How a funeral from half way around the world can seem familiar

South Vietnamese funerals often include street performers such as fire eaters and snake handlers. Here a brass band watches as a performance takes place.

By Euan Kerr

[G]iven the long and diverse history of human kind, it’s remarkable how alike customs can be in different parts of the planet.

That’s the idea behind a new exhibit at the Minneapolis Institute of Art opening this weekend. The show is built around a movie called “The Living Need Light, the Dead Need Music.”

That title is an almost direct translation of a Vietnamese phrase, said Tuan Andrew Nguyen, whose artist collective called the Propeller Group made the 20 minute film.

He said the title captures the essence of Vietnamese funeral practices.

“These ceremonies have to be lively and have a lot of music,” he said.

The Propeller Group film includes a well-known Vietnamese brass band which performs at funerals. For the film the group had them march in unusual places including mud flats.

Music at those funerals often comes from brass bands. And Nguyen, who spent part of his childhood in the U.S., said they reminded him of New Orleans jazz funerals, and that got it got him thinking.

“We found this really interesting kind of overlap between the two cultures that don’t speak to each other directly, yet they have like very similar ways of celebrating death,” Nguyen said.

That is part of the thinking behind “The Living Need Light, the Dead need Music.” The film is beautiful, engaging, and sometimes disturbing. It features many of the performers hired for funerals in Vietnam: professional mourners, acrobats, martial artists, fire eaters, snake handlers.

“For us, it’s about making a film that pays homage to the people that labor around the idea of death, “said Nguyen.

A central character in the film is Sam, a transgender woman. Transgender people often perform at Vietnamese funerals, one of the few places where they are welcomed.

While the Propeller Group is an artistic collective based in Ho Chi Minh City, Nguyen said, it initially described itself as an ad agency so it could get around government restrictions on film making.

Propeller described its early work as music videos, and it’s a term Nguyen uses for this work too.

“The film kind of sits on the edge of being documentary and fiction,” he said.

Minneapolis Institute of Art Photography and New Media Curator Yasufumi Nakamori said that was attractive to him. He realized he could build a show around the film using Mia’s vast collections.

“I invited them to collaborate with the museum, for them to select the objects and create the installations” Nakamori said.

Starting with the collection’s database, Nakamori and the Propeller Group searched for objects that reflected the ideas and artifacts in the film.

Minneapolis Institute of Art Curator of Photography and New Media Yasufumi Nakamori, left, and Propeller Group member Tuan Andrew Nguyen pose with a 10th century Chinese funerary mask. It’s at the entrance of the latest New Pictures exhibit at the Institute, which is based around a movie the Propeller Group made on Vietnamese funeral practices. The exhibit also includes artifacts from the museum’s collection and sculptures created by the Propeller Group. These include funerary masks of members of the Propeller Group, including Nguyen, created using 3D printers.

They gathered pieces from the Asian, African, Native American and classical collections, including a 4,000-year-old Egyptian model boat. It’s believed to be the oldest object in the Institute’s holdings.

As visitors enter the gallery, they see the film, playing continuously at the far end of the room. The objects stretch out towards the screen like a funeral cortege.

Mixed in with them are sculptures the Propeller Group made to build commonalities with the movie. A sixth century Buddha figure is surrounded by a gilded ring of fire similar to a scene in the film.

Also like in the film, there’s a huge ouroboros — or a ring formed by snakes, latching on to each other’s tails.

For the New Pictures show, Nguyen and Nakamori searched the Institute archive for pieces from cultures around the world with similarities to the images in the Propeller Group film.

The final effect of the show is somehow both alien and utterly familiar. Nakamori hopes visitors will recognizes the ideas if not the objects.

“I don’t want it to be just this exotic film from South Vietnam,” he said. “Rather I want a viewer to connect with their own lives.”

One example hangs on the wall at the entrance to the show: a 1,000-year-old gilt bronze funerary mask of a young woman. After seeing it Nguyen and another Propeller Group member had their own masks made using 3D imaging. They hang on the wall nearby.

“In these days and times where the selfie and the way that people imagine themselves and their portrait becomes so prevalent,” he said, “we wanted to rethink that.”

As Nguyen stood looking at his own death mask, he quietly said, “it’s surreal.”

Complete Article HERE!

How virtual reality is improving end-of-life care

In the UK, terminally ill patients are being transported from the hospice to other worlds.

By

[V]irtual reality is not just for showing off the latest games and inventions. The technology has found a purpose in the healthcare industry as part of improving hospice and end-of-life care.

