More About Death and Dying

For the past 20 years I have had a ministry with patients in nursing homes and hospitals.  That experience has taught me a lot about death and dying.  It is my hope that  this series of blogs has been and will be helpful for everyone who reads them.  Several items need consideration.

Having affairs in order

Not everyone has the luxury of planning for death. However, most of us want to retain some control and say-so in our final months and days of life. Those who take the time to think about and plan some of the details of their final care and comfort at death  are better able to retain some control over what happens to them.

Legal specifics of such planning include taking steps to get affairs in order by asking some basic questions:

  • Who will get my property and how should it be divided?  This can be achieved by having an estate plan with a will, trust, or other documents that set out how this should be done.
  • What kind of final medical care do I want?  Do I want life prolonged by artificial means?  What does a “do not resuscitate” order mean?
  • Do I want to be buried or cremated? Where will my remains be kept?
  • Do I want a funeral or memorial service? Who do I want to participate in my service? What music and readings do I want included?

Controlling pain and discomfort

According to recent polls, most of us say we prefer to die at home. The reality is that some three-quarters of the population die in some sort of medical institution, many of them after spending time in an intensive care unit.

A growing number of aging patients are not choosing life-prolonging treatments that might ultimately increase pain and suffering (such as invasive surgery or dialysis); deciding instead to have comfort or palliative care through hospice in their final days.

Emotional care and support

It is equally important to prepare for death emotionally, too. Several questions arise:

  • What quality of life do I want in my final days? Do I want to be kept alive as long as possible by any means possible though I may have no apparent cognitive functions
  • Are there relationships with friends and/or family that need mending before I die?

Often quoted in the literature on death and dying are the tenets of Ira Byock, MD.              Byock says a dying person needs to express four thoughts at the end of life: “I love              you.”  “Thank you.”  “I forgive you.” “Forgive me.”

  • Will I be treated as a live human being until the moment I die?

Though dying may be scary or sad or simply unfamiliar to those who are                               witnessing it, studies of terminally ill patients underscore a common desire to be               treated as live human beings until the moment they die.

Most patients also say they don’t want to be alone during their final days and                       moments. This means that caregivers should find out what kind of medical                           care the dying person wants administered or withheld and be sure that the                           medical personnel on duty are fitting in skill and temperament.

Favorite activities or objects can be as important as final medical care. Caregivers should discover what tangible and intangible things would be most comforting to the patient in the final days, such as favorite music or readings, particularly readings from sacred writings such as the Bible.

A spiritual dimension can help many people find strength and meaning during their final moments. What is the patient’s spiritual or religious understanding? What does the person’s spiritual understanding say about what happens after death and is their understanding adequate to sustain the person through death?

For additional help

  • Ira Bycock, The Four Things That Matter Most: A Book About Living, ed. New York: Atria Books, 2004, 2014.
  • Caring.com (https://www.caring.com/end-of-life) is an excellent online resource for caregivers seeking information and support as they care for aging patients and loved ones.  Caring.com offers thousands of original articles, helpful tools, advice from more than 50 leading experts, a community of caregivers, and a comprehensive directory of caregiving services.
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Spirituality at the of Life

Caring for a dying loved one isn’t easy. Even when you know the end of life is near, you might feel unprepared emotionally, physically, and spiritually. Understanding and knowing what to expect — and what you can do to increase your loved one’s comfort — can help both you and the one you love.

As your loved one approaches the end of life, he or she might talk about spirituality or the meaning of life, so encourage them to explore and address his or her feelings. If they do not have a saving knowledge of Jesus, share how Christ can come into their lives and give them eternal life. If the person has made a commitment to Jesus in previous years, is he or she secure in that Christian commitment or are there feelings of doubt? Are there unconfessed sins that need forgiveness? Are there broken relationships that need mending?

Communion might be helpful for friends and family to gather around the bedside and share the elements together with the loved one. This could be the occasion that could help your loved one say goodbye to friends and family. This also gives others an opportunity to say goodbye to the one who is dying. This would also be the time to have a prayer to commit the person to the Lord; giving thanks for sharing his or her life, asking for ease of pain and that God would draw the person to Himself and give her or him His love, His peace, and His presence.

Scripture passages can be read that tell of the faithfulness of God and His love and care. Other passages can point to the eternal assurance a person has through faith. Encourage your loved one to memorize some verses that give him or her added assurance of God’s love and grace eternal life.

Decide whether there will be a funeral or memorial service. Will there be a cremation or casket? What music is to be played and sung, and who are the musicians? What are the Scriptures to be read? There may be other details that would be helpful to the family and the officiating clergy in conducting a funeral service.

