Tag: Spiritual Concerns

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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.

Complete Article HERE!

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How clergy can help believers die a ‘good death’

U.S. clergy may be increasing the sting of death for many members of their flocks.

By David Briggs

[T]wo new studies find that many clergy are both ill-prepared and reluctant to fully engage in end-of-life conversations with terminally ill congregation members and their families.

The result, both studies suggest, is that more believers may be spending their final days enduring painful treatments with little chance of success in intensive care units rather than receiving comfort care at home.

One of the studies was a national survey of more than 1,000 clergy. The other involved in-depth interviews with 35 ministers from five states. The research raises three critical areas of concern:

· Too much faith in miracles: More than three in 10 clergy in the national survey said they would strongly agree with a congregant who said, “I believe God will cure me of this cancer.” Eighteen percent affirmed the belief that every medical treatment should be accepted “because my faith says to do everything I can to stay alive.”

· Lack of knowledge: In the in-depth study, spiritual leaders showed little knowledge of end-of-life care, including the benefits of palliative care and potential harms associated with invasive interventions. “Many grossly overestimated the benefits of aggressive medical procedures at the end of life,” researchers reported in the Journal of Palliative Medicine. Three-quarters said they would like more training in end-of-life issues.

· Fear of overstepping boundaries: The default position of many clergy, even those who personally believed it was against God’s will to suffer unnecessarily, was to merely support the decisions of dying congregants and their family members.

But even such passivity has consequences, researchers said, in that it can enable congregants to seek potentially nonbeneficial treatments that are associated with increased suffering.

The larger problem was summarized by one study participant: “We have not done a good job…on preparing people to die–that they don’t need to live the last days of their lives under terrible and excruciating pain.”

Competing principles

The new studies are part of The National Clergy Project on End-of-Life Care,

What is clear in both studies is the complexity in end-of-life decision making.

Spiritual principles such as the sacredness of life and the capacity for divine healing may come into conflict with other religious principles to comfort the suffering and place faith that God will care for individuals after this life.

For example, clergy were asked in the national study what they would talk about when visiting a patient with cancer and no hope for a cure.

Fifty-six percent said it is important to encourage acceptance of dying as part of God’s plan. Two-thirds would place a priority on suggesting hospice as a good idea. Eighty percent said it is important to talk about heaven and life after death.

Yet, 60 percent also would strongly encourage prayer for physical healing, holding out hope for a miracle.

At one extreme, 18 percent of clergy endorsed the idea of accepting every medical treatment to prolong life, and 16 percent said doctors and nurses should do everything possible to extend the life of a patient.

The clergy most likely to place their faith in divine healing were from the black church, Pentecostal and evangelical traditions and those serving low-income congregations, researchers noted in the Journal of Pain and Symptom Management.

The attitudes mattered to their flocks.

Clergy that endorsed life-prolonging religious values were approximately half as likely as other clergy to have a discussion concerning entering hospice, stopping treatment or forgoing treatment. The absence of a clergy-congregant hospice discussion was associated with less hospice and more ICU care.

In the in-depth interviews, no clergyperson said aggressive care was an “absolute good.” Several said it hampered a good death, and one said it was an “absolute bad,” researchers reported.

Yet despite their own strong views, many clergy refrained from influencing decisions about end-of-life care.

The ministers said they did not offer guidance out of respect for the “free will” of congregants, but researchers indicated a lack of knowledge of the medical consequences also played a role.

Humble approach

What can be done to assist clergy in helping religious individuals make better informed decisions about end-of-life care?

Clergy education is critical, researchers from both studies said.

The studies concluded that clergy training focused on the intersection of religious values and medical issues at the end of life offer several opportunities for improving care, including:

· Closing the gap between the clergy’s beliefs and actions.

· Empowering clergy to counsel congregants about the moral and spiritual implications of end-of-life medical decisions.

· Supporting religiously informed decision making by patients that minimizes unnecessary physical and spiritual suffering.

· Creating partnerships of ministers and disease-based and palliative care clinicians.