When someone is terminally ill, it may be inevitable that the individual will, at some point, go to a hospice or treatment center for end-of-life care or, at the least, to a respite center to give home caregivers a break.

However, in the UK under a creaking, strained, and underfunded National Health Service (NHS), sometimes these facilities may be suffering themselves from a lack of budget to make these stays as comfortable as they could otherwise be.

In addition, and perhaps most importantly, taking someone away from their home at such a stage can be a difficult transition.

To make this process a little less heartbreaking, local charity hospice Loros, which provides hospice and home care to roughly 2,500 terminally ill individuals across Leicester, Leicestershire, and Rutland, UK, has launched a new project which uses virtual reality to enhance end-of-life care.

The idea is to help those who have limited mobility to experience life outside of treatment and give them the chance to go back to places in their past which hold fond memories, as well as experience new areas beyond the hospice and home.

As shown in the video below, 70-year-old John, who is diagnosed with motor neuron disease (MND), is trying out the headset equipped with a video of Bradgate Park. This kind of technology can give patients a little more joy in their lives when perhaps it matters most.

Since being diagnosed with MND, we can get out but I can’t spend a lot of time out of the wheelchair, so being able to have these experiences through the glasses is really good,” said John. “It’s almost as good as the real thing.”

It’s a reminder that while many of us obsess over whether or not the latest mobile device will have a headphone jack or an impossibly thin shell or not, advances in technology can also provide far more important experiences.

Loros is currently working with a VR company to produce more films and hopes to commission new films that other hospice providers will be able to use in their own virtual reality services.

“Research suggests that the brain accepts the virtual world within 20 seconds after which the experience becomes all-absorbing,” Loros CEO John Knight commented. “We recognize that some of our patients are often restricted to where they can go due to their illness, so we wanted to help give them the opportunity to still enjoy life wider than their restrictions allow, through virtual reality.”

 Complete Article HERE!

Why we Need to Stop Saying, “I’m Sorry For Your Loss.”

By Ed Preston

There were about 150 people at my father’s memorial service.

[S]tanding in the receiving line afterward it seemed like every conversation, whether it was with an old friend or a total stranger, began with the exact same phrase, “I’m sorry for your loss.” Most conversations didn’t go far beyond that, partly because there’s not much to say in response except, “thank you.”

A few people managed to mix in another platitude like, “He’s in a better place now” or, “At least his suffering is over,” but it all started to sound like a broken record pretty quickly; one that I had heard many times before, seen played out in movies and even unknowingly participated in myself. Now it was being played for me at one of the most painful moments of my life, and the hollowness of that experience would literally change my course forever.

Why do so many of us struggle with what to say to someone who is grieving?

Perhaps it’s because of our cultural death phobia, and the way it pathologizes everything related to sadness. If we’re not better at dealing with grief, then it’s because we’ve never been taught better. Unfortunately, that leaves the majority of people with only one stock phrase in their repertoire, “I’m sorry for your loss.”

Grieving Needs More than Clichés. 

One problem is simply the overwhelming use of this one phrase, while simultaneously reserving it almost exclusively for the family. It seems as the close friends aren’t really grieving at all, while family members get the idea of loss hammered into them over and over.

Saying, “I’m sorry for your loss” is a bit like the cashier saying, “Have a nice day,” at the convenience store. It betrays a lack of original thought and is so pervasive it has become irritating for many.

When responses are this programmed, how sincere is the sentiment? As more people start to become irritated by it, choosing this particular phrase because it feels “safe” isn’t really that safe anymore.

Clarity Works. Euphemisms Don’t.

Using the language of loss as a euphemism for death is one of many ways in which our culture conceals the reality of death, perpetuates our phobias about it, and keeps us trapped. Spoken by a griever, “I lost my mother in 2015” is being used to avoid saying the word “died.” Spoken to a griever it expresses pity combined with distancing, “I’m sorry for your loss.”

The problem is that it’s linguistically incorrect. The verb “to lose” is active, something we do. The reality of grief is that someone else died. You didn’t lose them in the same way you would lose your car keys or your wallet, and depending on your religious convictions you may not feel like you lost them at all.

For most of my life, I definitely thought of deceased loved ones as lost because I was well trained by the culture to do so. Visiting a Native American friend one day I said something about losing someone and my friend responded, “You don’t have to lose someone just because they died.”

That was the first time I was exposed to the idea that it’s possible to live in the presence of the dead, not as frightening ghosts, but as honored members of the clan.

