Saturday, August 3, 2013

Spiritual support to the dying:The perplexing task

Death and dying is inevitable part of life. Yet we are not ready to think about our own death or the death of our dear ones. In this article I try to focus on the ways described in text books to provide spiritual support to the dying and the challenges faced by health care members.
The meaning and understanding about spirituality vary widely between individuals, even if they share the same religious thoughts. Deaths now days occur mostly in the hospitals and hospices. Physicians and nurses are faced with the challenge of providing spiritual support to their dying clients.

Support to the Dying:The challenge faced by health care teams

People nurture spirituality in many ways. For some, it may be about sitting quietly in one place and meditating, for others it is about having inner conversations with higher powers or doing prayers. Spiritual energy can also be manifested in loving relationships and having a joyful mood and care and concerns for others.
Health team members face death and dying everyday as a routine. Giving spiritual support to the dying becomes extremely challenging for the health care team members. Health team members can have inner conflicts with one’s own values and that of the client under care. It is very important to explore one’s own spiritual values and make sure that it is not imposed on the clients. It is written in textbooks that spiritual needs of the dying should be assessed clearly by talking to them and measures should be taken to see that these needs are met as far as possible.

Spiritual support;Spiritual needs of the dying

Need for meaning and purpose:
This may differ from client to client. A person who has lived for many years, has afamily, children and grandchildren will have a different outlook towards the purpose of life and death compared to a person who is very young and has just started the building of his family. The latter if unfortunately on the death bed will have more anxieties, worries and guilt feelings. People dying young have deep routed repercussions on their societal responsibilities. Many a times we remain uncertain in choosing the words to address this need.

Swami Vivekananda writes,

'Great is the tenacity with which man clings to the senses. Yet, however substantial he may think the external world in which he lives and moves, there comes a time in the lives of individuals and of races when, involuntarily, they ask “is this real?" To the person who never finds a moment to question the credentials of his senses, whose every moment is occupied with some sort of sense-enjoyment—even to him death comes, and he also is compelled to ask “is this real?" Religion begins with this question and ends with its answer.'

Care of dying: Need for personal dignity

The dying person is treated with dignity when he is given privacy and his family and religious people from the faith he believes in are allowed to be at his bedside. He or she may have the extreme desire to be respected and valued. They may wish to meet the dear ones or give gifts to them. Words of gratitude from friends and family will help in uplifting the morale and may help in preparing for and accepting death.

Care of dying: Fear of death

Many patients will have fear of death. some of them may panic;some others may show other signs of anxiety; very few express. Talking to the patient frequently on multiple occasions will help in bringing out what is there in their mind. It is not good to give false reassurances,but spending time with them will give them relief to some extent.
There is a belief that whatever we do to meet the spiritual needs of the dying, it should help the person to maintain peace and calm of the mind and to have very high spiritual or positive thoughts for the state of mind at death determines the life after death (if you believe in it).
As a person who is in nursing and has seen many deaths happen in front of my eyes, I wonder, what about the spiritual needs of the people who die when they are on ventilator? Have they got enough time to talk to their loved ones before intubation? Have they expressed their concerns and future plans? Could they say bye to their children? Are they leaving the earth with a feeling of incompleteness?

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