Family members who are slowly passing away is a common heart ache in families. The slow process of the dying can lead to multiple emotions. Anger, regret, hope, despair all mix with fearful anticipation of death but also a merciful end to the pain. These conflicting emotions can put caregivers and other family members in difficult emotional states. Counselors and pastoral caregivers can help these individuals, as well as the dying through this difficult process.
It is important though to understand the nature of the death, the process of dying and the emotional toll it takes on all parties. Pastoral Thanatology is the type of counseling that many become certified in to help others learn to better accept and deal with the process of dying.
The article, “Understanding Grief for Still-Living Family Members” from Ohio State University looks at some aspects regarding death and the living. The article states,
“The symptoms of grief people feel for a loved one facing a life-limiting illness fluctuate over time, a new study found – suggesting that individuals can adjust to their emotional pain, but also revealing factors that can make pre-loss grief more severe. Researchers examined changes in the severity of pre-loss grief symptoms in people whose family members had either advanced cancer or dementia.”
To read the entire article and to learn more about the study, please click here
Please also review AIHCP’s Pastoral Thanatology program. The program is online and independent study and open to qualified professionals seeking a four year certification in Pastoral Thanatology
Ethical Wills in the past have left detailed instructions on burial. These older Jewish customs have also become today templates to express emotional or non material things that you hope to hand down to someone. A dying person can hence list things he or she hopes to distill in son or daughter or grandchild. In addition, other family members can create letters or videos that let the person dying what they received most from them regarding their life. This is a difficult step for it involves acceptance of death but it allows for a better death and healing for all involved.
The article, “What is an Ethical Will?” from “Whats Your Grief” looks at the Ethical Wills Origins and how it has evolved to allow one to pass down more spiritual things to the ones they are leaving. The article states,
“I have now recommended ethical wills to many families who have loved ones who are dying. It is an incredible way for families to share what they will keep with them once a loved one is gone. For the person who is dying, the can share what they hope to leave behind that is not physical. Even when you cannot physically gather together, this is something you can still create. Family members can gather everyone’s written, video, or audio thoughts and share it with the person who is dying.”
Please also review AIHCP’s Pastoral Thanatology Program as well as AIHCP’s Grief Counseling Program and see if they match your academic and professional goals. Both programs are online and independent study and open to qualified professionals seeking a four certification.
The terminally ill face the reality of death every day. They may initially deny and bargain but the reality eventually sets in. How the terminally ill are treated is key to their dignity and hope. Hope and dignity to their personhood is key. One does not set out to rid one of hope but one also hopes to care and treat the symptoms of the terminally ill and guide them through reality.
One of the keys of respecting the dignity and hope of the dying is to treat them as the living. Too many times, doctors and other healthcare physicians dismiss the terminal ill as a lost case. Death is not seen as part of life but a defeat. On the contrary, death is an important part of our lives and how we “live” death is as important as how we lived our entire life. In doing so, the dignity of the dying is respected at the highest level by keeping them part of their own dying process. They should not be ignored, left out of decisions, or treated as children. The topic of death should not be avoided as if taboo, but truthfulness and respect should be applied to the dying. They need to be part of the process as much as possible.
In also respecting their dignity, hope should be nourished. False claims should not be presented but an open reality to hope should always exist. To dismiss one’s dreams and hopes is to disrespect the fire and spark of the human spirit itself. One can work with the dying and apply appropriate alternative therapies and give openness to the dying’s hopes and dreams. This does not mean one exists in a state of denial. On the contrary, this means, one accepts the dire situation and the nature of the disease, but also expresses the hope that is inherent to human dignity.
In nourishing both the dignity of living the death process as well as hope, those in pastoral care and pastoral thanatology can better treat the emotional element of the dying. It is as equally important that hospice or health providers not only treat and alleviate suffering of the body, but also the mind. This is why pastoral thanatology is so important in hospice.
If we do not understand the needs of the dying from an emotional standpoint or treat the dying as living, then we miss the entire point of pastoral care for the dying. We also miss the point of the human condition and the importance of death in the entire process of life. Elisabeth Kubler Ross and David Kessler were both pioneers in their field in expressing the rights and needs of the dying. They both dedicated their life to helping others experience death. They also helped train and educate so many people about death.