These days I’ve become accustomed to drawing comfort from the idea that I’m living in the presence of departed loved ones. Actually, speaking to them in quiet moments when I’m alone is one of several key components—like meditation, being in nature or remembering special occasions—I use to process my grief whenever it shows up. Whether one wishes to think about that in terms of psychology or in terms of the spiritual language, it seems completely irrelevant. All I know is that I find it helpful.

It’s the Wrong Mental Programming.

Experts in the field of grief care (Stephen Jenkinson, for example) are starting to recommend using the language of suffering, healing, and overcoming challenges instead. The language of loss refutes the notion that there might be an upside to grief, a spiritual deepening that can result from being exposed to something that’s an inevitable consequence of being born and choosing to love each other. By shifting to the language of suffering, healing, and overcoming challenges instead, death and grieving can once again become the redemptive processes I’ve come to believe they were always meant to be.

After personally experiencing the old cliché and its real world application thousands of times over several decades, I remember quite vividly the first time someone said, “I’m sorry for your suffering. I’m here with you.”

How different those words felt!

I immediately knew the stranger sitting next to me on a park bench somehow understood something that had been missed by all the close friends and family who had been sorry for my loss, but not present with my suffering.

Firstly, she knew I was suffering, and her use of the word “sorry” came across as authentic compassion rather than pity. Second, there was no distancing or avoidance in the way she said it. She knew what I needed most: validation of my grief and someone willing to listen, even if that meant listening through some tears. Best of all there was no judgment.

 

The Challenges Ahead.

Significant numbers of people are starting to open up about their dissatisfaction with this worn out cliché. Others seem almost determined to defend it as the ultimate expression of sympathy. What the defenders don’t seem to understand is that no one will ever be offended or hurt by not saying, “I’m sorry for your loss.”

For those wanting to improve their grief communication by eliminating clichés with more accurate, helpful, and authentic responses, but still aren’t sure what to say, here are a few other choices in no particular order. These are just a few of the many options available, and they can be combined in various ways to make them both personal and appropriate.

1. I’m sorry you’re suffering right now, but I’m here with you and willing to help any way I can. Is there anything you need right now?

2. I’m sorry for whatever challenges might lie ahead for you, but I’m here and willing to help. Would it be okay if I call next week just to check in with you?

3. Please accept my deepest condolences. I can’t imagine what you must be going through right now, but I know enough about grief to know that it can be very challenging. Don’t hesitate to call me if there’s anything I can do to help.

4. I’m so sorry to hear about _____. I’m sure you’re going to miss him/her terribly. How are you holding up?

5. I know there’s nothing I can say right now to make things better, but I also know that having someone to talk to at times like this is really important, so don’t hesitate to call me whenever you need to.

Follow any of those with what you loved most about the deceased or tell a story about a favorite memory of them, and I think most people will be pleased with the deep level of connection that’s instantly created. I’m absolutely certain the bereft will feel less isolated and better supported.

One reason is that the phrases above easily open into longer conversations, while “I’m sorry for your loss” tends to shut them down. In some cases, it’s even appropriate to simply remain silent and offer them a deeply heartfelt hug instead.

Most important of all is just being willing to listen and be present.

Complete Article HERE!

Death in the age of Facebook

Issues around social media may feel new, but technology has always created conflict in the way we grieve.

by

[I]f you’re reading this, three things are true.

You were born. You will die. And now, thanks to the internet, you’ll be publicly mourned.

Loved ones will change their profile pictures to photos of you. Stories will be shared on Facebook, Twitter, Weibo, VK. People may even snap selfies of themselves attending your funeral.

As familiar as we’ve become with the digital world, we’re still in the midst of adapting to our emotion-filled existences lived online. As social media evolves, we’re changing the ways we interact. The result: new etiquettes and new normals for every aspect of the human experience.

Even mourning.

“Over millennia, different communications media have affected and influenced how people relate to the dead,” says Tony Walter, professor of death studies at the University of Bath. “I see online mourning as the latest chapter in a story with a very long history and prehistory.”

Walter has tracked the evolution of grief back to the Stone Age. From the development of writing and mass literacy to photography and the recording of sounds and images, all had an identifiable effect on how we mourn.

Some academics see a strong parallel between grief on the internet and the advent of photography in the 19th century.

“That was revolutionary, this idea that you could have an image of the deceased,” says John Troyer, director of the Centre for Death and Society at the University of Bath. He’s also a member of the Order of the Good Death, a group of funerary professionals, academics and artists working to demystify death in a culture that fears it.

“Any new technology that gets used when it comes to death will almost always cause a momentary panic or freak-out,” he says. “Whatever the technology is, it just seems inappropriate.”