Your loved one might also find it comforting to leave a legacy — such as creating a recording about his or her life or writing letters to loved ones, especially to grandchildren.

Where Will You Die?

This is the second article dealing with death and dying.  The material has been freely adapted   available through the Mayo Clinics.

We can choose when we die.  We can choose, within reason, how we die. We can choose where we will die.  But, we cannot choose not to die.  Death comes to all.

Caring for a dying person isn’t easy. Even when you know the end of life is approaching, you might not feel prepared. Understanding what to expect — and what you can do to increase the person’s comfort — can help.

Most people will have choices for end-of-life care. Options might include:

Home care. Most people prefer to die at home or in the home of a family member. You can assume the role of caregiver or hire home care services for support. Hospice care — services that help ensure the highest quality of life for whatever time remains — can be provided at home as well.  The purpose of hospice is to ensure people die free of pain and with dignity. In many instances, you will not pay for hospice service.

Hospice provides an on-call nurse, medications, and medical equipment.  In many states hospice care is supported financially by Medicaid, and in other areas hospice care is supported by a hospital or by public gifts.

Inpatient care. Some people might prefer round-the-clock care at a nursing home, hospital or dedicated inpatient hospice facility. Hospice and palliative care — a holistic treatment approach intended to ease symptoms, relieve pain, and address spiritual and psychological concerns — can be provided in any of these environments.

Understand clearly what your family member wants at the end of life.  Talk with her or his health care team or a social worker. You might ask for a referral to palliative or hospice care specialists — health care providers trained in specific care for people nearing the end of life.

Also, understand what your hospital means by “Do not resuscitate”  and other terms. If your family member or friend has this phrase in their health directive, ensure everyone involved knows what  is meant and how that  fits into the person’s health care directive. If your loved one opts for life support, have an understanding of when you could”pull the plug”and end all treatment.

Whether you bring a dying loved one home or keep vigil at the hospital, you can take measures to provide comfort and relief at the end of life.

 

When Death is Near

This is some material adapted from the Mayo Clinic that I have used with families as they await the death of a friend or family member.  I hope you find this, and others coming, to be of help.

Caring for a dying loved one isn’t easy. Even when you know the end of life is near, you might feel unprepared emotionally, physically, and spiritually.  Understanding and knowing what to expect — and what you can do to increase your loved one’s comfort — can help both you and the one you love. A pastor or others in pastoral ministry can be of help to you.

It’s difficult to predict exactly when someone will die. As death approaches, however, your loved one might show signs indicating that the end of life is near. Look for:

  • A loss of interest in friends or favorite activities.  There may be glazed eyes with no sign of recognition. Do not take this personally, for there is no awareness of your presence.
  • Drowsiness, sleeping more, or having intermittent sleep.
  • Restlessness and agitation.While sleeping, the person might frequently change positions or pull at the bed covers or pajamas. Sometimes this can be a sign of pain.
  • Loss of appetite.Your loved one might eat and drink less than usual.  Trying to force them to eat or drink can cause food and water to be sucked into the lungs and  pneumonia or other breathing problems could develop. It is normal to want to feed them, for we feel guilty, thinking we are not caring for them properly.
  • Pauses or other changes in breathing.This could happen when she is asleep or awake.
  • Reports of seeing someone who has already died.Sometimes he may also tell you that he has seen Jesus, or heard music, or has seen a friend or family member who has died.
  • She might also experience a brief, final surge of energy. Though it can be confusing to see her with renewed vitality, remember that this is often a normal part of dying. If it happens, take advantage of the opportunity to enjoy her and say your final goodbyes.

For many families, keeping vigil near a dying loved one’s bed is a way to show support and love. If you decide to keep vigil, continue talking to your loved one, for hearing is one of the last things dying people lose.  They can hear when there is no evidence of connection with the external world, so take care what you talk about at the bedside.

If you think he or she would want to share this time with others, invite family members or close friends to show their support as well. Express your love, but also let your loved one know that it’s OK to let go and be with Jesus.

 

 

 

 

 

Does No One Care for You?

This blog originally was a meditation on Psalm 142 prepared for patients in a psychiatric evaluation hospital ward. I suggest you read Psalm 142 in a modern translation to get the full meaning of the meditation. I used the Good News Translation.

Several years ago, I visited a small village in Spain where every family lived in its own cave! They had all the conveniences of a house, but it was still a cave. At another time I visited a cave in France that had been used as a French prison. They turned off all lighting so we could experience absolute darkness. I didn’t know darkness could be so dark.

