The Culture Connection: Hindu End-of-Life Practices – Healthcare Professionals Blog
The Culture Connection blog series covers various customs and practices that someone involved in end-of-life care might encounter. Please refer to the introduction to this blog series for general advice. Today we look at Hindu end-of-life practices.
An Introduction to Hinduism
Hinduism, the oldest known religion, is the majority religion in India and Nepal. There are around one billion Hindus in the world and 1.8 million in the U.S. This religion is monotheistic (belief in one God), and God, known as Brahman, is the foundation of the universe. Brahman is infinite, formless, personal and loving. Brahman is manifested in many different forms, and Hindus choose which god or goddess to worship, so there are thousands of gods and goddesses, and each represents a characteristic of Brahman.
Hindus and Reincarnation
Hindus believe in karma and reincarnation, so they often handle death quite well because it’s merely one “death” among many that a soul experiences as they move toward more spiritual growth. What form the next incarnation takes depends on one’s karma — their thoughts, words and deeds. If a person has lived a good life, performed more good deeds than bad and been devoted to God, they are born into a more fortunate existence with a better spiritual status. They hope to eventually reach the highest spiritual level, called “moksha,” becoming one with Brahman and ending the cycle of reincarnation.
Even if a Hindu generates bad karma and the next life is a step back, reincarnation is seen as another chance to create good karma and experience a better reincarnation in the future. So death is simply the next step on the journey. Although there is comfort in knowing their loved one will be reborn in a new life, normal emotions associated with loss are still present, so compassionate grief support is important.
Hindu End-of-Life Care
One area where a hospice caregiver with a Hindu patient may have difficulty is in the concept of suffering. To a Hindu suffering may be a way of resolving bad actions from a previous or current life. A non-Hindu may think that someone is “suffering needlessly,” and Hindus may think someone is working out their spiritual growth. Hindus may see suffering as positive. Or they may want to be mentally alert so they can be meditating on Brahman and decline pain medication.
One Hindu philosopher said, "Let me not beg for the stilling of my pain but for the heart to conquer it." This may be difficult for a non-Hindu medical caregiver, since a primary role of hospice is pain and symptom control.
Each patient (or proxy) has the right to make their own healthcare decisions and the hospice care should be supportive of those decisions. It may help to offer to arrange a visit by a Hindu priest to help the family make this decision. Hindus who are from India may continue the Indian tradition of emphasizing decision-making by the family or community, rather than focusing solely on the individual, as we Americans are accustomed. These decisions may be made by the senior family member or oldest son.
Differences in other cultural practices — diet restrictions, cleansing rituals, modesty customs, etc. — may depend on whether a Hindu was born in the U.S. or moved here from elsewhere. It also depends on how Americanized they are. Many women from India will only want female medical caregivers. Many family members may visit the patient at once and crowd the room, since family and community are highly valued by Hindus.
The key is to be respectful and help patients complete religious practices that are important to them, perhaps by helping them get materials they need. Be helpful without being intrusive, and allow private time, either alone or with other Hindus.
Ideally, a Hindu should die at home surrounded by family and friends who are singing sacred hymns, praying, reading sacred verses or chanting. All of this is meant to keep the patient’s focus on Brahman.
In a facility, the dying person may want to have a small statue or picture of the family god placed nearby. The family may want to place a sacred basil leaf on the patient’s tongue or put a few drops of water from the Ganges River on the patient, which are purifying practices. They may wish to burn incense or oil.
Here is a Hindu prayer they may recite:
Goodness, love, grace, and gentleness,
Courtesy, friendship, and modesty,
Honesty, penance, and chastity,
Charity, respect, reverence, and truthfulness,
Purity and self-control,
Wisdom and worship –
All these together are perfect virtue,
And are the word of the loving Lord.
If the patient dies at home, pictures of deities in the household are turned to face the wall. The body is sometimes placed in the home's entryway with the head facing south to symbolize a return to Mother Earth.
If a patient dies outside the home, the family may want to bring the body home for ritual bathing, dressing, and for friends and family to say goodbye. This could also be done in a mortuary. Hindus prefer to accompany the body until cremation. The family may wish to witness the cremation and even start the cremation fire. The ashes are often scattered in a river or ocean or sent to India to be scattered in the Ganges River.
There is so much to learn about this fascinating religion. For a more thorough discussion of Hinduism and end-of-life matters, see “Hindu End of Life: Death, Dying, Suffering, and Karma,” by Susan Thrane.
Chaplain, Crossroads Hospice
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