Post-mortem photos are considered shocking now in western culture, but there’s an ancient precedent for the practice. Taking likenesses from the bodies of the dead dates back at least to Roman times, when death masks were cast in wax. The masks would then be displayed at home and sometimes worn at funerals.

Nipper the dog, now recognised as the mascot for audio label HMV, was originally painted listening to an Edison phonograph recording — as he sits perched atop a coffin. One of the technology’s imagined uses would be the preservation of the voices of the dead.

Death masks were used in more recent history, before the invention of photography, to capture a likeness of the deceased, particularly of important people. Some museums display death masks of notable figures, including the poet Dante and Napoléon Bonaparte.

A form of the Roman tradition of wearing the masks has returned on Facebook, where users in mourning often change their profile photos to those of lost loved ones.

The practice is also reminiscent of Georgians wearing black armbands, which served as visual signals the wearer was bereaved. Grief, experts say, used to be expressed in public.

In the modern world, however, our lives allow only so much time to mourn. Jobs keep us busy, families are on schedules. In the US, the situation is exacerbated because there is no federal bereavement law allowing people time off to grieve.

“I really believe that a lot of these social media mourning rituals are popping up because people aren’t able to mourn in public spaces the way that they used to,” says Candi Cann, an assistant professor at Baylor University and author of “Virtual Afterlives: Grieving the Dead in the Twenty-First Century.” “People have this need to be recognised as grievers.”

The portable tombstone

We’ve always talked to the dead.

Since the invention of the phonograph in 1877, people imagined audio recordings would be used to capture loved ones’ final words and preserve the voices of those departed. In private moments, we might even respond with “I miss you,” “I wish you were here,” or “You always knew what to do.”

This kind of talk has now made its way onto the internet. A message posted to a dead friend or a remembrance on a birthday demonstrates someone’s memory lives on.

Social media lets you address the dead directly and demonstrate that their memory lives on.

“When people would go and visit the tombstone and they would talk to the deceased, now you’re seeing that on the internet,” says Cann. “It’s essentially this portable tombstone.”

Social media gives us the illusion that the dead are still among the living. You can go to a Facebook or Twitter profile to read the person’s posts and look at their photographs. You can address them directly and post on their timeline.

“Most people will address the dead directly in the second person,” the University of Bath’s Walter says. “They do it knowing other people are going to read this, which is really interesting because if you’re writing to somebody it sort of implies they’re there and in some kind of way hearing this or receiving it.”

I Was Here

One of the most contentious issues around online grieving is the funeral selfie. It’s just what it sounds like.

Mourners pull out their phones, snap photos of themselves and other bereaved, and post to their favorite social media sites. To many, it seems gauche, even self-centered. It’s the latest example of a new death practice and it feels shocking to some people. A famous Tumblr even documented the trend until 2013, when it stopped updating.

“I think it was just an easy way for adults to tut at youth, like, ‘My God what are the kids doing, the kids these days are being corrupted by the technology,'” Troyer says. “I’d be more surprised if younger people weren’t taking selfies at funerals, because that’s what the phone has turned into.”

For a generation that’s grown up with phones and social networking, Cann says the selfie is just another component of their visual diaries. She says she’s seen that in her own daughter, who had surgery when she was 6 years old and asked to have her photo taken as soon as the operation was over. She wanted to document that moment.

Funeral selfies are just another entry in what are public diaries. They say, “I’m here and this is an important moment in my life.”

The complicated deaths

There are much darker taboos than whether it’s acceptable to snap a selfie at Gran’s funeral, like the deaths no one wants to talk about. Miscarriage, sudden death, suicide, voluntary euthanasia.

These are “complicated deaths,” says The Order of the Good Death’s Sarah Chavez, who also co-founded Death and the Maiden and helps run Death Salon. Unlike the sad but expected death of an older person or an ill patient, these can be controversial endings that make people uncomfortable. The response to these deaths can be very different.

Rather than an outpouring of support, the bereaved can feel isolated — and sometimes worse, Chavez says, speaking from experience.

Three years ago, Chavez’s unborn child was diagnosed with a fatal disease. When she told anyone, even medical professionals, the reaction was same.

“From dealing with decisions to counselors to specialists to anybody who I told, there was an immediate recoil,” Chavez says. “No one wanted to face me or deal with me.”

People mourning these deaths may look to social media, hoping to find people who’ve experienced similar traumas. Online social groups also provide a barometer to see how people will react.

It’s not always for the better.

