Spectrum Of Death And Dying Rituals: Practices Across Cultures

1. Describe the spectrum of death and dying rituals and practices across cultures. Why are death and dying rituals so significant?
2. What death and dying practices are contrary to your personal beliefs or chosen religious values? How will you support a patient's death and dying rituals and practices, and still honor your own?
Death and Dying and Spirituality
Introduction
Perhaps at no other time are people more spiritual than when they are confronted with death--their own or that of loved ones. People may scorn religious ceremonies in the midst of living life, but when the end comes, rabbis, priests, ministers, and various "holy" ones are sought. Regardless of culture, there seems to be a commonality in desiring to postpone death or to see that the dying have a proper send-off to wherever they are going. There is also a need to bring closure to the family.
Dying in America
Dr. Elisabeth Kubler-Ross identified five stages of dying: denial, anger, bargaining, depression, and acceptance. This does not mean that all people go through all the stages, but the stages do seem to explain the process of dealing with approaching death. The stages explain the grieving process, as well as the process of accepting one's own death. Health care professionals can benefit from Dr. Kubler-Ross's research.
Children grieve differently and may stay in the denial stage even after the loved one has passed. Children often ask when their mommy is coming back. One child, when told that Dale Earnhardt had crashed and died, said, "He'll race again tomorrow," perhaps because this is what happens in cartoons. Children do not understand the finality of death.
Dying rituals are performed for the peace of those left behind and for the peace of the dying patient. Loved ones need to know that they did all they could for the one who was dying. This will offer peace of mind for years to come. Modern medicine in America does much to alleviate pain and to allow a person to die in peace, often at home.
Hospices now offer assistance to the dying and to their families. Pain medication is offered, advice is given to the family, and general comfort is administered. People have the option of dying in their own home and surrounded by those they love. Still, approximately 70% of elderly Americans die in hospitals and in nursing homes.
Attitude is Everything
Attitude toward death dictates the rituals performed and the grief process afterward. Attitudes vary from fear and superstition, to calm acceptance, and to honor and glory. Culture and spirituality influence the attitude.
Christians face death with acceptance (God's will). Believing in a beautiful heaven where God and His Son Jesus reign–where there are no tears and no grief–as the final destination for those who embrace Jesus as their Savior provides a calm outlook toward death. It is beneficial to be able to tell children, "Daddy has gone to heaven" or to think of a loved one in the arms of a perfect God. It should be remembered that people from other cultures may have embraced Christianity while living in the United States.
Many people who believe loved ones are in heaven also believe that their relatives have the privilege of looking down on Earth and assisting those left behind. Thus, some individuals declare themselves able to communicate with those who have passed and offer messages, which are allegedly sent from above, to relatives on Earth. People seek solace in "hearing" from relatives in heaven.
Prayer is extremely important to Christians and others who pray to a deity. Religious representatives are often invited to come to the hospital and pray for the terminally ill. This is so important that hospitals traditionally allow ministers to visit the patient when all others, except for the family, are denied admittance.
Some cultures view death with fear and surround themselves with acts to ward off death or to ease the dying into the next level. Among Koreans, it is bad luck for a person to be brought into the home after dying, so it is important for the person to die at home. Koreans believe that signing one's name in red ink may bring death.
Chinese avoid the use of the word "death" and its synonyms. Using such words may cause bad luck. Some Chinese would even avoid buying life insurance, which is considered an invitation to death. As black is associated with death in American cultures, white is also a color of death in the Chinese culture. Chinese do, however, accept death as a part of life.
Other cultures believe that death will result in reincarnation depending on the life the person has led or the karma of the person. Prayer will be said for the ancestral souls to return in a higher caste in the next life. Often it is the responsibility of the elder son to take charge. This may take the form of prayers and other funeral arrangements.
The health care professional should avail him/herself of beliefs about suicide. Many religious beliefs condemn suicide as preventing the soul from continuing to heaven or whatever final destination is hoped for. Some, however, believe that suicide for a cause brings great honor and rewards. Those who perform that kind of suicide usually do not end up in hospitals.
Before cultures are criticized for superstitious beliefs, one should check his or her own "good luck" charms. For example, a multitude of stones promising "health and long life" grace the jewelry in America.
All the information about death and dying must be tempered with the fact that these cultures have been Americanized, at least to some extent. Practices in the states may vary from those that would have been practiced in the native land.
Grief
Grief varies from culture to culture and from person to person. Some cultures feel that loud wailing shows the extent of grief and the importance of the one who died. In some periods of history, professional mourners were hired to loudly weep and moan on behalf of the family. Other groups face death stoically and refrain from weeping.
The period of time between the dying and the burial may be 1 day, 1 week, or an even longer period of time during which the deceased may be surrounded with mementoes for the eternal journey, or there may be a send-off party with alcohol and funny stories about the deceased. In many cases, the wake becomes a social event, attended by people who have not been seen for years, and who would not be present if it were not for the death. The sadness of losing the loved one is overshadowed by being able to reminisce with old friends. Undoubtedly, the social atmosphere filled with condolences and memories aids in the grief process.
Conclusion
Just as attitudes toward death and dying vary with spirituality and cultures, they also vary among families. American families differ in emotional expression, as do families in other cultures. Health professionals must know all they can about the culture and be willing to step aside to see that important rituals be permitted at the end of life.