” wrote researchers in the Journal of Pain and Symptom Management.

These researchers and other experts at The National Clergy Project on End-of-Life Care don’t want to undermine religious beliefs. But they do want to ensure that faith leaders are informed about medical options before they influence a patient’s decisions.

“Our goal is for patients and families facing difficult medical decisions to receive better spiritual and medical care,” the project website notes.

Around 3 in 4 faith leaders are open to training on end-of-life care, recent research showed.

In addition to seeking out insights from medical professionals, members of the clergy may benefit from organizing conversations about death and dying within their communities. Rabbi Laura Geller, rabbi emeritus at Temple Emanuel of Beverly Hills, has done this as part of a broader effort to understand what people at her synagogue fear as they near retirement.

“The conversations were so rich and powerful that nobody wanted them to end,” she told the Deseret News last year.

Initial small-group discussions on life after retirement grew into a communitywide effort to better serve the needs of older synagogue members. People thought through how to emotionally and spiritually grow even as their bodies aged and illnesses loomed, Rabbi Geller said.

“How do you make meaning in the face of the fact that you’re going to die? That’s what faith communities are supposed to be teaching people,” she said.

Complete Article HERE!

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What Judaism Teaches Us About Grief And Loss

 

By Gila Silverman

[T]he headline on a recent Forward interview with Sheryl Sandberg asks if Sandberg can help Americans learn to grieve. Sandberg has certainly done all of us a great service by opening up a conversation about the way American do –- and don’t –- deal with death, dying and grief. In the essay that follows this headline, both Sandberg and Jane Eisner, who interviewed her, acknowledge that the rituals and structures of Jewish mourning can play an important role in processing our grief. As Jews, we are lucky. We do not need to create new ways of grieving; we need to look no further than our own traditions in order to learn how to grieve.

While the fact that everyone will die is universal, how we understand and respond to death is shaped by historical, cultural, political, economic, and, of course, religious, forces. Shared norms, values, and practices guide our expectations of how the bereaved should behave, of how we relate to the loss, of the responsibilities of the community, and of the social identities of the dead. As American Jews, therefore, the way we think about death is influenced both by our Jewish heritage and by the larger American culture.

In the United States today, death is primarily understood through the language and concepts of medicine, which focus on treatment, recovery and cure. Death is often perceived as a failure of the medical system, and talking about it makes many uncomfortable. Grief too is frequently seen as an individual and medical problem. Bereavement is a crisis to be resolved, and normal grieving behaviors are sometimes interpreted as symptoms of a psychiatric condition. For much of the 20th century, our understanding of grief built primarily on the psychoanalytic theories of Freud, and the work of grief was seen as letting go of the deceased, in order to free emotional energy for new relationships. Mourners were often told to “put the past behind”, “get back to normal”, and “move on”.

In the latter half of the 20th century, and into the 21st, new psychological models of grief emerged, primarily from researchers in North America and Western Europe whose methodologies allowed them to actively listen to the voices of the bereaved. My mother, Phyllis Rolfe Silverman, who died last June, was one of these scholars. In nearly 50 years of research in this field, she helped us to understand that bereavement is a time of change, a normal and expected life-cycle transition. Rather than something to recover from, mourning is a process of accommodation; it is not a linear process through a fixed set of stages, but a helix-like movement of negotiating a series of crises and accommodations. Mourning is an ongoing process of renegotiating a relationship, a “continuing bond”, with someone who is no longer physically present, and of reconstructing a meaningful world, and our place in it, following a loss. This is a process not of relinquishing an attachment or of giving up the past, but of changing our relationship to it. Grief is a life-long process, as the relationship to the deceased, and the meaning of the loss, is continually revisited and renegotiated as life events occur.

My mother always told us that Jews do grief well, that our Jewish traditions map perfectly onto the psychological experience of mourning. As I near the first anniversary of her death, and the end of my Jewish year of mourning, I understand now how right she was. Traditional Jewish laws prescribe a fixed set of mourning rituals and prohibitions, which are collectively referred to as Avelut (Hebrew for “mourning”) These rituals are designed to balance two core commandments: k’vod hamet –- honoring the deceased, and nichum avelim -– comforting the mourners. They make clear what is permitted and forbidden to the mourner during each phase of their grief, and outline for the community its responsibilities in caring for the dying, the dead, and the mourners. They recognize that what we need during the early days of intense pain and sadness is different than what comes later, as we accommodate to the empty space the death has left in our lives. Jewish rituals recognize that the individual is intertwined with the community, that, as the famous 1952 ethnography by Zborowski and Herzog declared, “life is with people”.

Our guidelines for mourning delineate who is considered a mourner (the parents, children, siblings, and spouse of the deceased), and the exact obligations and prohibitions guiding the behavior of each over time. These guidelines follow a clear progression, beginning at the moment of death, and continuing through the completion of the Avelut period, which is 30 days for a spouse, sibling or child, and one year for a parent. This is a highly structured process; as the mourners move from Aninut (entry into mourning) to Shiva (the first week), and then to Shloshim (the first thirty days) and eventually reach the end of Shanah (a year), they separate from, and then slowly return to, the social life of the community. Even after this year ends, those who have experienced a loss continue to participate in additional memorial rituals (yahrzeit, and, in the Ashkenazi tradition, yizkor) for the entirety of their lifetimes. At the heart of Jewish mourning rituals is recitation of the Mourner’s Kaddish. The kaddish, a prayer sanctifying God, is to be recited daily for the Avelut period, and must be said in the presence of a quorum of ten Jews.

Within a larger social context that still expects people to move on from their grieving fairly quickly, the year of Jewish mourning rituals, and the ongoing opportunities to remember the deceased, send the bereaved a strikingly different message. Our rituals recognize that ongoing mourning is accepted, expected and supported by communal norms, rather than being a reason to seek professional help. Jewish mourning rituals encourage the bereaved to temporarily withdraw from normal functioning, gradually accept the reality of the loss, mobilize social support, and find new meaning within the existing frameworks that guide their lives. In particular, the daily recitation of kaddish, and the annual marking of the yahrzeit, serve as a recognition that the memories of the dead will always be with us. These rituals acknowledge that death ends a life, but not a relationship.

By so publicly speaking of, and writing about, her grief, Sheryl Sandberg has powerfully reminded us that we need to acknowledge, make room for, and talk openly about grief. But it is not her job to teach us how to grieve. We have the wisdom of our Jewish traditions to do that.

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