End of Life Issues, Spiritual and Mundane - Preparations, Medical Decisions, & Focus

We all know that it is auspicious to be forewarned when death is approaching. While few know down to the minute, as our bodies begin to fail us or we receive a terminal diagnosis, we are given a chance to better prepare our consciousness and tie up our loose ends on the material plane. *

Sometimes we have a chronic disease that may vary in the timing that leads to death, and so we are in limbo, not quite here or there. It could accelerate or it could take its time. It's hard to know then how to balance spiritual concerns with the ongoing need to put food on the table. AIDS patients have written about going through their inheritance, expecting to die, and then new medical breakthroughs suddenly prolonged their lives. They then had to switch gears and go back to work, having lost important years of career building. The best trick is to manage to incorporate your spiritual awareness throughout your work day. I am blessed to be in a very tolerant workplace that allows for some religious symbolism as long as its not overdone or offensive to others. I also have i-tunes at work and have spiritual tunes loaded in, and head phones.

Obviously the thing to be done if death is imminent is to drop everything and turn to your spiritual practices, reading, chanting, if all else fails simply listening while someone reads or plays devotional music.

Even then you may be asked to make medical decisions. Do you choose risky procedures to prolong your life? When is it justified (and not an act of suicide) to refuse treatments? Just because they can keep your body going, should you let them? At some point it becomes counterproductive spiritually to keep clinging to this body we are presently in.

If you are dying from cancer, it is well established now that you can receive help from hospice and die in your own home or a hospice bed without someone trying to revive you. It is possible to make everything in your environment conducive to a spiritual frame of mind. Invoke the senses of sight (posters, pictures), sound (music or readings), and even smell (incense might be too much but there are scented water sprays that may remind you of the Deities' flowers, or someone can bring flower prasadam). Everything should support your crucial remembrance at the time of death. You might rehearse with loved ones phrases or japa that they should help you focus on.

It is not so clear cut with heart disease. If you go into cardiac arrest, do you choose to simply die or let them try to revive you? If it is sudden, you no longer have the facility to arrange to have some bhajan playing or a japa tape in the background to help you focus. There will be medical personnel bustling all around you. They will push out your family members. They may revive you only to rush you into another room, a catheterization laboratory, so they can go in and open up a blockage. Or maybe right into surgery (rendering you unconscious).

Since that's my likely scenario, I have wondered if I should simply carry around a spiritual first aid kit. (That was partly why I wanted an i-pod.) While certainly I can simply focus, that is not so easy to do as I found out before my surgery. When panic strikes it's good to listen to something transcendental to assist your mind. Then you don't feel alone anymore.

Of course, in those cases where we have no warning--car accidents--we have no chance to pop in a tape at that time. If we make it our habit to immediately chant whenever we have even a close call with another car, that habit may come to our aid. As I stated elsewhere, the brief time actually helped me when I had a wreck, as there was no time to panic or overthink it. Yet I didn't really have the time to come to some deep insight, either. "Hare Krsna!" Bang! And it was over.

I wanted to open this topic up for discussion, resource recommendations, inspirational quotations specific to the transition of dying, and anything else that might be useful to each of us as we prepare to leave these bodies behind us.

Please feel free also to talk about how loved ones may prepare for a death of a friend or family member. Knowing we are not these bodies does not stop us from grieving for our loved ones when we are undergoing the long-term separation that is death.

I will also post a few resources I have recommended to others with good results.

*(Regardless of health, making out a will and arranging for guardianship of minor children is just common sense. See the book, In the Checklist of Life: A Working Book to Help You Live & Leave Life by Lynn McPhelimy for other things one should think of writing for those left behind.)

Here are a few things I recommended on the womenheart message board, in the original words I posted there:

QUOTE

Our task is to figure out how to live with a more imminent sense of death and not let it terrify us to the point that we have no quality of life.

