Life and Death do not wait for perfect theories, definitive studies, and validated intervention procedures.

Life and Death

Two of the attributes that all humans share are the experiences of being born and the fact that everyone would eventually die.

Thanatologists: those who study the surroundings and inner experiences of persons near death

Stages?

Denial and isolation (No, not me!)Anger, rage, envy, and resentment (Why me?)Bargaining (If I am good, then can I live?); Depression (What's the use?); Acceptance.

Most authorities believe that these stages do not occur in any predictable order and may be intermingled with feelings of hope, anguish, and terror.

Death and Culture

Fear of Dying is innateDeath is a socially constructed idea The fears and attitudes people have towards

death and dying are learned from educational and cultural vehicles such as the languages, arts, and religion

Every culture has its own coherent explanation of death which is believed to be right by its members

Western vs Eastern Thought

Cultures can be death-accepting, death-denying or even death- defying. In the death-defying West, the strategies for salvation have historically included activism and denial.

In the East, the strategies have often been more contemplative and mystical.

No – Not Me!

The United States, and probably most of the societies in the West, is a death-denying/defying society where even the idiom of expression is that of resistance.

People vow not to go gently into the good night (Blake, 1988) or conjure images of fighting illness, or fighting the enemy, death (Kalish & Reynolds, 1981).

Death Anxiety Across the CulturesDeath anxiety is not prevalent to the same

degree across cultures.

In a study of Hindus, Muslims, and Christians: found that Hindus (who had the greatest belief in life after death) also tested lowest in death anxiety, followed by the Muslims, while the Christians showed the highest death anxiety

Don’t Talk About ItAlthough we are excited about discussions concerning birth, people in all cultures discuss death with extreme reluctance. However, even though we may use the same words to describe death, the actual meaning and conceptualization of death differs widely across cultures.

Among Many Cultures

Death signals an abrupt and permanent disengagement

In some instances, people are prohibited from

even mentioning the names of the deceased in the fear that doing so may actually endanger the lives of the living or prevent the ghost from leaving this earth and attaining peace.

What Scares You?

“Death doesn’t scare me. It’s what comes before death that terrifies me.”

Dying to CommunicateInterviews and Personal Narratives of over 1250

cognitive terminally ill hospice patients

60% Female - 40% Male

Ages 3 – 107

80% Caucasian

12% Hispanic

6% African American

2% Other

Dying to Communicate . . .

Concluded that…

Terminally ill people are not allowed to talk about their experience of dying even though this research shows they want and need to talk about it.

Listen The most basic of all human needs is the need to understand and be understood. The best way to understand people is to listen to them.

Ralph Nichols

3 year old Wisdom “I’m not afraid. My bunny is

going with me.”

“I loved my children and they’re all dead now. It’s not right to outlive your children. Never in my life did I expect that. That was a shame. I’m very old.”

107 year old Wisdom

The Death-Defying, Death-Denying Society . . .

A death-denying society is characterized by an inability to discuss death and dying openly. A death-denying society is one that views death as a punitive consequence of poor management of the physical self. A death-denying society attempts to regulate death to institutions, such as hospitals. A death-denying society places little value in a dying person.

Death accepting cultures of hospice and palliative care provide an environment in which the terminally ill person can talk about his or her experience of dying with people who not only understand the many dynamics of death and dying but embrace people facing death.

Conclusions . .

Need for Death Mediators

A death mediator has to embrace death and dying as a part of life and convey that acceptance in a humane and compassionate way. A death mediator is often found in an environment which values the dying. Death mediators are most often found in hospice and palliative care.

Society Does Not Want To Talk About Death and Dying

“It sure is strange you wanting to talk to me about dying. What type of study is it? You going to be a mortician? No, my mortician didn’t even talk to me about dying, you must be worse than that.”

“I think it’s great you’re willing to come here and talk to me about dying. Does your family know you do this?”

Patients Want to be Told the Truth

“He couldn’t tell me I was dying, either. What’s wrong with being honest? When did it become a bad thing to be honest? I wish he had just told me we didn’t beat it. We tried, but didn’t beat it. I would have understood that, and I wouldn’t have blamed him either.”

“My doctor was so busy, he couldn’t, didn’t tell me in person. He called and left a message on my answering machine. ‘Your MRI shows you have a brain tumor with mets everywhere.’ I think you need hospice now.”

“I think my life is ending too soon. I think I still had more in me to go. I wish I had done some things different, but you can’t cry over spilled milk. You look back and wish your eyesight was dimmer. Memory is a rotten thing, you know?”

Dying to Communicate

What the Dying Say about Life

Finally, somebody knows what is wrong with me. I thought I was going crazy. I’m just dying, that’s all, just dying…what a relief.”