Chavez said she scoured the internet for people who had experiences similar to hers. She found few. And those who posted their experiences overwhelmingly faced hostility.

A woman she knew gave birth to a stillborn child and, in her grief, got a tattoo of the child’s scan. She then took a photo and posted it to social media.

The response, from hundreds of people, was devastating.

People berated the mother, telling her “she should go die,” Chavez recalls. “Somebody actually said, ‘This is creepy wrong shit’.”

That’s changing, if slowly.

Private, safe forums have sprung up. Facebook groups have been created for people processing these deaths to seek support from others feeling the same emotions.

“Social media has really created this space for marginalized communities,” Chavez says. “It can make people feel like they’re not alone, there are others out there that are grieving with them, or are hurting, or are angry, or whatever those emotions are.”

Sun setting on gravestones at Abney Park Cemetery in London.

Etiquette in all things

So how should you respond to bereavement online? It’s not very different from how you’d respond offline, says Daniel Senning, a manners expert and spokesperson at the Emily Post Institute, an etiquette organisation.

“The first major faux pas that often happens is that you don’t want to scoop the news,” Senning says, noting that information travels fast on social media. “You don’t want to precede the family’s announcement onto social media if you can help it.”

Those close to the deceased should be told in person, but social media is appropriate for making sure a person’s wider circle sees the news.

As for offering condolences, Senning says there’s nothing wrong with responding to the news of a death in the medium you heard it. But that doesn’t mean you have to.

Senning says a handwritten condolence note carries the most weight. “In today’s rich communication environment, in making the choice to send a handwritten note, the medium itself becomes part of the message,” he says.

The more things change…

As it always has, the way we mourn is evolving. The internet is democratizing grief, even if the technology leaves us uncertain. But it always has, if that’s any consolation.

“These are just new norms or evolving ones, some of which are quite old and some of which look brand new,” the University of Bath’s Walter says. “It’s difficult for people to kind of negotiate this terrain. But I think it always was.”

Complete Article HERE!

For old folks left to die at Myanmar’s roadsides and cemeteries, these homes are their last hope

Cast aside “like rubbish” and turned away even by nursing homes, these elderly outcasts are given dignity at the end of life by volunteer groups outraged by their plight.

By

YANGON, MYANMAR: There she lay, on the ground in the darkness of night, moaning in pain as rats – drawn to the smell of blood from the lacerations on her body – nibbled at her wounds.

The elderly woman had just been involved in a road accident. But instead of getting help, the driver had abandoned the woman next to a rubbish dump by the road to fend for herself.

Daw Khin Ma Ma said her stomach churned at the sight of the battered old woman who was eventually conveyed to her nursing home. “Her rib bones were broken, some of which had pierced her lungs. We could see a hole in her back that had been gnawed on by the rats,” she said.  

“I’ve never seen such a terrible case before.”

The woman died some six months after arriving at the home.

Daw Khin is the vice-president of Twilight Villa (See Sar Yeik), a nursing home in Myanmar which takes in abandoned sick elderly citizens whom other homes turn away. This horrifying episode is just one example of why she is so dedicated to helping this group.

Cases of seniors being left abandoned by families near markets, railway stations and even cemeteries are on the rise. “These grandpas and grandmas at our nursing home have been cast aside at hospitals and under bridges like rubbish,” she said with heat.

(LINK: Poverty forces families in Myanmar to ditch their elderly)

Twilight Villa is tucked in a quiet corner surrounded by thatch and bamboo houses, an hour’s drive from downtown Yangon.

It started out with just eight senior citizens housed in a one-storey building in 2010, but today, it operates out of a modern four-storey building that includes an intensive care floor, courtesy of generous donors.

The home currently has capacity for about 70 people, but there are 50 more on the waiting list. It takes in only those over 70 years of age who are ailing and without any traceable family.

FAMILIES GO TO LENGTHS TO DUMP THEIR ELDERLY

Daw Khin is among a small but growing number of individuals and local non-profit organisations that have stepped forward to help the sick elderly who are in the last years or even months of life.

They have no training in nursing nor geriatrics, driven only by their passion to provide this group with dignified end-of-life care.

Daw Khin, a criminal lawyer by profession, co-founded Twilight Villa along with local philanthropist and award-winning writer Daw Than Myint Aung in 2010, after they found that nursing homes were unwilling to accept the sick elderly.

She said that some of these seniors are referred to them by the police, and they have little memory of their identities.

“Sometimes in the pocket of their jacket, there would be a note with just their name and age, such as Daw Pu, age 80. That’s all. When we ask them more, they can’t remember anything else,” she said.

