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Palliative care is an essential provision with faith awareness an important tool in administering spiritually sensitive care

“When you see

My corpse is being carried

Don’t cry for my leaving

I’m not leaving

I’m arriving at eternal love”

Mystic poets like Rumi can eulogise death in this manner, but for ordinary mortals death is indeed perturbing and scary. Death is the end of our worldly life and it disconnects us from our loved ones as well as the belongings and possessions we crave most. Yet, death is the only reality that is lying in wait for us; it is the only truth that we all have to confront. It is heart-wrenching to see our nearest and dearest die and it is painful to think that one day we all will have to face it. Death is frightening; the moment we are born our fate to die has become predestined.

Death is the unbeaten conqueror; it silently overpowers its prey without any mercy. It is very democratic and is life’s ultimate leveller. A victim’s wealth, power, fame, strength, age or looks do not matter. It makes no distinction between humans, animals or any other living thing.

Death is always shrouded in mystery. Because of this inevitable but unknown fear factor most people avoid thinking of death. We celebrate birth, enjoy the fruits of youthful vigour and adulthood and appreciate the wisdom and experience of matured life. However, we keep away from uncomfortable thoughts of death; in fact the British are known to not talk about death. We pretend death does not exist, but it comes in stealth and knocks at our door.

There is a parable which sums this up:

“Death asked life:

‘Why does everyone hate me but love you?’

To which life replied:

‘Because I am a beautiful lie and you are a painful truth’ “

Millions of people die in the world every day. A motionless body on the street is not uncommon in some parts of the world where death is more frequent due to malnutrition and man-made or natural disasters.

Our life is sacred from conception to death. The dead who once lived among us are also sacred. The life and dignity of every person must be respected and protected at every stage and in every condition. As with life, one of the most fundamental human rights is the opportunity to have a decent death.

Palliative Care

Palliative care (from the Latin ‘palliare’ or ‘to cloak’) focuses on the relief of pain and other symptoms and problems experienced by sufferers of serious illnesses, with care and respect. The goal of palliative care is to improve the quality of life by giving comfort and providing a support system to the person who is ill and also to those close to the patient. Palliative care can neither hasten nor prolong death. The World Health Organisation describes palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illnesses, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”

Palliative care can be delivered in any care setting – including at private and care homes, hospitals, day care centres or hospice inpatient units. Through pain relief many hospices and some hospitals manage a patient’s dying days with care and compassion and palliative drugs that are tailored to the patient’s pain. Families, where available, are involved in earnest. Family members spend much time with the patient. Some families prefer the patient to be at home where there is plenty of reassurance, comfort and love.

More and more people are now living longer; this is putting strains on the national budget on health care, including palliative care. However, there must be a strict medical code of ethics regarding palliative care.

Diversity of human traditions

We must educate our communities about the role and goal of palliative care. The Muslim community in east London has been hosting a series of meetings with palliative (end of life) care professionals. On World Hospice and Palliative Care Day we collaborated with faith leaders and hospices, including Richard House Children’s Hospice, St Joseph’s and London Muslim Centre in East London.

Our life consists of body, mind and soul; so, there is a need for physical, emotional and spiritual care. Religions tend to deal with birth and death well, and as such, religious communities are generally well-equipped to deal with palliative care with an emphasis on spiritual care. Institutional religions encourage their adherents to often remember death so that they can live a righteous and spiritually enriched life. According to the three Abrahamic faiths death is not the end of life; it is a new phase of an eternal journey. With strong moral and spiritual guidelines to look after the old and frail, the religious adherents try to overcome the fear factor concerning death and tend to use the network of extended families and religious institutions.

Spiritual care should thus be provided on palliative care to those who need it. Awareness of patient beliefs could be very helpful to the care providers; it creates a staff-patient-family relationship. Although still patchy, spiritual care in the NHS is now accepted as an important ingredient in palliative care in the UK. Judaism, Christianity, Islam and other faiths have valued this enormously and are working with the health services to provide a more effective care plan.

The focus on a patient’s quality of life has significantly increased in recent decades, albeit with emphasis on physical and psychological support. It is vital no community is left out from access to high quality terminal care. It is also important that spiritual well-being is linked with good health.

Understanding patient narratives of what constitutes a peaceful death is critical for palliative care. For this to happen doctors, nurses, and other health professionals should have basic training on spiritual care. Recruitment of staff from a broad range of ethnic, religious and cultural backgrounds is also important. We need a system of palliative care that is universal and serves all.

Image from: http://www.omicsgroup.org/journals/jpcmhome.php