I have been reading a number of books that have been helpful to me, trying to develop a more positive attitude towards death. Three of the best have been:

Winona's Web: A Novel of Discovery by Priscilla Cogan...A psycotherapist treats a Native American woman who has decided that she is ready to die soon--by natural causes. The therapist ends up learning from her about the purpose of life and what may lie beyond. A very affirming book, most comforting when I was in the hospital.

The Radiant Coat: Myths and Stories About the Crossing Between Life and Death An audiocassette by Clarrisa Pinkola Estes from Sounds True Recordings, 735 Walnut St, Boulder CO 80302 (All of her work is excellent) Again, very comforting.

Death: The Final Stage of Growth edited by Elisabeth Kubler Ross, MD A collection of essays about death

Also useful for information about the physical changes that happen from different kinds of death:

How We Die: Reflections on Life's Final Chapter by Sherwin B Nuland I wouldn't call this comforting, but it is informative and he has a whole section on heart disease. What was comforting was a description of sudden cardiac arrest. If one has to die of heart disease, that's the way to go!

Another great book, although geared to cancer patients, but deals a lot with how to live with impending death while you are trying to live, and accept both (and also a lot about how couples deal with terminal illness):

Grace and Grit: Spirituality and Healing in the Life and Death of Treya Killam Wilber by Ken Wilber, Shambala Books

I also find it helpful to attend to my spiritual life. While that may not be helpful to those of you who are athiests, I think a non-religious practice that's meditative in nature can be helpful to anyone. Consider it stress reduction. Or even spending time in nature can help you feel connected to something larger than yourself and your individual struggle with heart disease.

I would also add:

Advice on Dying by His Holiness The Dalai Lama, and The Pagan Book of Living and Dying: Practical Rituals, Prayers, Blessings, and Meditations on Crossing Over by Starhawk and M. Macha NightMare. This last book has some really beautiful poetry that can be appreciated in a non-denominational, universal way. One of the phrases I remember vividly is "You go from love into love."

I would love to see more books recommended from any other traditions, certainly including Vaisnava traditions. If there are special passages that would be particularly inspiring, please do post them. Thanks in advance to anyone who can add to this topic.

Blessed Be--

Tapati

This book was recommended to me by a devotee on another forum. I don't know if anyone here has read it and can comment.

Here's the link to a review and description:

http://www.vaisnavascare.com/the_final_journey_book.htm

QUOTE

THE FINAL JOURNEY--Complete Hospice Care for Departing Vaisnavas written by Susan Pattinson, RN (Sangita devi dasi) is an invaluable tool for anyone who will be caring for a dying relative or friend. This book is a Krishna-ized look at the compassionate art of hospice care and is expertly written for the layperson in easy to understand language. As the title suggests this is a complete guide which includes all aspects of care that one needs to confidently care for their patient. Sangita devi dasi is herself a hospice nurse with years of experience which she brings to her writing.
~Judy Harris RN BSN
Jusaniya devi dasi
Vaisnavas C.A.R.E. Inc. web site developer

It appears from the site that it came out of a project for Vaisnava hospice care run by devotees from ISKCON (just fyi). I am of course willing to take inspiration where I can get it on this topic, so that doesn't concern me. I will check out this book and report back.

QUOTE

My life is an instant,
An hour which passes by;
My life is a moment
Which I have no power to stay.
You know, O my God,
That to love you here on earth--
I have only today.

St. Therese of Lisieux

I think this is a very worthy topic and deserves to be explored and re-evaluated on a continuous basis, since all of us are facing the end-life situation. We need to develop structures that give answers to real-life-situations more and more, as devotees get older and face the reality of living in a demanding world more and more. a twenty, thirty or even a fourty something person has a different outlook onto the realities of life than an over-fifty one, let alone when the sixties, seventies and eighties are calling...

I have nothing to contribute at the moment to this topic, except the remark that I have some work going on in the back-ground which hopefully will get some good results, so that the care for vaishnavas facing chronic/terminal diseases could be re-oriented. One of the major troubles a dying person is facing is the fear of not being able to pay the bills for medical intervention necessary. When more reasonable treatments are available for chronic and terminal diseases one aspect of suffering, namely the mental one, the anxiety of leaving unpayable bills, can be reduced.

