This is the sixth article from a guest writer, Kadampa Buddhist and student social worker. The others can be found here.
At this time of year, Mexicans specifically remember the dead with the Day of the Dead. Traditionally, on the 1st or 2nd November for Mexicans, the souls of dead loved ones are invited back to visit the living. Communities across Mexico and elsewhere gather together to remember dead relatives and friends, toast their memory and reaffirm their feelings for loved ones who have died.
Health agencies around the world now celebrate the Day of The Dead to raise awareness of death issues to get people talking more about death for, as I try to point out in the following articles, it is important individually and collectively that we do so. In the UK, the Day of the Dead is the 4th November. Watch out for news and events relating to this, or why not do something yourself?
In my next couple of articles, I’ll be explaining how I used Buddhism and meditation to help me in my care of the elderly and the dying.
How to help the dying
In my third and final year as a student social worker I decided that my Buddhist values were best suited to the care of older people and the dying as there is less theorising about different types of care and more practical and dynamic compassion. I feel the elderly, frail and dying are the best service user group where Buddhism could have a lot to offer. There is a lot of good information in this website and in Geshe Kelsang’s book Living Meaningfully, Dying Joyfully.
In Living Meaningfully, Dying Joyfully (2009) Geshe Kelsang says you can benefit those who are about to die. He encourages those benefiting the dying to help keep the dying person’s mind calm and peaceful, trying to prevent them from becoming upset or unhappy. He stresses the importance of dying peacefully without any disturbance.
Geshe Kelsang (2010) also talks about the power of prayer. He says:
The power of our prayers depends upon the strength and purity of our intention and that having a mind of compassion for the dying or deceased is very important – if we have a genuinely compassionate motivation our prayers will definitely be effective.
Several times a day I dedicate my good fortune/merit to the vulnerable people I meet in my work as a student social worker; and when a service user I know dies, I do “powa” puja for them (transference of consciousness).
And how not to
During my final year of training I worked in an acute hospital trust within a discharge liaison team and I also focussed my dissertation on the care of older people and the dying. At work I played a part in helping service users leave hospital swiftly, but safely and legally. It’s been my toughest job so far because it can be a very busy environment in which to remain calm (I had to interrupt busy doctors and nurses in their wards – asking them to improve their paperwork and inform me about discharges). I was not Mr Popular with them but I managed the conflict well and made sure I got all the necessary information.
In my work it was challenging to see health and social care professionals disagree at times over the care and funding of care of a dying person. One memory that stands out is of a team colleague liaising in the battle between health and social care over who was going to pay for the service user’s care – whilst the actual service user was in the process of dying. What affect must this have had on the service user?
Most discharges are not deaths; they are often issues around finding an appropriate care home for the service user, perhaps issues around mental capacity and their medical fitness. Whenever there was a death there was often confusion about what was the appropriate action to take, whether to rush them off to home to die or to allow them to die in hospital. This was the topic of my dissertation – how to have a good death.
Where would you like to die?
In the UK, 56 to 74 per cent of us would like to die at home but 60 per cent of us actually die in hospital. Numbers of home deaths have been declining (to below 20 percent). Roughly 500,000 people die each year with fewer than 8,000 specialist doctors and nurses, so there is not sufficient capacity. This combined with an ever increasing ageing population and more people living with multiple and degenerate conditions means there are increasing pressures on the health and social care system. Many people are not getting their wishes fulfilled of having a good death – at home.
Talking openly about death
There is an increasing awareness campaign in the UK to address these problems and in the future there may be more of a role for social care and social work to pre-empt matters. The campaign is a continuous one that encourages everyone in our society to talk openly about death e.g. making wills well in advance, and planning and caring well for those who we know are very ill and perhaps dying. They even discuss issues around advance directives involving not using resuscitations and switching off life support machines, in certain circumstances.
I found similarities with this campaign and Buddhism in that they both recognise that we don’t like to talk about death too much. In Living Meaningfully, Dying Joyfully, Geshe-la says:
Although intellectually we all know that one day we shall die, generally we are so reluctant to think about our death that this knowledge does not touch our hearts, and we live our life as if we were going to be in this world forever.
Through my dissertation research I found sociologists who agreed with this view, saying that, historically, institutions in our society have protected us from thinking about death, helping us suppress or suspend our thoughts about death.
At Kadampa Buddhist Centres we don’t have to wait for the Day of the Dead to discuss death and dying and how an awareness of death can enrich our spiritual practice These kinds of discussion take place regularly!
What do you think? Is it too morbid or depressing to think or talk about death? Or has it helped you live a happier, fuller life, and/or to help others who are dying or bereaved?