The Final Journey --
Complete Hospice Care for Departing Vaisnavas
(Torchlight Publishing)
by Sangita devi dasi (Susan Pattinson, RN, CHPN, Certified Hospice Educator)

Excerpt from Chapter 1:

Spiritual Care in Hospice

In many ways, the hospice philosophy of caring for the spiritual needs of the patient coincide with our Krishna consciousness philosophy. In both, death is a natural occurrence to be eventually experienced by everyone. Both teach that spiritual distress is universal in those confronting imminent death. Both encourage spiritual support. It would be difficult, however, to find two hospice professionals (even clergy) to agree on the meaning of “spiritual care.”

When one is dying of a terminal illness spiritual issues have a way of surfacing and moving to the forefront. It is easy for a medical professional (even those working in hospice) to miss or ignore spiritual pain. In his book, “Notes on Symptom Control in Hospice and Palliative Care,” Dr. Peter Kaye writes about the patient who may say, “I seem to be wasting away,” or “I’m not eating enough.” Kaye states, “It is tempting for the doctor to respond by asking about diet or dysphagia (difficulty swallowing), when it is fear of not existing that the patient is struggling to express.”

Most hospice patients I have cared for expressed the importance of a strong spiritual faith when facing death. For each, it meant something different, but I encouraged them all to become more introspective at a very crucial time in their lives. Whether they were Catholic, Protestant, Jewish, or Buddhist, I held their hands and prayed with them. With some, we discussed the meaning of life as they saw it. Many wished to talk about heaven and hell. Some even mentioned reincarnation as a “possibility.” I gave them all prasadam, gave them flowers that had been offered to Krishna, and even had some taste caranamrita from the Deities. I never told them to believe in something different from what they had trusted to be true their entire lives. I simply helped them to get in touch with their beliefs even more. It is interesting to note that I have cared for only one patient who professed to be an “atheist.” From the time he entered the inpatient hospice unit he remained depressed in spite of receiving anti-depressant medications and a great deal of emotional support from the staff. He refused visits from the pastor and spoke often about their being “nothing after death.” Unfortunately, this poor man died very angry.

As a caregiver to a devotee you carry a big advantage. You both share the same beliefs and maintain the same goal of life. And what is that goal?

In the Bhagavad-gita (2.51), Lord Krishna instructs Arjuna, “The wise, engaged in devotional service, take refuge in the Lord, and free themselves from the cycle of birth and death by renouncing the fruits of action in the material world. In this way they can attain that state beyond all miseries.”

It is natural for devotees to speak about spiritual topics because it is a part of the Krishna conscious process for self-realization. In general, devotees are very comfortable discussing death and dying. If you are fortunate enough to also have a support group of devotees in your community then you, the caregiver, as well as the devotee you are caring for, can take shelter in the soothing comfort of that association. But, “spiritual topics” often exclude discussing “spiritual pain” which for the dying devotee may take many forms, including fear, doubts, and a sense of urgency to become more spiritually enlightened. A good caregiver should not only be a good preacher, but a good listener and friend, as well.

Srila Prabhupada writes in the Bhagavad-gita (6.32), “One who is Krishna conscious is a perfect yogi; he is aware of everyone’s happiness and distress by dint of his own personal experience. The cause of the distress of a living entity is forgetfulness of his relationship with God. And the cause of happiness is knowing Krishna to be the supreme enjoyer of all the activities of the human being…A devotee of the Lord always looks to the welfare of all living entities, and in this way he is factually a friend of everyone.”

The Dying Devotee’s Bill of Rights

Once someone chooses to accept hospice care, he should be aware of some basic rights in which he is entitled. They are as follows:

- I have the right to participate in decisions concerning my care.

- I have the right to expect continuing medical attention even though my illness is incurable.

- I have the right to be free from pain.

- I have the right to have my questions answered honestly.

- I have the right not to be deceived.

- I have the right to express my feelings and emotions about my approaching death.

- I have the right to discuss and expand my spiritual realizations during this dying process.

- I have the right to die in the Krishna conscious environment I choose.

- I have the right to die with dignity.

- I have the right to expect my wishes to be respected regarding what will happen to my body after death.

- I have the right to have help for my family in accepting my death.

- I have the right to be cared for by caring, sensitive, knowledgeable people who will attempt to understand my needs and will gain satisfaction in helping me face my death.

Any lesser treatment of the dying Vaisnava would be an enormous injustice.

(Continued on next page.)

(Click here to learn more about Vaisnavas CARE and how to order The Final Journey.)
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