Caves are interesting places to visit, but I wouldn’t want to live in one. I enjoy a cave if there are lights and safe paths to guide you, but if they shut off the lights, it would be just plain spooky to spend a night in a cave

David wrote this Psalm while hiding in a cave in fear of King Saul. Twice David has had to flee to a cave for fear his life. David had been favored by Saul, but now things have changed. Instead of acceptance, there is rejection and animosity. Instead of having the king’s favor, David is hated and hunted.

Few, if any of us, has had to take refuge in a cave. But most of us have been in David’s metaphorical cave of loneliness and despair. When he uses words like “complaints” and “troubles” [verse 2], we know how he feels.

He is ready “to give up” and his enemies have “hidden a trap” for him [verse 3]. He has no on to help him or protect him. David looks around and feels there is “no one to help me, no one to protect me” [verse 4]. He cries out, “No one cares for me” [verse 4]. David is “sunk in despair” [verse 6]. In verse 7 he asks God to free him from his “distress.” That word could also be translated as “prison,” so he is saying, “Free me from prison. . . .”

You may feel that you are in the cave of loneliness and despair. You may feel that there is no one to help you. You may feel you are in prison and no one cares for you. You may feel friends and family don’t understand what you are feeling, and they deny you your feelings.

Throughout the psalm, David uses first person singular: “I call to the Lord,” “I bring him my complaints.” This continues through the psalm. This teaches me that faith in God must be personal. The faith of your parents will not do when you find yourself in a cave of depression and despair. The faith of a wife or husband may be sufficient for them, but their faith will not get you through the dark. You must know God personally through Jesus Christ, and if you are to call on God, you must know him personally.

Your faith must be strong enough that you can stand alone when you leave hospital. It is wonderful when you have friends and family who support you and pray for you, but that may not always be the case. You may still feel rejected, alone, and unloved.

I don’t know whether David was in the cave by himself or that there were others with him. He may have been surrounded by his own fighting men and still felt the way he did. Sometimes you and I can be in the midst of a crowd of people and feel as if we are the only person there.

You don’t have to be in the same circumstances as David to have his same feelings. You may feel trapped and alone in a cave of guilt. Sometimes you know you have done something wrong and feel guilty. You feel isolated from friends and family. You feel isolated from God – that is healthy and can lead to healing when we confess our wrong doing.

However, many times we can feel guilty without having done anything wrong. This can paralyze us because we cannot think of any reason why we should have these feelings. Our sense of guilt continues to grow and we feel trapped in our cave.

There is a way out of your cave. David said, “he knows what I should do” [verse 3]. Be honest in your talk with God; tell him exactly how you feel. Admit your own insufficiency and God’s all-sufficiency. Prayer is a way to recognize and verbalize your needs and to become prepared to receive from God what you ask for.

Let your loneliness, gloom, and despair make you cry out to God to bring your soul out of prison, so you will be able to give thanks to God’s name. The Lord knows where you are. Ask him to save you, spiritually for eternity, and from the cave you are living in right now.

Prehistorical Peoples

The term “prehistoric peoples” may seem strange to some of you. It simply means people who existed before written history and are generally listed as either Homo neanderthalis, Homo erectus, or Homo sapiens. According to Ian Tattersall, homo sapiens is the species to which all modern human beings belong and is one of several species grouped under the genus Homo. But it is the only one that is not extinct. The name homo sapiens means “wise man,” and was created by Carolus Linnaeus, the father of modern biological classification, in 1758 CE. The Latin noun homo means “human being” and sapiens is the Latin participle that means “discerning, wise, sensible.”

There is evidence that perhaps Homo neanderthalis and Homo sapiens existed at the same time briefly. Israel is one of the only places in the world where skeletons of both populations are found in adjacent sites—in several caves on Mt. Carmel and in the Galilee. Thus, a wide variety of studies regarding the origins of modern humans (our species) and the demise of the Neanderthals focus on remains in Israel. It is also no surprise that the cluster of prehistoric caves on Mt. Carmel was recently declared as a UNESCO World Heritage Site.

How Do We Learn About Prehistoric People?

Obviously, we are limited in our knowledge of prehistoric people because we have no written records to help us. Our information comes primarily through archaeology, but some information also comes from the field of anthropology. Both of these fields use scientific tools in making their discoveries.

Archaeology is basically the study of humanity and its past through the excavation of sites. Archaeologists study things that were created, used, or changed by humans. They do this by studying the material remains — the stuff we leave behind, such as tools, pottery, jewelry, stone walls, dwellings, and monuments. The goal of archaeology is to understand how and why human behavior has changed over time.