Photos of volunteers with the residents at Twilight Villa.

Daw Khin fumed at how some caregivers go to great lengths to abandon these seniors – even using different modes of transport to ensure that they can’t find their way home.

“They might be transported in a car, then a trishaw, and then by ferry to the other side of the river where they’re abandoned,” she said.

Some are dumped because they had suffered a stroke or some mental illness. “When we ask them where they live, they would say, ‘a market is near my house, and I have little grandchildren’. If they could remember more details, we would surely send them back,” she said.

Then there are those like 87-year-old Daw Kyi Kyi, who was referred to the home after her husband and two sisters died. She has no children.

She wakes at 5am every day and spends her time praying and meditating. The company of friends and the staff at the home help to relieve any loneliness.  “I am happy here,” she said. “I can live peacefully; it’s like living in heaven with all my friends.”

TURNING TO SOCIAL MEDIA TO RALLY HELP

Like Twilight Villa, the group Save The Aged focuses on the sick elderly who have nowhere else to go.

It was started by a group of 15 young, public-spirited volunteers who were so moved by their plight, they took to the Internet and social media to rally help for them.

So successful were they that – for a country with a low Internet penetration rate – they managed to raise enough funds solely through social media to open a nursing home in 2015.

Save The Aged volunteers Hnin Hnin and Phyo Thiri

Volunteer and accountant Daw Phyo Thiri said: “There were other organisations such as Save the Children but there were none that looked after the elderly. We were inspired to create a group to help those that we had met.”

They started out by repairing the homes of these old folks and helping them with expenses such as for food and medicine, as well as conveying them to the hospital when they were sick. They had no donors initially, and most of their expenses were borne by the volunteers.

With no physical office, they communicated via WhatsApp and social media, posting pictures and videos of their activities on Facebook. As their digital presence grew, they managed to get donations and more volunteers, especially among the young.

Save the Aged currently provides care and accommodation to around 25 homeless elderly, all aged above 65.

Resident Daw Kyi Kyi Khin, 85, was living alone and surviving on occasional donations when some Save The Aged volunteers brought her to the home.

She said: “Now I live peacefully here and I have nothing to worry about. They treat us like their own parents or grandparents.”

NO MONEY TO DO MORE

However, funding continues to be an issue for these NGOs – a problem made even more acute in a poor country like Myanmar.

Daw Phyo said Save The Aged would like to do more but is limited by the lack of resources. The NGO relies solely on donors, who include Myanmar nationals overseas in countries such as Singapore, South Korea and Australia.

When they were building the home, they had to pay for the construction in instalments – and at one stage, they ran out of funds. Thankfully, another appeal for funds online managed to raise enough to complete the project.

“We only have enough funds to run the day-to-day operations,” said Daw Phyo. “For the longer term, we would like to expand, to buy new land and build new homes. We would like to support the elderly even more, and we are looking for donors.”

Twilight Villa, too, relies mostly on public donations.

The government’s Social Welfare Department provides the organisation with 25,000,000 kyats (S$26,000) a year in subsidies but they can only use it to buy rice.

Daw Khin said she would prefer to have more flexibility with the subsidy, for medical supplies or to pay their employees.

AN AGED HOME WITHOUT ELDERLY?

But more than that, she would love to see the day when there is no more need for homes such as hers.

She cited the example of one home for the aged she knows of which – curiously enough – has no seniors living there.

The residents in that village in the state of Kachin have learnt to value and respect their elderly folks for the part they have played in society, and so everyone chips in to take care of them in their twilight years, she said.

“If a family is too poor to take care of an elderly person, they will bring that person to another family who will take care of him or her. The whole village takes care of the elderly. That’s why there is no old person in the home for the aged.

“This is excellent. We need this to be the situation in every family,” she said.

Complete Article HERE!

How to Live When You’re Dying

Embrace the idea of death for a better life.

By Wesley Baines

Death.

It’s a concept that few wish to dwell on, but one that will eventually become a reality for each of us. For some of us, it comes rushing up sooner than we’d like, and suddenly the hands of the clock are moved up to five minutes till midnight. For others, the hands move at their normal pace, but our minds linger on what those final moments will hold.

The truth is that we are all dying. Every last one of us. But by learning to accept death, by allowing the ticking clock to drive us to greater heights rather than to deeper despair, we can truly live. And in choosing to live in the face of death, we not only improve the time we have left, but also set an example for others so that they might do the same.

