Pastoral Thanatology

Grief Counseling Certification Article on Death and Dying

Posted on by Mark Moran

They say the only certain things in this life are death and taxes.  Death is a guarantee at the moment of birth and becomes ironically part of living itself.  It plays a key role in our life span in this temporal world.  Yet, it is the most feared and avoided topic despite its central importance to our life itself.  Thanatology attempts to understand the nature of death and dying itself and attempts to explain the science and philosophy of death.  Grief Counseling tries to help us adjust to the process of dying or the death of another.  Together, they can help an individual better discuss, deal and cope with this very natural life event.

Traditionally, death has many characteristics.   Lack of respiration, lack of pulse and heartbeat, zero response to stimuli, lowered body temperature, stiffness of the body and bodily bloating are all signs of death.  The Harvard Criteria lists death as something that leaves the individual unresponsive to stimuli, no movement or breathing and no reflexes.  Furthermore it notes that there is no longer any circulation of blood to the brain and a flat EEG exists.

What constitutes a state of death? Please also review AIHCP’s Grief Counseling Certification

 

Death hence has it characteristics and permanence once a certain time period of such lack of activity exists.  While the fear of not being dead and buried may have existed long ago, today’s science clearly delineates the boundaries of alive and dead.   Death though is more than a physical event, but is also for many a spiritual event.  It is an event that leads to a new birth in spiritual beliefs and is more than just merely the end of physical activity.  While spirituality and death may not have empirical evidence to support it, the belief itself is wide held throughout humanity.  It can also be said, while it cannot be empirically proven, life after death, it is also said it cannot be disproven.

The dying process leads to death and is more than a physical journey but also a spiritual and emotional one for the dying as well as their loved ones.  The biggest question to ask is when does dying begin?  Philosophically one can say, dying begins the day we are born, but health studies require a more definitive definition that denotes a direct and acute movement towards death itself.  While one may be dying, sometimes, one may not even know the event is occurring.  This is why recognition of the facts is essential to officially declare one is dying.  The facts need to be communicated and realized for the psychological, emotional and spiritual elements to enter into the equation.  When nothing else can be done to prevent the acute event, one officially realizes they are dying and will die due to a particular thing.

The expression and communication of dying to another is something that healthcare professionals have recently been hoping to improve in regards to delivery of the news.  In the past, the dreaded news has been expressed coldly and sometimes abruptly.   As an event of failure to the medical world, the person was left to process the information without guidance or compassion.  Today, those in Pastoral Thanatology, look to help the dying die with dignity but also understanding and compassion.  Hospice prepares the dying for the ultimate end, looking to reduce pain and prepare one emotionally and spiritually for death.

Physicians and healthcare providers though can better communicate death to their patients.  Sharing smaller facts and gauging responses are key, as well, and not overwhelming the dying and their family at first.  Explanations and time to educate are key, despite the discomfort of such bad news.  Allowing pauses and questions and time to process is key, but also respecting denial.  Being there and giving the time is key. Another important element is not to stretch the truth, but to be completely honest, but in that honesty, again, find the time to listen and not mechanically leave the scene after such heartbreaking news.  Many healthcare professionals are not trained in explaining death and are only trained in the mechanics of what is occurring physically, while dismissing the emotional and mental aspects of death.

Once one is faced with dying and accepts the outcome, certain questions become obvious to the dying.  Certain trajectories manifest to the dying that map out their final days.  The biggest are certainty and time.  How long does one have and what to expect in the final months, days or hours.  Some trajectories are quick, others linger, and others occur unexpectedly.  These aspects can greatly change how one prepares for death.

Death comes for all. How we prepare depends on multiple factors. Please also review AIHCP’s Pastoral Thanatology Program

 

Obviously each trajectory has their benefits and disadvantages.  Preparation in death can allow one to put all business aside, but leaves one to the mental long anguish of knowing the end is coming.  Quick deaths can reduce this anxiety but leave one with very little time to prepare financially, spiritually and emotionally.