Thank you for contributing and your project sounds interesting. One shouldn't have to worry about money when they are dealing already with serious or life threatening illness.

In additon to worrying about our own Krsna Conscious death, devotees naturally would like to help their relatives have as peaceful and God conscious a crossing as possible. I noticed that vaisnavascare.com also had stories of devotees helping their parents out by chanting to them or with them, giving Deity prasadam such as garlands, utilizing ganga water, etc.

I also read their stories of the passing of devotees, including an old acquaintance of mine, Mulaprakriti devi dasi. (She has done so much wonderful service I am in no doubt that she had the most positive death one can have. ) Generally these are cancer narratives, and it becomes very clear that the devotee is getting close to death, so naturally the focus is on reading, hearing, chanting, and having people chant beside the devotee who is too ill to continue to chant out loud.

I find that these stories, while dramatic and moving, don't really help me figure out how to prepare for a death that may come from my heart suddenly stopping (sudden cardiac arrest). I need to work and keep my health benefits. I can't drop everything and simply read and chant and do service. I'm doing all I can within the limitations of going to work 40 or more hours a week, but if sudden death strikes me as I'm puzzling over an accounting problem I'm not going to have time for more than a quick "Hare Krsna!" before I lose consciousness. I have to hope that that's enough. Yet I prefer the idea of months or weeks of intense focus just before I leave my body.

Of course, even the cancer patient may be taken by an accident on the way to the hospital, and I know one heart patient who died of cancer. None of us knows when or how, really. That's why we have to try to be prepared and remain prepared.

Can anyone comment on or give sources supporting the use of Tulasi leaves when someone is dying? I understand they are (at least) placed in the mouth of the departing person.

Thanks!

My great aunt just left her body the day before yesterday. as she was primarily cared for by my mother in law, the best I could do was give her a strand of Tulasi beads for her wrist. But I did hear of putting Tulasi leaf in the mouth, and had a friend who did that for his mother when she passed. I don't have anything but dried Tulasi, plus, it would be hard for me to explain to my mother in law why I am putting "basil" in Mary's mouth

when I am not sure either...

Hopefully the Tulasi beads helped ward off any Yamaduttas, which was my worry for her.

I'm not sure if I can valuably contribute to this topic, for I'm very young (and by that, I can be in the illusion that death is just a thing of very far future) and can't give a really Vaishnava viewpoint. But I try. Unconsciousness, caused by bodily conditions, will certainly cease with the soul leaving the body, so at least in tha moment one can remember - now not one's brain, but by one's mind/soul. But I think that we should depend on Radha-Krishna. I think they give Their grace to the devotee who desires to remember Them at the moment of death - even if s/he couldn't do that by him/herself, for some reason. For that, I believe that surgery and other procedures causing or requiring unconsciousness don't endanger one's journey to Them.

But I also don't think that it is a sinful suicide to refuse medical treatments. You yourself don't do anything which endangers you life. It is also interesting, that in some cases, even active suicide is encouraged in the scriptures (most notably the sati and the suicide of a fallen renunciate).

I was in my ISKCON years troubled with a similar question on another illness: Which is better to a Gaudiya Vaishnava? Being in an advanced stadium of Alzheimer's disease, which inhibits ability for remembering, or to commit suicide, thinking of Krishna and Radha?

On Tulasis and other forms of prasada: one of my ISKCONer friends practically bootlegged a great deal of offered Tulasi leaves to mix them with the ashes of his dead relative. I don't know whether is is scripturally advised though... Generally giving them by mouth is the custom. Caranamrta is also used either by sprinkling or by making the departing person drink it.

Perhaps some will find the following text on impermanence and death useful. Even though it is written by a Tibetan Lama, you will see that this contemplation can be practised by anyone without any regards to religious or sectarian considerations.