What clergy say – and what they do not say – can make a major difference in whether believers experience a “good death,” the studies find.

“There are times,” one black minister from Chicago told researchers, “Death itself is a cure to what ails you. It’s the healing.’’

Complete Article HERE!

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Where Do I Go To Mourn?

By Ariele Mortkowitz

[T]he Jewish tradition is rich with mourning rituals. We’ve done it as a nation for millennia; mourning the loss of Jerusalem, lamenting the Holocaust, remembering the long lost days of the Holy Temple. As individuals, we do it with bagels and covered mirrors and week-long shiva visits. We can say Kaddish (the mourner’s prayer) for a year. There is plenty of space and opportunity to grieve.

And it’s a good thing. A great thing even. It’s supportive. It’s community showing up at times when someone might be at their lowest low. It’s not leaving people to manage their grief alone. It’s a built-in system of shoulders to cry on, arms to lean on, caretakers, yentas – all of them creating a space for you to mourn and pause before gathering strength to move forward.

But while we offer so much to mourn those who have passed, there is nothing available to support those mourning pregnancy loss. There are no rituals. No one brings bagels. No one even talks about it. Some rabbis will tell you that you are not even permitted to say Kaddish after a stillbirth. It’s like it never happened.

And there’s a logical reason for that. In times long ago, pregnancy loss was incredibly common. It was also often very public. It was rare to find a family that had not lost a child or infant in the course of their family-building. In fact, many parents lost more than one in their lifetimes. So if the custom would have been to stop everything to mourn, people would have been in states of mourning constantly. And one could say that therapeutic value of shiva/mourning rituals would be diluted. The rabbis, in their wisdom, thought it better to not make such a big deal of pregnancy loss – precisely because it was so common.

But what about today? 2017. When pregnancy loss is not something that happens as often in each family? And certainly not in the same public way it did in olden times? What do we do with these feelings of loss that can be so devastating – particularly in the midst of communities that value children so highly?

Where should a couple take their grief when they learn that they will not be able to be parents? How should a mother-to-be mourn the loss of a life that she cherished? What prayer should she say? There is no ritual. No one talks about it openly because of the attached shame and disappointment of not being a “fruit bearer.”

It’s rough. It’s lonely. And it is incredibly sad.

It is ironic that a faith community that is normally so very good at supporting individuals laden with grief, can fail so terribly at addressing this common and natural loss.

I know of more than a few synagogue regulars who stopped attending services and recuse themselves from the ebb and flow of Jewish communal life after a miscarriage or when they continue to fail to conceive. With no “official” way to mourn a pregnancy loss or a fertility struggle, it can be incredibly isolating and “othering” for couples — often pushing people away from their communities during the very time they need support most. They feel not understood, invalidated, wrong for being so heartbroken. The absence of ritual or commemoration of pregnancy loss sends a message loud and clear: “Your loss is not a real loss. It is not worthy of the community’s attention or caring.”

Ouch.

So we wanted to do something about that. We wanted these important community members to feel held and supported and we wanted to validate their loss and let them know that they are not alone in their grief.

This month, we participated in Yesh Tikva/The Red Stone’s “Infertility Awareness Shabbat” in an unusual way. Our goal was to create a space for empathy and understanding about infertility in the very tight-knit, family-focused Jewish community. But, rather than ask our clergy to talk about infertility or pregnancy loss in a sermon as has been traditional, we decided to do something new.

On the Sabbath before Passover, the Agam Center at Ohev Sholom invited the entire community to “Light A Candle For Your Loss.” We circulated an anonymous form and asked our community members to indicate the number of memorial candles they would like illuminated on their behalf and gave them the option to have their candles dedicated or labeled in the manner of their choosing.

The response from the community was overwhelming. We lit forty-seven candles, submitted anonymously by thirty individuals – just from our 300 family congregation alone. We displayed these candles publicly, at the entrance to our sanctuary, in our light-filled atrium. Every community member passed by the memorial display on their way into services, and our clergy, Maharat Ruth Balinsky Friedman, invited the community to pay their respects and honor the (often silent) loss felt deeply among our grieving community members.

