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This program is made possible through a collaborative community-education partnership between The Consortium for Advancements in Health & Human Services,

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Presentation on theme: "This program is made possible through a collaborative community-education partnership between The Consortium for Advancements in Health & Human Services,"— Presentation transcript:

1 This program is made possible through a collaborative community-education partnership between The Consortium for Advancements in Health & Human Services, Inc. and the presenting agency. The primary goal of this effort is to increase public awareness and access to hospice care, through the provision of community- based education. Contact Hours are awarded to professionals who complete this program by The Consortium for Advancements in Health & Human Services, Inc. BC Farnham, MSW, MBA; Debbie Favel, RN, MSN, CHPN; Dr. Denise Green; Sheryl Matney, MS; Jenny Gilley Carpenter, LPN.; Karina Lemos, RN.; Elizabeth R. Pugh, LBSW.

2  This education program for healthcare professionals was developed by The Consortium for Advancements in Health and Human Services, Inc. (CAHHS) and is facilitated by the presenting agency via a community education partnership agreement. CAHHS is a private corporation and is solely responsible for the development, implementation and evaluation of its educational programs. There is no fee associated with receiving contact hours for participating in this program titled, Exploring Culture as it Relates to Death and Dying. However, participants wishing to receive contact hours must offer a signature on the sign-in sheet, attend the entire program and complete a program evaluation form.  The Consortium for Advancements in Health and Human Services, Inc. is an approved provider of continuing nursing education by the Alabama State Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. The Consortium for Advancements in Health & Human Services, Inc., is approved as a provider of continuing education in Social Work by the Alabama Board of Social Work Examiners, #0356, Expiration Date: 10/31/2014.  The course listed above was completed on / / and is approved for 1.0 CEUs. Approval number: 79003632. To claim these CEUs, log into your CE Center account at www.ccmcertification.org.www.ccmcertification.org  In most states, boards providing oversight for nursing and social work recognize contact hours awarded by organizations who are approved by another state's board as a provider of continuing education. If you have questions about acceptance of contact hours awarded by our organization, please contact your specific state board to determine its requirements. Provider status will be listed on your certificate.  CAHHS does not offer free replacement certificates to participants. In the event that CAHHS elects to provide a replacement certificate, there will be a $20.00 administrative fee charged to the individual who requests it.

3  Participants completing this program will be able to:  Discuss how Native American culture impacts practice when facing death and dying.  Identify how Asian culture impacts practice when facing death and dying.  Discuss how African American culture impacts practice when facing death and dying.  Identify how Latino culture impacts practice when facing death and dying.

4  Because they lived so close to nature, all Native American peoples from the Stone Age to the modern era knew that death from hunger, disease, or enemies was never far away. The various death customs and beliefs, which first evolved during the invasions of Asians from Siberia to Alaska across a land bridge during the last Ice Age at least 12,000 years ago, gave them the means to cope with that experience.

5  Most Native American tribes believed that the souls of the dead passed into a spirit world and became part of the spiritual forces that influenced every aspect of their lives.

6  Burial customs varied widely from tribe to tribe. Indians disposed of their dead in a variety of ways.  Lets explore the practices of some different tribal groups.

7  Rites among Native Americans tended to focus on aiding the deceased in their afterlife. Some tribes left food and possessions of the dead person in or near the gravesite. Other groups, such as the Nez Perce of the Northwest, sacrificed wives, slaves, and a favorite horse of a dead warrior.

8  Some Southwestern tribes, especially the Apache and Navajo, feared the ghosts of the deceased who were believed to resent the living.  And, others take a rather organic and mystic position about death and dying…. Consider this excerpt from a recent article.

9  History shapes the future…  Although many of these practices are now considered to be only a matter of cultural history. Many Native Americans practice modified versions of their customs and death practices of the past.

10  Almost every human being has the desire for continuance after death and as with many religions, the Chinese believe they have a soul.  Therefore the Chinese people are encouraged to live a life that will prepare them for personal salvation in the afterlife.

11  The Taoists believe that human energies live in the underworlds, spiritual mountains and heavenly places.  The concept of soul is influenced by Buddhism, Confucianism, Taoism and folk religion. Confucians believe in hierarchy of souls within each person and these souls are linked to the energies of the cosmic universe.  Taoists, Confucians and folk religions believe that the energies of the soul return to the universe in the form of yin and yang forces and that the souls need help to go their separate ways.

12  There is evidence that as early as the Shang period (1500 1050 B.C.) that the Chinese cared for their departed ancestors as well as feared them. The Chinese focused their attention on their life's continuance through their ancestors, who gave them life and sacrificed many of life's pleasures.  They believe that to sacrifice for one's offspring is to instilled in them a sense of obligation to their elders and ancestors. According to the "Scripture of Filiaty" (Warring States Period 453 221 B.C.) these obligations consist of taking care of the body, as it is a gift from one's parents, to be successful in life, to glorify ancestors, respect to ones elders, just to name a few.

13  The Chinese believe that they live beyond the grave.  It is assumed that the dead influence the life of the living, therefore proper burial, observance; mourning and continuous offerings of food and gifts to the ancestors will ensure that the living will be taken care of. When these rituals are not observed it can result in the wrath of your ancestors raining upon you, resulting in sickness, financial ruin and cause disharmony in the family.

14  The realm of the ancestors is considered to be dark and murky.  The Chinese believe that the world of the departed spirits is similar to our world, only difference being time.  Morning in our world is night time in their world and that is why the spirits show mainly at night.  They believe that the spirits in the other world also need food, clothes, money, processions; they also believe that they must also deal with bureaucrats.  "Ten Courts of Hell", where spirits where judged and suitable punishment is meted out. Here it was decided who would go to hell, return to earth or remain in heaven.