Some archaeologists were interested in the individuals, nations, and geographical places mentioned in the Bible. Consequently, the field of biblical archaeology was developed and the first biblical archaeologists set out to discover if the Bible was a reliable source of information. As a result, biblical archaeologists have verified many of the places, names, and events through archaeological digs. Though archaeology is the primary way to reconstruct a real-life context for the biblical world, archaeology can never prove any of the theological suppositions of the Bible. Archaeologists can often tell you what happened when and where and how and even why, but no archaeologist will tell anyone what it means. To do so would go beyond the purpose and method of archaeology.

Prehistoric People and the Bible

Some Christians may feel uncomfortable thinking about prehistoric people for whom we have no written records. Where do we find them in the Bible? Since the Book of Genesis is the flashpoint, we should approach the book as an ancient document, and use only the assumptions that would be appropriate for the ancient world to gain understanding.” God gave his authority to human authors to record his message and share it with the world,” writes Walton, “so we must consider what the human author intended to communicate if we want to understand God’s message. . . . We must understand how the ancients thought and what ideas underlay their communication.”

The ancients were concerned with questions about the mysteries of life, such as: Who made the world? How will it end? Where do we come from? Who was the first human? What happens when we die? Why does the sun travel across the sky each day? Why does the moon wax and wane? Why do we have annual agricultural cycles and seasonal changes? Who controls our world, and how can we influence those beings so our lives are easier? The first eleven chapters of Genesis are the answers of ancient people to those questions based upon their understanding of the Creator God and his purposes.

We ask the same questions today, but ancient people answered those questions differently than we do, and we have to interpret scripture according to the answers that they gave and recorded for us. We do a disservice to scripture when we impose a 21st century mindset upon these ancient thought forms. Because of God’s revelation in Jesus the Christ, Christ followers in the 21st century have a knowledge and understanding of God and his purposes and a knowledge of the universe that ancient people did not and could not have.

Christians who take the Bible seriously believe that God inspired the thoughts of the writers when they wrote the Bible, but the words used are tied to the writer’s world and his understanding of God and God’s purposes. The Bible was not written to us; but it was written for us. What message did the biblical writers send? What was the message the first readers received? When we understand that, we can discover what the message should be for us today. Since we are far removed from the original sacred writings, it is very possible that we could misunderstand the communication that is intended.

The authority of Scripture comes from what the Bible affirms, and its affirmation is that (1) God has wanted a people to call his own, (2) God took the initiative and continually seeks those who would be his, and (3) there are consequences when humans refuse to be God’s people. Some theologians refer to this as “salvation history,” and this affirmation of salvation is rooted in the culture and thought patterns of the world in which Old and New Testament writers lived. The Bible is a book of faith, so there should be nothing contrary to Christian belief and the authority of the Bible in studying ancient people and trying to understand how they thought and communicated.

Prehistoric People and Religion

Since Neanderthals are our nearest human cousins, according to geneticists, we shall start our journey with them. One of the hottest topics in scientific research right now involves determining just how intelligent Neanderthals were. For years, the prevailing view was that Neanderthals were primitive, poorly developed brutes when compared to modern humans, only capable of expressing themselves in grunts and groans. Discoveries in the last few years have really brought this assumption into question.

Though extinct, the Neanderthal species of human beings is closely related to modern humans. Recent genetic studies show the DNA of Neanderthals differs from that of modern humans by just 0.12%. There are some anatomical differences between Neanderthals and modern humans, and changes in climate, diet, and disease control could account for these differences.

However, archaeologists have discovered evidence of a Neanderthal culture, and if archaeologists are correct, people were worshipping 50,000 years ago. Archaeologists have unearthed Neanderthal graves containing weapons, tools and the bones of a sacrificed animal. All of these suggest some kind of belief in a future world that would require these tools.

An approach combining a global field recovery and the reexamination of the previously discovered Neanderthal remains has been undertaken in the site of La Chapelle-Aux-Saints (France), where the hypothesis of a Neanderthal burial was raised for the first time. This project has concluded that the Neanderthal of La Chapelle-Aux-Saints was deposited in a pit dug by other members of its group and protected by a rapid covering from any disturbance. These discoveries attest to the existence of West European Neanderthal burial and of the Neanderthal cognitive capacity to produce it.