The responses from the community came pouring in.

“Thank you for doing this. Don’t really have words right now. Just gratitude to have the opportunity to mark my little boy’s birth, especially so close to the actual date.”

“This is absolutely beautiful. Thank you for giving a voice to so many who are on this journey. All my love and support for your amazing, very necessary work.”

“I thought I’d fill out the form because it was a lovely idea – and then found myself in tears, making a small space for something I mostly push aside. Kudos to you for creating the holy opportunity. Really proud to be a part of this community.”

As far as I know, our decision to publicly anonymously recognize pregnancy loss in the synagogue community is a unique endeavor to validate this loss and create a space for a life-experience that can be so isolating and stigmatized and reframe it as an opportunity for communal support.

As we filed into the sanctuary for Saturday morning services, we stopped to read the inscriptions and dedications next to the memorial candles. They took my breath away. Here is but a sample of what was shared:

“I would have loved to love you.”

“Eternally grateful for the journey you were a part of, as painful as it has been. Your loss made way for those we watch grow, shaping me into a mother who strives for daily patience and gratitude.”

“Mothers Day 2011. You were and then you weren’t. Still wonder why I wasn’t supposed to be your mommy.”

“For the family I thought we’d have and the empty seat at our table that I wish we had filled.”

The Agam Center is working hard to make people feel seen and understand that their community is indeed there for them during their time of sorrow or struggle. We want to help people in the midst of a fertility journey see that they are truly not alone, and that there have been so many others – even right in their very synagogue community – who have walked this path with them. We are creating a space to mourn something that is usually so privately painful – particularly in a tradition that is, ironically, so “good” at supporting mourners in other circumstances. I am hopeful that we can begin to highlight ways that communities can create spaces for these losses and families unrealized.

Rather than staying home and feeling isolated, these mourning couples made a point to come to synagogue that week and watched as others learned about and began to appreciate the magnitude of the loss they were feeling. They came inside from standing on the fringe of the community and felt embraced and found solidarity, all without a word. This heartbreakingly beautiful display was our community’s way to show that all loss is real loss and to remind those still struggling that they are not alone in their grief of hopes for the family of their prayers.

May our communities know no more suffering. Amen.

Complete Article HERE!

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After Great Pain, Where Is God?

An etching from “The Book of Urizen,” by William Blake.

By Peter Wehner

[T]hese days I find I’m more alert to the grief and sorrow around me than I once was. In part it’s a product of my age, of youth giving way. I’m guessing my situation is not that different from many of yours.

Last month I checked in on a childhood friend whose 13-year-old son committed suicide last year after struggling with a brain injury. He told me, “I’ve stopped crying every day, which is a major transition.” He added, “I spent more than a year trying to get him well and keep him alive, and only in recent days have I finally, mostly, lost that mode of thinking. I don’t have to do anything now because I can’t.” Yet in his dreams, my friend said, his son is still alive and he’s checking on him to make sure he’s O.K.

Another lifelong friend recently died of colon cancer. His wife wrote to me: “I wish I could tell you that we are walking this journey with courage and faith, but that really doesn’t describe our situation at all. The outward courage feels like a ruse to convince ourselves that this immense pain will subside in time, and the weakness of our faith is showing us its shallow limits.”

Sometimes the struggles are not about death but things like addiction. Two weeks ago I spoke to a friend whose wife had told him she no longer wanted to be married to him because of his relapse into alcoholism, which he described as a “deep, dark struggle” that robbed him of his true personality. (He’s now in recovery, trying to rebuild his life.)

Stories like these are hardly the whole of life, and most of the people I know are in a pretty good place. Yet every life has a story, and every story is marked by pain, loss and sorrow. Sometimes we suffer; other times we have to watch people we love suffer. Each situation is difficult in its own way.

I’m no theologian. My professional life has been focused on politics and the ideas that inform politics. Yet I’m also a Christian trying to wrestle honestly with the complexities and losses in life, within the context of my faith. And while it’s fine for Christians to say God will comfort people in their pain, if a child dies, if the cancer doesn’t go into remission, if the marriage breaks apart, how much good is that exactly?