The long mental process of accepting death was best laid out by Elisabeth Kubler Ross.  Kubler Ross worked with the dying and found they responded in a five stages to death.  Namely, denial, anger, sadness, bargaining and acceptance.  Each phase while not always ordered, showed the emotional response of most people to the news of death itself.  The news can be so terrifying that one may react in a variety of ways trying to control what one cannot control.  The ultimate end is acceptance because death is guaranteed for all.

Charles Corr also pointed out the reaction to the news of death.  At the epicenter is the physical reality of dying, followed by the psychological reaction, followed by the social reactions and finally the spiritual reactions.  As the wave of the news spreads, the dying story encompasses all aspects of the person’s existence.

Buddhist stages of death are more spiritual.  They see various stages of loss of sensation, to visions, to nothingness itself.  In Christianity, death is seen as the result of sin.  It is a punishment and the severing of soul and body, but it is temporary, and the body one day is restored to the soul.   It is important to understand the spirituality of the individual who is dying and to help them fulfill any incomplete spiritual exercises before death.  This gives comfort to the dying.

How death eventually takes the person is something very intimate and seen by family and healthcare workers.  While it can be painful, it is sometimes very peaceful, as the body surrenders to death.   While many may never have it, it is everyone’s hope to experience a happy and peaceful death surrounded by love.  This is the most anyone can ask for as this dreaded but important part of our life occurs.  One needs to be prepared and think about this event.  It should not be disregarded as morbid, but seen as an important part of life.  The thought of dying well is something we should all smile towards when that day comes.

If you would like to learn more about Grief Counseling and Pastoral Thanatology, then please review AIHCP’s Grief Counseling Certification and Pastoral Thanatology Certification.  The programs are online and independent study and open to qualified professionals seeking four year certifications in these disciplines.

Please also review

“Death, Dying and Human Society”by David Kastenbaum

“On Death and Dying” by Elisabeth Kubler Ross

Pastoral Thanatology Program Video on World Religions and Dying

Posted on by Mark Moran

When helping the dying, it is also critical to help them with their spiritual beliefs.  This may well involve one dealing with another one of a different faith.  It is important to try to find one a representative of one’s faith as soon as possible if death is approaching or if one needs spiritual rituals conducted, but if not, and it is not possible, it will be important to be able to sojourn with the dying.

It is important to respect the dying’s wishes, their religious beliefs and to listen.  It is also helpful to have some knowledge of other faiths and the beliefs that coincide with dying.  Please also review AIHCP’s Pastoral Thanatology Program and see if it matches your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Pastoral Thanatology.

 

Please also review the video on death beliefs

Pastoral Thanatology Program Video AIHCP

Posted on by Mark Moran

Care of the dying is essential.  All human beings deserve to die with dignity.  They deserve not just to have their physical needs met but also their spiritual, emotional and mental.  The dying deserve to die with dignity-minimization of pain and comfort.  They should die with kindness and love.  Unfortunately this is not possible for all, but for the ones who are able, family, chaplains and caregivers can provide the love and support to help the dying leave this world with peace.

Pastoral Thanatology is key in this.  It looks at pastorally helping the dying in all phases of human existence.  It goes well beyond the physical but also addresses fear and grief as well as helping family better help the soon to be deceased.

AIHCP offers a four year certification in Pastoral Thanatology.  The program in online and independent study and is open to qualified professionals.

 

Please review AIHCP’s video for its Pastoral Thanatology Program

Pastoral Thanatology Certification Article on Caregiver Duties to the Dying

Posted on by Mark Moran

Many patients who are dying face a sterile environment in a hospital, not comfortable and with many good intentioned healthcare professionals.  Unfortunately, many healthcare professionals are not trained to help individuals deal with death, or are able to emotionally and spiritually offer consolation.  The death of a person is seen more as a failure than seeing death as part of a new step in existence or part of living itself.

In some cases, the dying patient is cared by also an older relative who also is facing emotional as well their own physical struggles.  This can also compound issues.

The dying patient in essence has multiple needs from a physical, emotional, mental and spiritual standpoint.  They need not only physical care but whole care of their entire essence.  Death and dying is a scary time in life but it is part of life.  Death is not a failure, nor is it something unnatural.  It is the second biggest event in one’s life next to birth itself.  Yet it is shunned due to various taboos.  Helping someone die well is part of the importance of end of life care.  Palliative Care looks to help individuals deal with cancer life diseases, while Hospice prepares the person for death by not looking to necessarily heal but manage symptoms.