15  1. family gives public announcement  2. family members don mourning clothes of white cotton and hemp  3. ritual bathing of the corpse  4. make food offerings to the dead, burn spirit money and other possessions such as houses, car, furniture made of paper  5. install ancestral tablet at the family alter  6. pay money to ritual specialists to safely remove the corpse  7. play music to settle the spirit  8. seal the corpse in airtight coffin  9. remove the coffin by procession to the grave site.

16  It is believed that the bones of the corpse represents power which lasts beyond death which can affect the fate of the living, because of this belief the Chinese prefer to bury their dead rather then cremate.  A fung shui expert will be called in to determine the time, place and direction the body should be buried.  After the burial the soul must be cared for according to mourning customs.

17  Death has always been to many a forbidden topic of discussion. However, in the African American community death is very much an important aspect of culture. It has been stated that death traditions, customs, procedures, mourning practices, burial rites, and even the structure of African American cemeteries differ greatly from that of non-African Americans. It has been stated amongst the black community that death is not a time of sadness but a time to rejoice for the deceased no longer has to endure the trials and tribulations of this earthly world. The deceased are indeed mourned and missed, however, death is also a time of celebration. These emotions and procedures of death is what is focused on.

18  Many African Americans may not be aware that some of the present day traditions and customs of death can be traced back to African roots of the Bakongo and the LaDogaa tribes.

19  Death to African Americans is not an event which just occurs, is "handled," and then forgotten about.  Old beliefs and superstitions, are remembered and acted upon.

20  There is usually a five to seven day mourning period before the actual funeral. Before the funeral takes place there is generally a ceremony known as a wake.  At this time, close friends of the family of the deceased pay respects to the family and view the body.  Many wakes take place at the funeral parlor, but have been known to take place at the church or the home of the deceased. This is a time when everyone gathers and eats food cooked by the family members, and shares memories of the deceased.

21  Once reaching the cemetery many traditions (or superstitions) are followed concerning the actual burial of the dead. It is believed that it is important that the dead be buried feet facing east; to allow rising at Judgment Day. Otherwise the person remains in the crossways of the world.  Coins are placed on the eyes of the dead to keep them closed. However, coins were also sometimes placed in the hands as the deceased person's contribution to the community of the ancestors-or perhaps, as a token for admittance to the spirit world.  For the same purpose coins are also placed on or around the grave site.

22  In the Latino culture, there is a complex relationship between health and illness, as well as the physical, mental, and spiritual parts of a person’s life.  Family involvement is very important. The family- centered model of decision making is highly valued and may be more important than patient autonomy. In the Latino culture, this is called familismo, which is characterized by interdependence, affiliation, and cooperation.

23 Relatives participate in the spiritual and physical care of their ill family member. The family may be apprehensive about giving technical care without receiving education and training.

24  The family may prefer to hear about medical news before the patient is informed so that they can shield the patient or deliver the news gradually.

25  Your patient and family may prefer to be at home at the end of life. The patient may believe that the hospital setting is impersonal or that the routine disrupts the family’s ability to take care of their loved one.  Your patient and family may believe that God determines the outcome of illness and that death is a natural part of the life process.

26  When talking to your patient and family about terminal illness do not use euphemisms. They do not translate well, and it makes it difficult for the interpreter to communicate. Use of clear and specific language will help the patient and family better understand the prognosis and make decisions about palliative care.  Your patient and family members may not be assertive or aggressive when communicating with doctors and clinical staff. They may not want to have any direct disagreement. As a result, important issues and problems may not be discussed, unless you initiate a dialogue

27  Your patient and the family may display pictures of saints. Saints have specialized and general meanings for Catholics. For example, St. Peregrine is associated with cancer, St. Joseph with dying, and Our Lady of Lourdes with body ills.  Some families may want to honor their deceased relative by cleansing the body.

28  Prayer and ritual may be a part of the end-of- life process for your patient and the family members. Family members may use prayer or bring special amulets and rosaries (prayer beads) while visiting a dying patient.  The family members may request that they keep candles burning 24 hours a day as a way of sustaining worship. Electric candles should be made available for patients and families.

29  There may be a belief that a person’s spirit is lost if they die in the hospital rather than the home setting.  The last rites (now anointing of the sick) are important for people who are Catholic. A priest or lay visitor may be asked to perform these rituals when a person is close to death.

30  Death and dying is a significant aspect of life for anyone… regardless of culture.  It is important professionals continue to increase knowledge and skills that support culturally competent practice.

31  Once you have completed the program evaluation, certificates for professionals who desire them are available.  Thank you for your participation and interest in our community education programs.

32  The following are electronic references used to develop this continuing educational program:  http://www.mainehospicecouncil.org/diversity/E ndLifeCare-Latino9_04.pdf http://www.mainehospicecouncil.org/diversity/E ndLifeCare-Latino9_04.pdf  http://www.deathreference.com/Me-Nu/Native- American-Religion.html http://www.deathreference.com/Me-Nu/Native- American-Religion.html  http://www.theosophy- nw.org/theosnw/world/america/my-moff5.htm http://www.theosophy- nw.org/theosnw/world/america/my-moff5.htm  http://www.helium.com/items/1322399- chinese-beliefs-about-death http://www.helium.com/items/1322399- chinese-beliefs-about-death  http://northbysouth.kenyon.edu/1998/death/de athhistory.htm http://northbysouth.kenyon.edu/1998/death/de athhistory.htm


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