During 1940 C. S. Lewis wrote “The Problem of Pain.” Lewis’s answer to why an all-good and all-powerful God would allow his creatures to suffer pain was a bit too neat and tidy. Among other things, he wrote, “God whispers to us in our pleasures, speaks in our conscience, but shouts in our pain: It is His megaphone to rouse a deaf world.”

Now flash forward two decades to the publication of “A Grief Observed,” which Lewis wrote after his wife’s death. God’s megaphone didn’t just rouse Lewis, it nearly shattered him. In writing about his bereavement, Lewis described what it was like to go to God “when your need is desperate, when all other help is vain, and what do you find? A door slammed in your face, and a sound of bolting and double bolting on the inside. After that, silence.” He added: “Not that I am (I think) in much danger of ceasing to believe in God. The real danger is of coming to believe such dreadful things about Him. The conclusion I dread is not ‘So there’s no God after all,’ but ‘So this is what God’s really like. Deceive yourself no longer.’ ”

Years ago I had lunch with a pastor and asked him about his impressions of “A Grief Observed.” His attitude bordered on disdain. He felt that Lewis allowed doubt to creep in when his faith should have sustained him.

My response was the opposite. Perhaps because my own faith journey has at times been characterized by questions and uncertainty, I found the fact that the 20th-century’s greatest Christian apologist would give voice to his doubts reassuring. And Lewis was hardly alone in expressing doubts. Jesus himself, crucified and near death, gave voice to the question many people overwhelmed by pain ask: “My God, my God, why have you forsaken me?”

Jesus’ question, like ours, was not answered in the moment. Even he was forced to confront doubt. But his agonized uncertainty was not evidence of faithlessness; it was a sign of his humanity. Like Job, we have to admit to the limitations of human knowledge when it comes to making sense of suffering. “From the biblical evidence,” the Christian author Philip Yancey has written, “I must conclude that any hard-and-fast answers to the ‘Why?’ questions are, quite simply, out of reach.” So, too, is any assurance that the causes of our suffering, the thorns in our flesh, will be removed. So what, then, does Christianity have to offer in the midst of hardships and heartache?

The answer, I think, is consolation, including the consolation that comes from being part of a Christian community — people who walk alongside us as we journey through grief, offering not pieties but tenderness and grace, encouragement and empathy, and when necessary, practical help. (One can obviously find terrifically supportive friends outside of a Christian community. My point is simply that a healthy Christian community should be characterized by extravagant love, compassion and self-giving.)

For many other Christians, there is immense consolation in believing in what the Apostle Peter describes as an eternal inheritance. “In all this you greatly rejoice,” he writes, “though now for a little while you may have had to suffer grief in all kinds of trials.” It is a core Christian doctrine that what is seen is temporary and what is unseen is eternal, and that what is eternal is more important than what is temporal.

But even so great an assurance as eternal life, at the wrong time and in the wrong hands, can come across as uncaring. It’s not that people of faith, when they are suffering, deny the heavenly hope; it’s that in being reminded of this hope they don’t want their grief minimized or the grieving process overlooked. All things may eventually be made new again, but in this life even wounds that heal leave scars.

There is also, for me at least, consolation in the conviction that we are part of an unfolding drama with a purpose. At any particular moment in time I may not have a clue as to what that precise purpose is, but I believe, as a matter of faith, that the story has an author, that difficult chapters need not be defining chapters and that even the broken areas of our lives can be redeemed.

The book of Isaiah, in prophesying the messiah, describes him as “man of sorrows and acquainted with grief.” We’re told “by his wounds we are healed.” For those of the Christian faith, God is a God of wounds, where the road to redemption passes directly through suffering. There is some solace in knowing that while at times life is not easy for us, it was also hard for the God of the New Testament. And from suffering, compassion can emerge, meaning to suffer with another — that disposition, in turn, often leads to acts of mercy

I have seen enough of life to know that grief will leave its mark. But I have also seen enough of life to know that so, too, will love.