Hence care for the dying is usually divided up amongst various groups from doctors to nurses to family to ministers and chaplains.  Each playing a pivotal part.   In some cases, individuals fall through the cracks and their most important emotional and spiritual needs are neglected.  To ensure complete care though, it is important to understand a patient’s rights when dying and what are the most important aspects to address for the dying

The dying have multiple physical, emotional, mental and spiritual needs. Please also review AIHCP’s Pastoral Thanatology Certification

 

Looking at physical needs are the first aspect.  It is essential to give comfort.  Pain management, breathing, and overall comfort is key.  Pain management looks to address pain and discomfort from a chronic and acute sense.  Unfortunately, not all pain can be caught in time and in some cases, individuals needlessly suffer from a physical standpoint.  Legal statues have been passed that insist that treating pain is essential part of care.

Beyond pain, other issues such as breathing, skin sores, insomnia, loss of appetite, constipation, dehydration, nausea and fatigue are all issues caregivers must address in providing care to the dying.  Keeping the patient comfortable and out of distress is a key part of care of the dying patient and it is a right of every human being to die with dignity and limited pain as possible.

In these cases, the six month period of hospice can supply a person with many pain management strategies. Unfortunately, many individuals do not utilize this service or consider it a taboo of giving up on life.  None of this is true.  In fact, some may recover or live longer, but this is not the goal of hospice.  Hospice is about pain management and comfort.  This is why it is so important to utilize to maintain one’s own dignity and comfort in dying.

Beyond these physical needs comes the numerous emotional and mental needs of the dying patient.  Many want to be healed or fear death.  More pastorally trained healthcare providers can also give the dying some sort of care in this regard.  First, by speaking to them as a person.  This is critical.  Caregivers need to speak to dying as the living.  Many are spoken about in the shadows as if they are already gone.  It is important to understand the emotional grief of the dying.  False promises are not encouraged but hope.  Hope that they will not die alone.  Hope that their wishes will be carried out.  Hope that they will be remembered.   And in some cases, discussing death no matter how uncomfortable.

Many dying wish to discuss the elephant in the room but are left to the side and emotionally left to themselves while family mourn them in advance or nurses treat them merely as a number.  This is truly sad because the dying are still alive.  They still have emotional needs and desires.

Beyond these emotional issues is also the spiritual.  This is a more difficult road to cross because some individuals may be of a different faith or have no faith at all.  One should speak to the family or look for cues.  One should not look to convert one to another ideal, but merely discuss faith or what the dying wishes to express and ensure that the proper religious authorities meet their spiritual needs.  Many religious cultures have a variety of needs to be met as death approaches and death anxiety can be lessened by many when religious needs are met.

As an individual embarks on the road of death, they need companions to help them.  Due to taboo of death discussions, or seeing death as a medical failure, or seeing patients not as full human beings, then dignity in death is lessened.  It is important for care givers to ensure full human dignity at the physical, emotional, mental and spiritual levels are met for the dying.

Please also consider reviewing AIHCP’s Pastoral Thanatology Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Pastoral Thanatology

Resources

Care of the Dying Patient edited by David A. Fleming and John C. Hagan III

 

Stress Management and Pastoral Thanatology Article on Primary Caregiver Stress Reduction

Posted on by Mark Moran

Helping an aging family member is difficult.  Primary caregivers suffer from numerous struggles and stresses.  They give up time but also time to care for themselves.  This lack of time to care for oneself can lead to anger, grief, and guilt later.  Being there for a loved one is important and becoming a caregiver for a family member is the ultimate statement of love but one needs to ensure proper health and care for oneself.

Primary caregivers deal with stress they sometimes conceal. Please also review AIHCP’s Stress Management Consulting Program

 

Many times, the primary caregiver forgets to care about oneself spiritually, emotionally, mentally and physically.  This leads to their own illness or mental breakdown.  It is important then primary caregivers understand that they are only as healthy to care for the loved one as they allow themselves to be.  So it is imperative to ensure better self care and stress reduction.  Sometimes that means taking a day off.