If we do not understand death now, we will not be able to have a better death ourselves, nor be equipped to help one’s loved one’s experience death. So many regrets and un-needed pains exist because the dying experience was not properly conducted in terms to expression of emotion or inclusion of the dying in their own affairs. Death is seen as the final chapter and as a scary one at that. It is fine to be intimidated by it, but it is part of life and like all aspects of life, it is critical that we live death to its fullest. We need to respect it as much as we respect birth and respond to it properly.
If you would like to learn more about Pastoral Thanatology or would like to become certified in Pastoral Thanatology, then please review AIHCP’s Pastoral Thanatology program and see if it meets your academic and professional goals.
Death is not the end to spiritual people. Death is a continuation. Many view death as primarily an end point and something to be avoided at all costs, but death is as part of life as birth and plays a pivotal role in our development.
Spirituality is key in death. Many may view life in a more materialistic way, but even so, spirituality without a higher end can be beneficial to the dying. Spirituality and a commitment to something higher or bigger than themselves. The traditional ideal of spirituality sees this in regards to religion, faith and a God, while others may see it as a way of life, or giving to the greater cause of humanity. Spirituality allows one to approach death with more dignity and understanding.
In David Kessler’s book, “The Needs of the Dying”. he addresses five important stages and elements of spirituality. In some cases, death or the news of death bring about this stages and to them the benefits of death open one’s soul. Spirituality is for the mind and soul, not the body itself. Death can bring about a healing of the soul for the future existence.
Kessler points out that the first step is expression. Expression is needed in regards to one’s physical ailment. One needs to let the anger or grief out. Many are angry at God for suffering and misfortune or why they have a particular disease. It is important to express the feelings of death to be able to face them and understand them. No particular feeling is wrong or right but are catalysts to understanding.
Following expression is a spirituality of responsibility. One begins to take account of one’s life and begin to understand that not everything in life was everyone else’s fault. Taking responsibility allows one to humble oneself and identify issues of life that were once so black and white and maybe see that the issues and common factors were oneself. It can present an important spiritual transformation that without death could never occur.
Naturally following responsibility stems forgiveness. One does not wish to die bitter and angry but instead looks to forgive. Death can bring broken and shattered families together in forgiveness. One is able to set everything straight and see things far more clearly than before. Petty arguments and proud stances become trivial when one is about to lose his or her life.
Acceptance of the death is also an important step in dying. One may not desire to die but it is important to accept death when no other route is left. One needs to learn from oncoming death what life truly is. This is only possible when one faces death and accepts it as part of his or her continuing journey.
In this, spiritually, one should find some sort of gratitude. Life is not defined by what was accomplished or how long one lived, but a life is defined by birth and death. No life is incomplete. Each life has a certain amount of time. Gratitude for life and what has been given is key in spirituality when dying. It cherishes what has been given instead of lamenting what was taken.
Spirituality is important in dying. It helps one to understand the comprehensive nature of death. Death is no longer an end point but part of a process and something that is as important to life as birth itself. If you would like to learn more about Pastoral Thanatology and the science of dying, then please review AIHCP’s Pastoral Thanatology Program and see if it matches your academic and professional goals.
Pain is a natural nerve reaction telling the body that there is damage to tissue. It is an essential warning device. It sometimes hastens death and lets the person know the body no longer is viable and sometimes in death it can be absent. Unfortunately, individuals cannot decide if pain will be present in their final days or not but every person has a right to die with as little pain as possible. Physicians and family need to ensure their loved one’s receive the necessary pain management.
Pain management should be simple but it is not always simple. Many individuals see pain differently. Pain for the most part is dependent upon the individual. This is why it is so crucial to express for the terminally ill or dying to express their levels of pain. Doctors may prescribe pain medication levels for an average curve and supply too little for someone who may have a lower tolerance for pain. It is important for individuals to let doctors know their pain level. They need to express the type of pain, the level of it, the place of it, and its duration.
Some may seek to hide their pain, fearing if they accept certain medications, they are hastening death, but the reality is pain management is not about giving up, but instead, living in comfort with what days remain. It is crucial and a right of every patient to be pain free or at least as pain free as possible. Families who see their loved ones suffer, need to be the voice of those to weak to express their pain and ensure the proper medications and pain relievers are supplied.
Many doctors may fear the issue of addiction with greater pain relievers, but the fear of addiction is mute once a person has reached the threshold of death. Death is coming and addiction of certain medications is not an issue nor ever should be. Addiction can become a topic for discussion for pain management of the living, but never should be an issue for the dying. Comfort and pain relief is the most important concern after someone has reached a certain point.