Is It Always BAD News?

“ Whatever happens, I don’t want to die in pain. I mean, who does? I don’t care what you guys need to do, I don’t want to be in pain. Don’t make me use a gun (laughs) . . .

.… I’m not talking on me, I mean on you guys. If I have real bad pain, I’ll just shoot you.”

“I think it is going to be very soon and I’m, I am going to be well again somewhere else. Will you tell them that for me afterwards. Tell them I was happy to be leaving. Not leaving them, but released. Tell them that okay, when they are sad.”

“How do you say goodbye? I was never good at it and now, well, I’m really having a hard time. How do you know when to say goodbye for the last time?”

3 Things You Own (Things you would be sadden to

lose, include pets here)

3 Personal Attributes (What you like about yourself)

3 Activities You Enjoy (Sex is an activity)

3 People You Love (Children can be grouped into 1)

“It makes me a little crazy to think about it, but that’s all I ever do. I wonder, I keep wondering is this it? Is this my last day on earth? I don’t want to close my eyes. If I stay awake, I stay alive. I wish I was ready. I wish I could tell you that, but I’m not, I don’t want to die.”

“I’m so tired. I think I’m ready now. I don’t think too much about it anymore. I wish it would just happen. Get it over with and let’s move on. I’m ready now, tell them all that okay? Tell them I was ready finally. Tell them please.”

“Oh heavens no. It doesn’t scare me. It’s rather fascinating if you ask me. I just wish I had more time and energy to explore it and find out where I was going with all of it. I hope there is awareness. . .

I don’t want to miss a thing.”

“I’ve made myself an urn. I’m painting it bright red. That way nobody will forget where I’m at. . . Somebody will have to date it though. Can you do that for me?”

“Don’t forget how to spell my name. . .

Harry. H A R R Y!

You got it?”

They Never Forget

They may forget what you said – but they will never forget how you made

them feel

Carl Buechner

Analogy of cultural diversity using weaving as an example.

Although weaving is a universal technique, the patterns that result from this process are culturally unique and identifiable.

Thus, even when they use the same materials, patterns used in Navajo, Chinese, Persian, Japanese and French tapestries are recognizable not only in terms of colors, but also of patterns and textures. This range of diversity applies to issues about death and dying.

Attitudes and BeliefsAmong the cultural indicators to be considered are:nature of the beliefs toward the meaning of life, death and the

hereafter; funerary rituals and strategies for body disposal; the physical and symbolic boundaries between the worlds of the

living and the dead; the perceived role of the dead on the affairs of the living; the degree of social stigma attached to those dying, dead, or

bereaved; orientations toward and rates of suicide, murder and abortion; death prevention and avoidance as a social goal; the death socialization of children (including death themes in

children's stories and games) and their involvement in funerary ritual;

the taboo status of the topic of dying and death in everyday discourse;

the language used regarding death.

DifferencesSouth Pacific cultures believe that life, as is

generally construed, departs the body of a person in different situations, such as when one is ill or asleep. Thus conceptualized, people can be said to "die" several times before the final death.

Truskesian CultureThe Truskese of Micronesia believe that life ends at

40 years of age, and when you reach 40, you are, in effect, dead.

Given the physically demanding activities engaged in by people in this society, there seems to be a noticeable decline in the ability of the Truskese to perform their socially assigned roles at acceptable standards at this age.

Sensing that the end must be coming, the individual begins to prepare for death and is viewed as being dead even before he or she transitions to that point as viewed from the Western perspective.

Western – Christian ThoughtDeath occurs only once. Christians do not believe that everything

ceases at death. The person sheds his or her bodily form but continues on in spirit where there are consequences.

The faithful - believers who kept the faith - are rewarded with eternal joy in heaven.

Sinners proceed to hell.

Mother Teresa“Death is nothing else but going home to

God, the bond of love will be unbroken for all eternity.”

Native AmericansAmong some Native American tribes (and

certain segments of Buddhism), the dead and the living coexist

the dead can influence the well-being of the living. If the dead (ancestral spirits) are properly reconciled, the likely outcome is a benevolent spirit that protects the interests of the living.

If not accorded the appropriate treatment, the result is an unhappy spirit that may ignore the well-being of the living, leading to misery.

Navajo Legend One day, the Navajo people placed an animal hide in

water. If it did not sink, then no one would ever die. However, if the hide sank into the water, then death would be part of life. The Navajo did not watch the hide, but turned away from it instead. While their backs were turned, a coyote threw some rocks on top of the hide. Of course, this made it sink down into the water. The coyote's reason was that if no one ever died, there would come a point at which there wouldn't be any more land on which the people would live. This is the reason death comes for all of us eventually.