Complete Article HERE!

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Soul midwifery – ‘Midwives’ of mercy

The new breed of inspirational carers helping to ensure people’s dying days are spent in the comfort of their own homes

By Jane Feinmann

[C]olin Barber takes great comfort in the fact that his terminally ill wife, Valerie, was able to die peacefully in her own bed.

On Tuesday, September 1, 2015, ten days after she had been discharged from hospital, Valerie, who had bile duct cancer, took her last breath at home in their bedroom — ‘exactly as she had wanted, with her father and me on each side of her bed, gently holding her hands’, recalls Colin, 56, a business psychologist.

It was, he says, as serene a death as it could have been.

Yet it was nearly so very different. Instead of spending her last few days in peace at home, Valerie, like many patients, could have ended up being rushed to hospital and dying on an anonymous, noisy ward.

But she was one of the lucky ones: she was able to plan for her last days and ensure her wishes were adhered to, thanks to an award-winning new approach to end-of-life care known as soul midwifery.

The idea is that, just as a birth midwife helps to ease a baby’s entry into the world, a ‘soul midwife’ eases people’s dying days.

It is a cruel failure of modern medicine that while the vast majority of people — eight out of ten, according to the Office for National Statistics — want to die at home with their symptoms controlled and their loved ones around them, nearly half actually die in hospitals. Only one in five gets to die at home.

And just how ghastly dying in hospital can be was set out in a report by the British Medical Association published last March.

Based on interviews with more than 500 doctors and patients, it painted a grim picture of patients being given ‘entirely inappropriate invasive treatments’, and junior doctors often too fearful to provide adequate pain control.

Pressure on beds can mean dying patients are ‘shuffled between wards’, preventing continuity of care, while single rooms are prioritised for patients who pose an infection risk, so the dying rarely get privacy. The NHS failure to provide a dignified, peaceful death was highlighted this month by a study published in the BMJ’s Palliative and Supportive Care journal, which identified a postcode lottery in specialist palliative care.

As a result of this, patients are far more likely to be rushed to A&E at the end of their lives than to die pain-free, in peace, at home.

NURSES HAVE NO TIME TO CARE
The BMJ report followed a recent survey of almost 1,000 hospital nurses in which two thirds revealed they didn’t have enough time to care properly for dying patients.

Such is the concern that patients are being failed, that last week the National Institute for Health and Care Excellence (NICE) re-published guidance on end-of-life care first issued to doctors in 2015.

This restated four essentials: the need for doctors to draw up a care plan, provide individualised symptom control, monitor patients daily and ensure adequate hydration. Most people, says Professor Gillian Leng, deputy chief executive of NICE, receive good end-of-life care ‘but this isn’t always the case’.

End-of-life champion: Felicity Warner established soul midwifery in 2004

Good care involves asking people about their preferences as well as controlling pain, adds Sam Ahmedzai, a retired professor of palliative care who worked on the latest NICE guidance.

Yet a recent study showed that only one person in seven who could communicate their desires had those wishes documented.

This is far from a new problem. Ten years ago, a major report, the End of Life Care Strategy, featured an innovative plan to end the situation where ‘most people would prefer to die at home while only a minority manage to do so’, as then Health Secretary Alan Johnson put it.

Along with improved palliative care, the plan involved healthcare practitioners working harder to ‘identify people approaching the end of life and discuss with them their needs and preferences’.

DOCTORS CAGEY ABOUT THE TRUTH
Ten years on, although there has been a slight improvement (back then nearly six out of ten people were dying in hospital) there is still ‘a long way to go’, Claire Henry, chief executive of the National Council for Palliative Care, told Good Health this week.

So why is it still proving so difficult to get things right?

‘Some deaths happen suddenly, out of the blue, while with some patients it’s difficult to be sure whether they are dying or will recover,’ says Professor Ahmedzai.

‘That’s why we say that every patient in the last days of life should be monitored daily in case there have been changes and there is a chance of recovery.’