It is the duty of pastoral care givers and healthcare providers to provide the best comfort to the dying. Physically, pain relief is one of the most important elements of pastoral care. It is important to reduce or remove pain as much as possible for the dying so they may experience a death of peace and dignity when possible.
If you would like to learn more about our Pastoral Thanatology Certification or would like to become certified in this field of care of the dying, then please review AIHCP’s program and see if it matches your academic and professional goals. The program is for healthcare professionals and those involved in ministry and focuses on preparing individuals with the training and knowledge needed to help the dying and their families deal with end of life issues. The program is online and independent study and leads to a four year certification.
Pastoral Care of the dying is beyond treating the body and providing comfort but also helping the soul prepare for death. Spirituality plays a key role in this process of death. While the subject should not be breached unless invoked by the patient, it is important for healthcare providers to have some understanding of faith and spirituality. It is important to see how faith plays a role in dying and how to react to faith based statements from patients.
The article, “Spirituality Is An Important Part of Cancer Care, But Nurses Need More Support” by Kaitlyn D’Onofrio looks at how nurses view spiritual care. Her article states from a case study of nurses that
“For nurses to provide spiritual care, institutional acknowledgement of the importance of spiritual care is needed. Nurses have highlighted the lack of adequate settings to address spirituality. Spiritual care needs to be a part of the institutional vision to enable the provision of this care to become relevant and accountable by institutions,”
Dying is as much part of life as birth, yet many dismiss it, hide it and avoid it. Death is a taboo subject for many. It is forbidden word of bad luck. When such attitudes persist, how one experiences death or experiences death with a loved one can be negative.
It is important to face death as we face birth. We need to live the dying process fully and despite the pain, stand by those who are dying. David Kessler explained it best as how we used to meet our loved ones at the gate of an airport. We met them there, but when their time to leave arrived, we walked them to the gate. While this is no longer possible since 911, the idea and analogy fits perfectly. We welcome many from day 1 and in some cases we also say good bye to them. We cannot cheat the process. We cannot just drop them off at the terminal and allow a shuttle to carry them off. We need to be with them every step of the way.
In honoring them, in honoring the death process, loved ones need to be with the loved one, yet many negative ideas on death prevent this important time of bonding. Seeing death as the enemy, as a bad word, and as something to be avoided, leads to regrets later. It not only affects the dying loved one in a negative way, but it also prevents healthy healing later for the surviving person.
How many times, do individuals not speak about the person’s condition, avoid the disease, maybe even avoid the dying person? How many times, do individuals chastise other family members for speaking about death to the dying, or express emotion.
In addition to dismissing death, many hide emotion. They think one must be strong for the loved one who is dying. This prevents true expression of love. It incurs unresolved issues that can later haunt the bereaved. Most importantly, it prevents the dying to express their own emotions with the loved one. So many chances are lost when death is not spoken about with the dying, or emotions are not permitted to be shared in this intimate moment.
So what do we speak about to the dying? David Kessler and Elisabeth Kubler Ross would simply state, “listen”. By listening, we give ourselves to the dying, and we also allow them to open up. No conversation is wrong. It allows the dying to express their frustrations, their fears, their dreams. It allows closure in things that may never find closure.
Somedays, certain conversations about the reality of death may not be beneficial. Other days, simply talking about the game and allowing the dying to live suffices. Other times, discussing death can help the person face the reality and discuss important matters, or share certain feelings. It is critical in these narrowing days of life, that one shares what one feels. To hide and take away this precious time of mutual disclosure will never be there again.
Hence it is important to share things, to discuss death, to discuss anything and most importantly listen. It is also crucial to share emotion, to allow the dying to know it is fine to be cry too! Too many times, individuals masquerade their feelings in these final precious moments.
Death is part of life and not something that should be done wrongly. Dying wrongly or experiencing death with a loved one is not about how one dies but how one experiences that death or process. One who experiences death with communication and no false faces is not denied the dignity of it. One who sojourns the dying to the final gate, experiences its entirety. It is far from pleasant but when dying and loved ones experience death fully together, then it far more healthy in the short term for the dying and the long term for the mourner. It is a moment in time that is intimate and precious and one we owe our loved ones to experience fully with them.
That is the pain of life but it is part of life. We must live life to the fullest and live it correctly. Death is no different.
