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End of Life Care of the Patients of Hindu Faith. NARESH PATHAK, M.D.,F.A.C.P. Assistant Clinical Professor, Nova South Eastern University Voluntary Faculty, University of Miami School of Medicine Diplomat, American Board of Hospice and Palliative Medicine

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End of Life Care of the Patients of Hindu Faith


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    1. End of Life Care of the Patients of Hindu Faith NARESH PATHAK, M.D.,F.A.C.P. Assistant Clinical Professor, Nova South Eastern University Voluntary Faculty, University of Miami School of Medicine Diplomat, American Board of Hospice and Palliative Medicine Clinical Consultant, Vitas Innovative Hospice Care Teacher, Science of Spirituality Expert Medical Reviewer, Dept. of Professional Regulation, State of Florida

    2. Preface • More and more ethnically and culturally diverse groups of people are reaching end of life in USA • Hindus, Muslims and Buddhists are the fastest growing cultures here • Understanding their belief systems and coping mechanisms are essential in delivering end of life care to them

    3. Tech Support Is Temporarily Suspended Due To A HINDU Holiday

    4. Background - Hinduism • Probably the oldest religion on planet • Originated in India • Fundamental belief – This life is but one of countless ones our soul migrates through • We are SPIRITUAL BEINGS going through a temporary human experience • Cycle of birth, death and re-birth are the results of ones own desires and actions • Freedom from this cycle is TRUE FREEDOM and oneness with GOD

    5. End of Life Care of a Hindu • Physical care • Psychological care • Spiritual care

    6. Physical Care of a Hindu - 1 • “Body is a Temple” • “No shoes in the house” • Nutrition - Vegetarianism • Fasting - Cleansing?, Not eating before a bath • Personal Hygiene – same sex care-giver, privacy, social acceptance of incontinence in bed, Views on Foley, diapers, and bed side commodes

    7. Acupuncture / Anti-Decubitus Mattress

    8. Physical Care of a Hindu - 2 • Physical Suffering may be viewed as “dissolving old Karma(deeds)” • Pain control – perception of pain, social tolerance, repentance, desire to be in pain • Medication – vegetarianism and gelatin based capsules, acceptance of pain, desire to be alert and aware, views on blood transfusion

    9. Psychological Care of a Hindu - 1 • Depression – seen as weakness, meds for depression are accepted better then tranquilizers are accepted • Anxiety – varies according to acceptance of death, meds affecting alertness and awareness may not be accepted

    10. “I’m sorry, but the only way I can deal with stress is by passing it to others.”

    11. Psychological Care of a Hindu - 2 • Fear - Directly proportional to the understanding of Death as “The End”, and to the degree of attachment • Insomnia – Related to fear of death, sleep aids may be accepted well • Desire to be at home, rather then in the In Patient Unit

    12. Psychological care of a Hindu - 3 • Suffering – Result of unfulfilled desires(future) and attachments(past)…therefore Suffering is a CHOICE • Desire to know / Not to know the prognosis • Families’ wish to tell / Not to tell • Level of education and ability to understand • Conflict between traditions of the past and the medical advances of the present

    13. Spiritual Care of a Hindu - 1 • Concept of GOD – True understanding vs. Superstitious beliefs • Universal Consciousness (abstract) • Deities (concrete) • GOD = Ishvara = Controller

    14. In The words of YODA :- • THE FORCE has a light side and a dark side • And it holds the Universe together • Just like the DUCT TAPE

    15. Spiritual Care of a Hindu - 2 • Concept of SELF – True understanding vs. false beliefs • “Spiritual beings going through a temporary human experience” • Suffering comes from our mis-identification of ourselves with our body, mind and ego • “I am the SPIRIT who wears the body rather than the SPIRIT living in the body” • “I am the WITNESS to the body, the mind and the intellect

    16. He would never have attained NIRVANA if I hadn’t nagged him.

    17. Spiritual Care of a Hindu - 3 • Concept of the RELATIONSHIPS – our prior actions and deeds bring us together in this life • There is universal oneness before birth and after death • Our mis-identification of ourselves with the the body and the mind creates separation of “mine and yours”…thus creating the sense of “loss” at the time of death

    18. Spiritual Care of a Hindu - 4 • Concept of DEATH – Temporary stop in the journey of the SOUL • Levels of Death – Physical, Mental • Concept of RE-BIRTH – analogy of mind as the software and body as the hardware • Death is an ILLUSION (SPIRIT does not die) • SPIRIT is an energy which can not be created nor destroyed

    19. “I’m afraid medicine doesn’t know all we’d like to know about treating ‘bad karma’.”

    20. Spiritual Care of a Hindu - 5 • Suffering is a choice • Choice to identify with the Body, the Mind or the Spirit • Concept of Faith and Trust • Role of the Priest, the Temple, the Scriptures

    21. Spiritual Care of a Hindu - 6 • Role of Rituals – Singing, Chanting, Lighting candles and incents, photos of prophets and deities • Services after death – Cremation, burial, feeding the body to vultures, long term preservation of the body, organ donation • A Hindu Monk performs his/her own death services when he/she enters monk hood

    22. R. J. Harwell………Born -------------------- 1914 Gave Up Smoking – 1957 Gave Up Booze ----- 1973 Gave Up Red Meat – 1983 DIED ANYWAY ------- 1991

    23. “The good news is that you’re biodegradable.”

    24. End of Life Care of a Hindu • Conclusion • Awareness of diversity within Hinduism • “Everyone is Unique, just like everyone else” • Be aware of local recourses such as a Hindu Temple or a Hindu Priest • http://www.hindumandir.us/index1.html • http://www.garamchai.com/temples.htm • http://www.hindutemples.org/