Research shows that, in fact, in four out of five cases GPs can predict which of their patients will die within the next 12 months. And three out of four deaths are anticipated by medical teams, according to NICE.

Professor Ahmedzai says: ‘We should be asking anyone admitted to hospital with a serious illness about their preferences for where and how they wish to die, should that look likely. But doctors often don’t because they are embarrassed or just too busy to handle that conversation. It can’t be an excuse. We must make time for the dying.’

Indeed, a major problem is that too often, dying patients simply are not told what their doctors know. Sometimes this is because doctors are unwilling to discharge patients so they can die at home because effectively ‘such a decision can be seen as an acceptance of failure’, the recent BMA report noted.

Research shows that in four out of five cases GPs can predict which of their patients will die within the next 12 months

Certainly, no one told Valerie or Colin that she was dying.

The banking relationship manager from Brentwood, Essex, had cancer diagnosed in 2013, two weeks after her 50th birthday, after noticing that the whites of her eyes were yellow.

Her GP referred her for an MRI scan, which revealed a large tumour wrapped around her bile duct.

She had surgery to remove part of her liver along with the gall bladder and bile duct, followed by three months of chemotherapy.

‘After the treatment we began to be optimistic that she was recovering,’ says Colin. But in October 2014 a scan identified nodules of cancer in the liver, too scattered to be removed surgically. In August 2015, Valerie took a sudden turn for the worse and had to be admitted to hospital.

‘We’d just come back from holiday, when she’d canoed 15 miles down the River Severn,’ recalls Colin. ‘Then one day she woke up so weak she could barely stand.’

Even so, ‘it didn’t occur to me that she was gravely ill,’ he recalls. ‘No one at the hospital mentioned the word ‘dying’.’

Valerie’s discharge from hospital three days later depended only on a physiotherapist checking that she could walk upstairs, which the couple took to mean she was on the mend.

‘But looking back on it, her doctors must have been aware that she was dying,’ says Colin. Not least because the next day, after an appointment with the cancer specialist, she was referred to hospice care.

It was not her doctors but Valerie herself who first put what was imminent into words. ‘Back at home, Valerie told me she was dying and I had to accept it,’ recalls Colin. That was when she asked him to be her soul midwife, ensuring her dying days were as she wanted them.

CARERS TO EASE THE LAST DAYS
Soul midwifery is a unique approach to end-of-life care.

In the words of Felicity Warner, the woman who founded it, ‘just as a birth midwife ensures a safe delivery into this world, the soul midwife’s role is to do the same for the dying, to make a good death possible, a dignified, peaceful and even enriching experience’.

This means ‘providing comfort, continuous support and reassurance’ — in practice, after a terminal diagnosis, this involves helping to support the patient as they make an end-of-life plan.

In the final stages the soul midwife might sit by the dying person, holding their hand, playing soothing music and burning appropriate oils. Krista Hughes, a soul midwife based in Chertsey, Surrey, works privately in people’s homes but is often called to a hospice, she says, to work with those with ‘terminal agitation’.

It is a term recognised by clinicians and often managed with sedatives, but as a soul midwife, she prefers gentle breathing, maintaining eye contact and softly repeating the person’s name.

The work of soul midwives was recognised when Felicity Warner was named 2017 End of Life Care Champion by the National Council for Palliative Care and the Royal College of Nursing. The seed for soul midwifery was planted more than 20 years ago when Felicity, now 58, was working as a journalist and interviewed several women dying of breast cancer.

The women told ‘how lonely it felt to be dying despite their medical care and their families around them’.

Not only were their doctors and nurses too busy to talk about death and dying but, surprisingly, Felicity found the women were becoming increasingly distant from friends and family who couldn’t cope with the reality and masked it with platitudes such as: ‘You’ll be feeling better soon.’

Researching how people died before the rise of modern ‘curative’ Western medicine, Felicity found a range of practices ‘that had in common the fact that they respected the act of dying as a sacred time’.