Please also review AIHCP’s Pastoral Thanatology Program and see if it meets your academic and professional goals. Care of the dying is an important field and the Pastoral Thanatology Certification can help one in helping others die well and in peace.
Dying is part of life. Dying is not a failure but a pivotal part of human experience. No-one truly knows what is like to die but individuals can learn how to face it. Elisabeth Kubler Ross and David Kessler wrote extensively on death and the needs of the dying. They discussed vital aspects in how to counsel and listen to the dying.
One of the biggest things they emphasized was to treat the dying as if they are still alive. To many times, the dying are seen merely as an old shell of what they once were. The dying are defined by their disease, not who they were. The term my “dying grandfather” is applied instead of my “grandfather who is dying”. Dying is not the essential quality of the person. The essence of the person remains.
When listening to the needs of the dying, one needs to see the full humanness of the person. They need to see the light within the person’s eyes, not the disease, the machines keeping the person alive, or the crippled body. The person still exists.
It is essential to treat the dying with dignity and respect. They deserve to be spoken to about their condition. They deserve to be involved in the decisions, if conscious. They deserve to be recognized. This is family should not shun the conversation of death, or hide their conversations outside the hospital room. The dying need to be treated as living.
The dignity of the dying is critical to maintain as a living person. They need to be listened to, spoken to, and not treated as if they already dead. Hope should never be denied. Hope is a key element. While some may remained to the reality of approaching death, hope can continue to fuel the dying. Since they are alive, hope is still always alive. To die with hope is not a bad thing.
Dreams of a cure, or a miracle are not bad things. Too many times, doctors and healthcare professionals see death as defeat and not part of life. Once the disease progresses to a certain point, they no longer view the person as alive. They sometimes dismiss hope because of their own defeat. Death, however, is not defeat. Death is natural and is as part of life as birth. Hope for life even during terminal illness does not mean one is in denial of his or her condition but that one is alive and ready to face any challenge, even to the very last breath. This is the essence of the human spirit and the true meaning of being alive.
One cannot label the dying as dead but treat them as alive. One must see in the dying, the face of a man or woman in her prime, not defined by old age or disease. Whether one believes in miracles or does not, whether one is spiritual or not, one cannot dismiss hope if they work with the dying. Hope is a powerful thing. Whether it prolongs life or does not, it definitely does not hurt the person. If the hope is well rounded in reason but yet optimistic, one can live while they are yet dying.
One cannot dismiss the final time of death as wasteful or useless. There is always a reason. More time to learn, or teach others. Family may come closer, or learn new things during the dying process. Maybe the dying wishes to see one last person.
It is important to grant hope but also to discuss death, to let the dying know they are still a complete person. They can accept death with dignity as well as fight for every breath, or they may succumb to death with the love of others surrounding them. Only if the person is given the dignity they deserve while dying is there a true possibility for a happy death.
Dignity and hope are key elements of living the fullness of death. It may seem contradictory to say living the process of death but that is what it truly is. When we view the dying as already dead, there is no true process, no true experience of this ultimate event. Death is part of life and hope and dignity are essential elements of “living” a “healthy” death.
I recommend reading the classics of Kubler Ross, as well as David Kessler’s works on the matter. Their insight, experience and analysis of death are essential to anyone working in the field of hospice, pastoral thanatology or grief counseling.
If you would like to learn more about death and dying, or would like to become certified in Pastoral Thanatology, then please review AIHCP’s Pastoral Thanatology Certification and see if it matches your academic and professional goals.
Good article on the importance of funding palliative care and assisting life and dealing with suffering than ending life through assisted suicide. Pastoral Care is about preserving life and helping others find comfort in the end of life.
The article, “Catholic Medical Association: fund palliative care, not assisted suicide” by JD Flynn states,
“Palliative care involves medical care and pain management for the symptoms of those suffering from a serious illness, and refraining from taking actions that directly take the life of the patient, as opposed to the practices of assisted suicide and euthanasia.”
Terminally ill patients deserve good care during their last months. Hospice is a critical aspect to that. Hospice needs to ensure that patients are cared for and meet standards that ensure the best qualify of care for the dying.
The article, “Terminally Ill Patients Deserve Hospice Care Reforms” by Ross Marchand states,
“Every year, hospices offer millions of sick and vulnerable Americans a refuge from medical tests and endless injections in their final days. In 1982, lawmakers realized that a growing network of hospices offered similarly effective but more pleasant care than hospitals for terminally ill patients, at a fraction of the cost.”