The article, “CAREGIVER STRESS PREVENTION GUIDE” by Jessica Thomas takes a closer look at how primary caregivers can reduce stress on themselves.  She states,

“Caregiving for a family or loved one can be an extremely stressful experience for the caregiver. This stress can have a devastating impact on the caregiver’s physical and mental health and can also generate a wide range of conflicted emotions. Often caregivers find themselves feeling hopeless, as if the situation that they are in is an endless series of days and sad tasks. However, caregivers should not feel this way. There is a wide range of resources and strategies that can help caregivers successfully navigate their stress, no matter what type of caregiver situation they find themselves in”

To read the entire article, please click here

Please also review AIHCP’s Stress Management Consulting Program as well as AIHCP’s Pastoral Thanatology Program.   Both programs are online and independent study and open to qualified professionals seeking four year certifications.

 

Pastoral Thanatology Program Article on Caregivers

Posted on by Mark Moran

Caregivers often suffer the most in their care of the ill.  This is especially true for loved ones who become the primary care givers.  Nurses also suffer seeing individuals slowly die as well.  This type of difficulty can cause problems for mental health and can lead to depression.  Those in pastoral care may also experience this type of depression.   So many times, caregivers put others first and forget about their own mental health.

After the death and sadness witnessed, many caregivers of the dying can become depressed. They need to ensure their mental health is also cared for. Please also review AIHCP’s Pastoral Thanatology Program

 

The article, “Hope for those suffering from caregiver depression” by Ann Nunnelly looks closer at care giver burnout and depression.  She states,

“The caregiver position is now including spouses, children, and grandchildren. Along with this responsibility comes a need for spiritual and emotional support so the caregiver doesn’t fall prey to depression and their own physical and emotional sickness. Did you know that rough statistics show that 30% of caregivers die before those they are caring for?  In addition, an increase in auto immune disease and depression haunts an exceptionally large number of caregivers. ”

To read the entire article, please click here

Please also review AIHCP’s Pastoral Thanatology Program and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Pastoral Thanatology.

Chaplains, nurses, hospice and palliative care professionals are all excellent candidates for this program

 

 

Pastoral Thanatology Certification Article on Family Grief with a Dying Loved One

Posted on by Mark Moran

Anyone can reflect on the death of a loved one and if focused can feel the panic and dread.  Immediately wishing to remove it from one’s mind, one turns attention way to more pleasant thoughts, but the reality is, many families have loved ones diagnosed with cancer or dementia and other life altering illnesses.  These individuals live with the knowledge their family member will die probably, unless a miracle, die soon.

Families can have a difficult time with dying process of a loved one. Please also review AIHCP’s Pastoral Thanatology Program

 

This type of mental torture leads to grieving the death prior in many cases.  It can be anticipatory in nature.  When death does come, it may affect the initial reaction to the death.  One may feel relieved, or one may feel guilty, or one continue to grieve.  Pastoral Care givers need to help the grieving family almost as much as the person dying.

The article, “Understanding Grief for Still-Living Family Members” from Technology Networks based off Singers research found in J. Health Pyschol looks deeper at this concept of pre grief of family.  The article reveals research from Singer that discussed the reaction of families dealing with long term illness of family members.  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, please click here

Please also review AIHCP’s Pastoral Thanatology Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Pastoral Thanatology

Pastoral Thanatology Program Article on Death and Dying

Posted on by Mark Moran

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.

Caring for the dying is an emotionally difficult thing for living family. Please also review AIHCP’s Pastoral Thanatology program

 

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

 

Pastoral Thanatology Program Article on an Ethical Will

Posted on by Mark Moran

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.

Ethical Wills are an beautiful way for the dying to express the more important spiritual things they impart on their loved ones.

 

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.”

To review the entire, article, please click here

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.

Pastoral Thanatology Article on Death and Dignity of the Elderly

Posted on by Mark Moran

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.

It is important that the dying play a role if they can in the process of death. Please also review AIHCP’s Pastoral Thantology training program

 

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.