She established soul midwifery in 2004, and has since trained 600 soul midwives — many already have a health practitioner qualification — with an initial three-day course, followed by an apprenticeship lasting around a year.

Qualified soul midwives’ costs are in line with local rates for services such as counselling, though many also work as volunteers at hospices or use the qualification to help care for a terminally ill relative.

Valerie herself had attended a three-day soul midwives’ course shortly after recovering from the cancer surgery in August 2014.

‘It was something she thought she would like to do one day when she was stronger,’ recalls Colin.

So when Valerie told him she thought death might be near, he asked if she wanted him to contact the organisation to arrange for a soul midwife to visit.

Instead, she told him to read her copy of the soul midwives’ handbook so he could take on the role.

For Colin, this meant as well as ensuring Valerie’s comfort, he was her gatekeeper.

While many people want strong intravenous pain control in their last days, Valerie didn’t — ‘she wasn’t in much pain and wanted clarity of thought to the end, yet it took time and effort to stop the palliative care team administering the sedatives,’ says Colin.

‘I had to contact Valerie’s GP and get him to approve her decision, then inform the hospice nurses.’

Three days before she died, the couple celebrated their 17th wedding anniversary. ‘We wrote cards for each other and exchanged presents. The next morning, Valerie told me she had stayed for our anniversary and now she was ready to go. It was her time to die.

‘She had told me she wanted to imagine she was floating away on a boat and asked me to play soothing background music. I lit candles and used essential oils.

‘She had also warned me that the last sense to go would be her hearing, so I read prayers and spiritual affirmations.’

Soul midwifery will not be for everyone. But Colin is in no doubt that it helped Valerie to a comfortable and tranquil death.

‘Of course I longed for a last-minute reprise, a miracle recovery that would keep her with me. But I recognised that Valerie knew what her body was telling her, and did my best to concentrate on our time well spent together. I’m certain she knew that, and appreciated it.’

Complete Article HERE!

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Is there really life after death?

Brain activity is recorded 10 MINUTES after patient dies in an ‘unexplained’ case

Scientists from from the University of Western Ontario in Canada studied the extraordinary case of a patient continuing to release delta wave bursts after they were declared dead. We normally get these delta waves during a deep sleep

By Phoebe Weston

[L]ife may continue even after death – just in sleep mode.

Doctors have found scientific evidence that people’s brains can continue to work after they are clinically dead.

A patient showed persistent brain activity for ten minutes after their heart stopped and experienced brain waves we normally get during deep sleep.

Doctors in a Canadian intensive care unit described the case as extraordinary and unexplained.

Researchers from the University of Western Ontario in Canada assessed electric impulses in the brain in relation to the beating of someone’s heart after life-sustaining therapy was removed.

Brain inactivity preceded the heart stopping in three of the four cases.

However, in one of the cases, the patient’s brain continued to work after their heart stopped.

‘In one patient, single delta wave bursts persisted following the cessation of both the cardiac rhythm and arterial blood pressure (ABP),’ the researchers said

There was significant differences in electrical activity in the brain between the 30-minute period before and the 5-minute period after the heart stopped.

‘It is difficult to posit a physiological basis for this EEG [brain] activity given that it occurs after a prolonged loss of circulation’, according to the paper which was published in the National Centre for Biotechnology Information.

Across the four patients recordings of their brain were very different – suggesting we all experience death in unique ways.

The experiment raises difficult questions about when someone is dead and therefore when it is medically and ethically correct to use them for organ donation.

As many as a fifth of people who survive cardiac arrests report having had an other-worldly experience while being ‘clinically’ dead.

However, scientists say it’s far too early to be talking about what this could mean for the post-death experience – especially considering it was only seen in one patient, according to Science Alert.

In 2013, a similar phenomenon was investigated on experiments on rats whose hearts had stopped.

In one of the cases, single delta wave bursts persisted after the heart had stopped and the patient was clinically dead. The experiment raises difficult questions about when someone is dead and therefore when it is medically and ethically correct to use them for organ donation

The research, which was published in the journal Proceedings of the National Academy of Sciences revealed rats had a burst of brain activity one minute after decapitation.