Whether you’ve recently found your own clock unexpectedly moved forward or if you simply find your eventual end more discomforting than you’d like, there are lessons to learn here that will make the remainder of your life not mere a series of days, but beautifully alive.

Accept and Acknowledge

As a culture, we don’t like to talk about death—it’s one of our staunchest taboos. But the problem with this is that we don’t deal with it. We pretend it doesn’t exist, that the clock isn’t ticking at all.

And so because we don’t deal with death in a meaningful way, we become divided into two camps—those who are paralyzed by the fear of death, and those who feel it will never happen to them. Both views are mistakes.

Those who are terrified of death are limited by it. They are confined to what is safe, and live lives of mental agony. Those who feel invincible, on the other hand, lack the motivation that only an awareness of our limited time can bring.

But when we embrace death, when we acknowledge it by openly talking about it, and when we can accept that it is inevitable, we can make use of it. It can be our friend.

When Steve Jobs gave his 2005 Stanford commencement speech, he told the students: “No one wants to die. Even people who want to go to heaven don’t want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because Death is very likely the single best invention of Life. It is Life’s change agent.”

He went on, saying “Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.”

Dealing with your own impermanence is painful. It means making yourself vulnerable and open. It means intentionally processing things you’d rather tuck beneath the rug. But when you do, when you accept and acknowledge, you can move past the fear of, or indifference toward, death, and in doing so, you may just find life for the first time.

Be Kind to Yourself

Learning how to live in the face of death means learning to love yourself. It means you learning to be kind to you.

This means several things. First, it means, as Jobs said, avoiding the idea that you have something to lose—forgive yourself for any perceived failures. The burdens you place upon yourself, the weights you pile onto your shoulders—take them off. They’re not a big deal.

This doesn’t mean shirking your responsibilities toward those you love and care about. It doesn’t mean that you don’t work to make the world a better place. This simply means that you don’t carry these things as a weight. You don’t constantly berate yourself for not attending to them well enough.

You do your best and move on.

If you have a habit of being unkind to yourself, tapping into the awareness of death is an empowering tool that can help you forgive yourself. And once you forgive yourself and let go of your fears of imperfection and underachievement, you’ll have so much more room in your life for the things that truly matter.

Perspective and Priorities

Considering the reality of death brings perspective. It helps us see what is truly important.

What matters to you? Is it your family? Is it your web of relationships? Are you committed to a cause? Are you bent on creating something beautiful with your life? Are you spiritual or religious? What deserves your time?

Likewise, what are you doing that is wasting your time—for many, the thought of death brings this to mind first. Are you working overly long hours or spending time with people who don’t truly value you? Are you obsessed with the future at the cost of living in the moment?

Once you’ve acknowledged death as a part of life, you can use this to drive you trim the fat and focus on what’s really important to you. It forces you to examine your life, and like Socrates once suggested, the examined life is the one worth living.

In an interview with the Guardian, Holly Webber, a British woman diagnosed with terminal cancer, has this to say about how her perspective has changed since her diagnosis.

“Sometimes I feel like I’m on another planet looking in on this one. I can’t relate to people stressing about work or getting the Tube. People are so wound up, but it’s such a waste of time and energy. Chill out! I hope that by reading this, someone out there will take a second to think, ‘I’m glad that’s not me. Maybe I should worry less about the things that don’t really matter.’”

Allow death to grant you perspective on your priorities, and you’ll gain the life you truly want.

A New Life From Death

You’ve heard the old cliché, “Carpe diem,” which is Latin for “Seize the day”. This phrase is the essence of what death has to teach us. Be present. Live in the moment. Love the people in your life with all your heart and mind and soul.

Because in a hundred years, those business reports will be dust. Your money will be gone. Your fears and burdens won’t matter.

And that should make you feel free, not fearful.

So be open to the idea of death. Talk about it without fear or denial. Use it to shed your woes and gain a better perspective on your priorities.

Above all, use death to live. It’s one of the best things you can do for yourself, as well as for those who love you.

Complete Article HERE!

At the End of Life, a Way to Go Gentle

By

[W]hile confronting the prospect of death, people like me — grappling with a diagnosis of advanced cancer — often consider what sort of care they want and how to say goodbye. Given the delicate negotiations in which the dying need to engage, do intensive care physicians with their draconian interventions act like proverbial bulls in a china shop? My fear of pointless end-of-life treatments, performed while I was in no condition to reject them, escalated when I read Dr. Jessica Nutik Zitter’s book, “Extreme Measures: Finding a Better Path to the End of Life.”