Circle of LifeDie happily and look

forward to taking up a new and better form. Like the sun, only when you set in the west can you rise in the east. Jelaluddin Rumi

BuddhistThe universal law of karma

... is that of action and reaction, cause and effect, sowing and reaping. In the course of natural righteousness, man, by his thoughts and actions, becomes the arbiter of his destiny.Paramahansa Yogananda

Attitudes and Beliefs When you are born, you cry, and the world rejoices. When you die, you rejoice, and the world cries.

Tibetan Buddhist saying

Death in HinduismSome cultures, such as the Hindu, envision a

circular pattern of life and death where a person is thought to die and is reborn with a new identity. This exit and reentry into life can occur multiple times.

Death is not viewed as the end of all but only a step in the existence of soul, a temporary cessation of physical activity. Since Hindus believe in reincarnation and the trans-migration of the soul, they approach the subject of death without much fear.

Hindu BeliefAccording to Hindu belief, it is necessary for

the skull to be broken by a blow with a cudgel at the cremation ground, to free the soul from entrapment within the skull.

MuslimA Muslim's body must be washed at least

three times after death with soap and water. Perfume may be used, or camphor placed, in the orifices and armpits, while prayers are said and passages read from the Qur'an.

Gyan Rajhans Scientist and Hindu Spiritual Thinker

“We brought nothing with us when we came, and would take nothing with us when we leave this world. In fact, we will leave a little extra behind if we lead a life of goodness and philanthropy. If we become soul-conscious, death will be an "ordered" process, carried out in full consciousness and with understanding of cyclic purpose. Once understood, the fear of death ceases. It gives us a certain power to control our passing over to the other side of the veil. Let us approach death with as much normalcy as we can manage.“

RussianIn Russia, a copper coin was thrown in the

grave to help the dead person redeem a better place in the other world.

After the death of the farmer or his wife, a horse or a cow died on the farm, it meant that the deceased took his/her share with him/her to the other world (usually an egg was put in the armpit of the body so that he/she would symbolically have his/her share.

Ritual and CultureIt is important  to emphasize the situational

aspects of death rituals when interpreting these rituals cross culturally and to take into account the cultural context where the rituals that surround death take place

Culture & RitualsWhen examining death rituals cross-culturally

it is easy to attribute the same symbolic significance to similar rituals. Nevertheless, after looking at the rituals, used in the context of the culture they were created in, the symbolic meaning can be quite different. 

Crying, for instance,  is common at funerals. In our western countries it is a spontaneous expression of feeling whereas in other cultures crying is mandatory on certain occasions, including funerals, to symbolize the attachment between persons .

Omens: Symbolic interpretation of certain signs.

The foreteller of death can be a bird or some other natural object.

An instance of death in the neighborhood can be foretold by a raven's croaking, a bird flying on the window or into the house, a death tick ticking on the wall, a dog's howling, the cackling of a hen.

The number of years one expected to live was counted by the cuckoo's calls.

Other omens include noises in house at nights, itching of the nose, stalks of straw crossed in a peculiar way during threshing the grain,. In spring one could foretell poor crops and also death Even at childbirth people tried to foretell by looking out, what kind of death the baby would die.

Dreaming of a dead person, a priest, or a gift given by a dead person predicted the dreamer's death. The symbolic language is the most interesting feature in the interpretation of dreams.

Omens were also observed during funerals.

Tombstones & Graves

Most modern cultures mark the location of the body with a headstone. This serves two purposes.

First, the grave will not accidentally be exhumed.

Second, headstones often contain information or tributes to deceased. This is a form of remembrance for loved ones; it can also be viewed as a form of immortality

CremationCremation is a more recent phenomena. It

became visible in the late 19th century and it was long seen to be the preserve of the freethinker, the consciously modern and even the weird.

In the US, the growth of cremations has also been associated with a social change – the breakdown of family and community traditions and the decline in mainstream religious affiliation

Preparation of the CorpseIn Judeo/Christian countries like America and most of

Europe, the body is embalmed and often dressed in fancy clothes to be buried. It has been suggested that this ritual is preformed because the "sacred quality of man exists in the soul and spirit, and that the body, as a temple or chamber for the spirit during life, deserves decent and respectful treatment" (Haberstein, 1960).

In some parts of Africa the corpse is bathed and dresses as well. Some Africans believe that there is a long journey between this world and the next and that death is a continuation of life and not an ending. Thus, the body is bathed and dressed in a manner to represent these beliefs of travel for a difficult journey. Therefore, although the ritual of 'grooming' of the deceased for burial may look similar for both Americans and Africans the symbolic significance of the rituals are quite different.

The End

People living deeply have no fear of death.

~Anais Nin