The pattern of activity was similar to that seen when the animals were fully conscious – except signals were up to eight times stronger.

The researchers said that the discovery that the brain is highly active in the seconds after the heart stops suggests that the phenomenon has a physical, rather than spiritual nature.

It has been argued that the dying brain is incapable of such complex activity and so near-death experiences must have their origins in the soul.

It suggests something happens at the brink of death that pushes the conscious brain to a high level of arousal, potentially triggering the visions and sensations associated with near-death experiences (NDEs).

As many as a fifth of people who survive cardiac arrests report having had an other-worldly experience while being ‘clinically’ dead.

Typically NDEs involve travelling through a tunnel towards an intense light, being separated from the body, encountering long-departed loved ones or angels and undergoing some kind of judgment of ‘life review.

Some emerge from NDEs as transformed individuals with a completely altered outlook on life, or a new belief in religion.

But many scientists believe near-death-experiences are nothing more than hallucinations induced by the effect of the brain shutting down.

Complete Article HERE!

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The teacher gets schooled on the question of death

Norris Burkes

By Norris Burkes

[F]irst, I need to assure you that my wife, Becky, only wears dead things around her neck during S-week. That’s the week she challenges her pre-kindergarten class of 4-year-olds to wear something that starts with the letter “S.”

The dead thing was a necklace her brother made from snake vertebrae and turquoise. It must sound terribly gross to the uniformed, but believe me it was a real attention-getter when she taught fourth grade.

Last year during S-week, my wife stood fingering her serpentine skeleton and asked, “Class, who knows what this is?”

 

One kid said, “Your fingers,” but that’s how literally little guys think.

“No,” Becky said. “This is a necklace made of snake bones, ‘Ssss,’ ” she said, making the snake hiss. “S-nake for S-week.”

“Ewww. Is it dead?” asked a prissy girl in the front row.

“Yes.”

“How did it die, Ms. Burkes?”

“Things just die,” she said with a dismissive inflection.

The kids seemed unprepared for that word “die,” so I’m guessing “dead” never came up during D-week.

“Aww,” exclaimed a sympathetic boy.

“Do squirrels die?” asked a kinetic boy who often chases the figurative squirrels.

“Yes,” my wife said slowly. She was beginning to see this line of questioning as a stacked deck.

Hoping to draw a better hand, Becky called on a favorite, little Brayden, whose parents she sees regularly at the gym.

Braydon put his cards face up on the table. “Do people die?”

“Yes. Every living thing dies eventually,” she explained.

Just then, an eerie stillness paralyzed their up to now wiggly bodies. My wife offered what she hoped would be one last touching example. “My mom died.”

“Is my mom going to die?” Brayden asked.

“Oh, don’t worry.” Becky said. “My mom was much older than your mom.”

Of course, the question no one would dare ask was, “Will I die, too?”

As a hospice chaplain, I can tell you that the unquestionable answer to that unasked question is “yes.”

As we move through the holy season of Lent, we recall the wisdom of the one who made it clear that he was going to die. He knew the timing of his death and he knew how he would die. Yet his followers resisted his predictions despite his saying, “It’s appointed unto a man once to die and after this the judgment.”

Since those words were first recorded, many seek to emphasize the judgment part. Yet, I think there’s a deeper meaning. Jesus was calling us to live our lives with a heightened sense of expectation and joy. He wants us to live at peace with all men as well as our God.

Alcoholics Anonymous calls this kind of life, “Keeping your side of the street clean.” That means we can’t predict our lifespan, but we can choose the way we live our lives.

Still searching for meaning, those kids kept drilling their teacher.

“My grandmother is old,” chimed one. “Is she going to die?”

My wife had reached a dead end. This was the moment every public speaker knows, the point stage actors describe as “dying out there.”

She thought about quoting Ecclesiastes, “To everything there is a season … a time to be born and time to die.” But instead, she glanced at her watch and said, “Oh my, kids! It’s time for recess!”

Complete Article HERE!