Dr. Jessica Nutik Zitter

Dr. Zitter confronts the sort of scenario that haunts me because she works in specialties that are sometimes seen as contradictory: pulmonary/critical care and palliative care.

In her new book, she refers to the usual intensive care unit approach as the “end-of-life conveyor belt.” She argues that palliative care methods should be used to slow down and derail the typical destructive I.C.U. approach that often torments people it cannot heal.

Over the past few years, quite a few studies have indicated that physicians are less likely than the general population to receive intensive care before death. Many doctors choose a do-not-resuscitate status. Dr. Zitter highlights the insight upon which her colleagues base their end-of-life decisions.

According to Dr. Zitter, even what are intended to be temporary intensive care measures can put a patient on that conveyor belt to anguish and isolation. She writes of breathing machines, feeding tubes, cardiac resuscitation, catheters, dialysis and a miserable existence prolonged within long-term acute care facilities. In an account of the evolution of her own ideas about doctoring, she also explains why it remains so difficult to change intensive care units so they can better serve the terminally ill.

“Extreme Measures” analyzes a complex cluster of suspect but ingrained attitudes that bolster hyperaggressive methods. Medical training fosters a heroic model of saving lives at any cost. American can-do optimism assumes all problems can and should be solved. Both doctors and patients tend to subscribe to a “more is better” philosophy. If technology exists, surely it should be used. Physicians’ fears of litigation plays a part, as do patients’ fantasies of perpetual life. For too many, death remains unthinkable and unspeakable.

One of Dr. Zitter’s compelling patient narratives teaches a clear-cut lesson. It involves an 800-pound man “too large to fit into the CT scanner,” but “too unstable to be transported to the nearby zoo’s CT scanner.” Surgery would therefore be impossible. The patient, a 39-year-old she calls Charles, is bleeding from his intestinal tract, his heart is exhibiting erratic behavior, his kidneys have failed and his liver is foundering. Yet he and his relatives want the doctors “to do everything.”

Although Dr. Zitter tries to explain to Charles and his family that chest compressions would break his ribs and electric shocks would burn his skin, they insist on “a full-court-press resuscitation attempt when he died.” To Dr. Zitter, “Running a code on this dying man felt… akin to punching him in the face and would probably have had the same utility.” Honoring his wishes would require breaking the oath: “First, do no harm.”

Other case histories in “Extreme Measures” are more troubling because their moral implications are less obvious. After a dramatic brain bleed from a major clot, a 45-year-old she calls George faces an operation that cannot return him to who he had been. His wife wants to know what Dr. Zitter would do if he were her husband. She explains that her husband would accept paralysis if he could remain communicative with her and their children at home.

Although Dr. Zitter fears that the surgeons who operated on George never broached the topic of his quality of life after surgery, she is heartened upon his return to the I.C.U.: He gives a thumbs-up. “What if, as a result of our talk, his wife had not consented to the surgery? Would I have been his unwitting killer?” This moment of self-doubt is followed by another turn of the screw. When Dr. Zitter later phones George’s wife, she says: “I am a single mother, but with another angry child.”

“Extreme Measures” includes a number of stories that explore the difficulties of talking about the subject of death with dysfunctional families, wracked by depression or feuds, and across racial, religious and ethnic divides. Often and to her credit, Dr. Zitter finds herself baffled, unsure of how to balance cultural priorities, human needs and medical possibilities. Throughout, she struggles personally and professionally to redefine common responses to terminal conditions.

In place of hope for recovery, Dr. Zitter emphasizes “the miracle of time at home, of pain management, of improved quality of life. These are all concepts I have seen families embrace in place of survival — the only concept of hope previously imagined.” And to people refusing “to play God” by withdrawing a breathing tube, she asks whether “they were playing God by keeping [a relative] alive when her body was actively dying.”

For readers who wish to avoid the end-of-life conveyor belt, Dr. Zitter concludes “Extreme Measures” with some practical advice on, for example, procuring a Physician Order for Life-Sustaining Treatment (POLST), a legal directive that emergency responders, paramedics and emergency room doctors are supposed to follow (but sometimes don’t, as Paula Span reported in The Times earlier this week).

Without this sort of documentation of end-of-life wishes, Dr. Zitter writes, a 90-year-old with metastasized prostate cancer ended up paralyzed and tethered to machines after cardiac arrests. “Our well-intentioned resuscitative efforts had crushed his cancer-weakened neck bones, rendering him quadriplegic.”

Passionately and poignantly, Dr. Zitter reminds us that “conveyor belts, regardless of their destination, are not meant for human beings.” Sometimes less is more.

Complete Article HERE!