The Neanderthal graves show that when these early people became conscious of their mortality they created some sort of explanation that enabled them to come to terms with death and dying. The animal bones indicate that the burial was accompanied by a sacrifice. In the Neanderthal graves, the corpse has sometimes been placed in a fetal position, the correct spiritual or psychological posture for right action in this world or the next. Some 50,000 years ago, someone took great care to dig a grave for this unknown person and to protect his body from scavengers. all of which suggest some kind of belief in a future world that was similar to their own. The Neanderthals may have told each other stories about the life that their dead companion now enjoyed. They were certainly reflecting about death in a way that their fellow-creatures did not. Animals watch each other die but, as far as we know, they give the matter no further consideration. The Neanderthal graves show that when these early people became conscious of their mortality, they created some sort of counter-narrative that enabled them to come to terms with it. The Neanderthals who buried their companions with such care seem to have imagined that the visible, material world was not the only reality. From a very early date, therefore, it appears that human beings were distinguished by their ability to have ideas that went beyond their everyday experience.

Excavations at Raqefet Cave on Mt. Carmel have revealed a number of fascinating insights in prehistoric Israel. Archaeological investigations show that the Natufians—hunter-gatherers living 15,000–11,600 years ago in the Levant—held feasts at the burial sites of the deceased and decorated the graves with flowers.  Excavations at ancient sites all over prehistoric Israel have yielded, among other things, stone tools, butchered animals, and evidence for the control of fire.

As Barbara J. King has noted, religion is best understood both as practice and belief. In more advanced cultures, practice and belief may also include sacred texts that prescribe a set of beliefs. When texts are involved, what a person believes about a god or sacred forces really matters. In many human societies, past and present, though, there is no text. Everyday life involves appeasing gods or spirits, honoring the ancestors, and a sense of the sacred and/or the supernatural. “It’s within this context,” writes King, “that the case for Neanderthal religion — for ritual practices steeped in connecting to the sacred world — is most convincingly made.”
To support the possibility of Neanderthal religion, King refers to the Gobekli Tepe, a massive hilltop site in Turkey. After carving limestone pillars with all sorts of animal images, they hauled the 16-ton stones into multiple huge rings without the help of wheeled vehicles or domesticated animals. The Gobekli Tepe people carried out symbolic and sacred activities on a hilltop they adorned with massive architecture — 5,000 years before Stonehenge. What forms those religious practices took are unknown at this point.

——————

John H. Walton, The Lost World of Genesis One. (Downers Grove: InterVarsity Press, 2009): 15.

Barbara J. King, “Were the Neanderthals Religious?” Cosmos and Culture 13, no. 7, December 16 (2016). https://www.npr.org/sections/13.7/2016/12/07/504650215/were-neanderthals-religious.

How Am I Thinking?

Critical thinking is not merely a bag of tools for a person to use within an academic course.  Nor are critical thinking tools a way of arguing to silence an opponent. Critical thinking is thinking about our thinking in everyday life.  The Paul-Elder approach to critical thinking states it like this:

Whenever people reason, they reason for a purpose, in answering a question or given set of questions; they use information, in making inferences and coming to conclusions; they take certain beliefs for granted (make assumptions) in conceptualizing situations and experiences; they reason from some point of view; and there are implications of their thinking.

In problem solving I am given a problem and asked to solve it.  Critical thinking is problem solving, but it is more than problem solving.  Some issues are too ill-defined or ill-formed to be problems, but they do require critical thought, such as reading an editorial.

I have to ask: why is the editor writing this? What are the sources of his or her information and are they reliable? What are the inferences being made and what conclusions are reached?  What is the conceptual framework of his or her argument and the assumptions being made?   What is his or her point of view?  What are the implications of his point of view?

Now, I think through the editorial, not to build an opposing argument, but to understand what the editor is writing. To respond intelligently to the editor, I must be aware of the concepts, point of view, etc. that I hold.  If the editor has a conclusion better than mine about the issue, then I should be open to changing and/or revising my thinking.

On a personal level, I have studied, and continue to study, both science and the Bible. A question arises: how did the universe originate?  I might assume there are major conflicts between what I learn from science with what I learn from the Bible.  Or I could assume there are no conflicts, or only few conflicts. The point of view, concepts, and assumptions I hold color the conclusions I reach.

I understand the naturalist view of creation just happening by chance and respect it.  However, my thinking processes have led me to conclude that there is a God who, over a long period of time, has been creating, and continues to create, the universe, and that the Big Bang theory is currently the best explanation for how God began to create.  I have concluded, too, that the naturalist view of creation is basically a philosophical interpretation of scientific data, just as my conclusions are basically a theological interpretation.

In a polarized world, we must do more than simply throw stones at one another or that we must win the debate.  No one has complete knowledge and not all ideas are equal.  So, part of my critical thinking is to continually look for those answers that are better.