QUOTE

Contemplation of impermanence as an antidote to attachment to this life
by Khenchen Konchog Gyaltsen Rinpoche

"The whole world is as impermanent as clouds in an autumn sky. Birth and death are like the movements of a dancer." One should meditate on death, on the decreasing time that remains, and on the inevitability of separation. To meditate on death, think that it is the stopping of breath, the transformation of the body into a corpse, and the scattering of consciousness. To meditate on the shortness of life, think that your life since last year has become shorter, that since last month it has become shorter still, that since yesterday it has become yet shorter, and that even since this morning it has become shorter. In the Bodhicharya Avatvara it is said that life is each day becoming shorter, and that as there is no way to add to it, we surely experience death. To meditate on separation, consider that no matter what dear friends and close relatives we have, we must separate from them when death comes. No matter what wealth we have accumulated or how beautiful our body has been, we must leave them behind.

Another way of meditation on impermanence is to consider that we will definitely die one day, that we do not know when this will happen, and that when we die nothing will help except the realization of the teachings. It is certain that everyone who has ever been born has died. Even great masters who achieve many qualities, or famous people, or wealthy persons all experience death. There is no way of escaping. One reason that death is certain is that the body is composed of many elements and all things which are composite will decompose. This is the nature of change. Life is decreasing from moment to moment. For this reason, also, death is definite. Each moment that passes bring us closer to death. It is like the archer who shoots the arrow through space until it reaches the target. The arrow does not remain in space even a moment. In the same way, from the day we are born until we die, life does not stay still for even a moment. Life is also like a flowing river. As the river does not cease its flow even for a moment, so does life, gallops on. It is ever changing, yet ever the same in its change. Our life moves daily closer to death like the prisoner moving towards his place of execution. Our life has no predictable span, especially in this world system. Some beings die in the mother's womb, some at the moment of birth, some as infants, some in youth and some in old age.

The body has no value in itself. It is but a composite brought about by many causes and condition. If we analyze it, we cannot find anything permanent in it. Generally, everything one can name acts as a catalyst for death. If even food or drink or medicines in some circumstances can cause death, all other things can, too. Life is as fragile as a bubble in the water. At the time of death, our wealth will not help us. No matter how much we have accumulated in our lives, we must leave with empty hands. Moreover, wealth is actually harmful because it creates attachment and anger. If one has negative karma through accumulation of wealth, one must experience its fruits. Friends and relatives will also not help at the moment of death. No matter how powerful, skilled, or wealthy they may be, they cannot protect us from death. Nor will one's body help. No matter how strong it has been or wealth they may be, they cannot protect us from death. Nor will one's body help. No matter how strong it has been and how agile, no matter how expressive and attractive, it cannot protect us from death. It is like the sun which cannot stay from setting. Not only can it not protect us, but it is the cause of much suffering. How often it produces pain, discomfort, hunger, thirst, and the fear of attack! And by protecting ourselves from danger, we can create further karma which brings yet more suffering.

We may also meditate on impermanence by thinking of those who have died, recognizing that this will one day be our state. For example, if we know a dying person, we can meditate on how he used to be strong, clear of complexion, capable of body, joyful of mind. Yet disease has suddenly caused him to lose all physical power, to grow dark of complexion, to suffer in the mind, to writhe in pain, and to derive no benefit from medication. Aware that there is no escape, he surrounds himself with friends and relatives, eats his last meal, pronounces his last wishes, and stops breathing. No matter how important he was to his family or his nation, his body must be carried away. Some of his relatives may cry and try to hold onto him, some may faint from grief, but he cannot return. His body is then either buried, or cremated, or thrown into the river. One should therefore meditate that one day the same will happen to oneself. One is not beyond this.

If we hear that someone is dead, whether he be known or unknown to us, we should think: One day I, too, will be like that person. We should also remember those who have died, young or old, in our family or city, thinking: Soon I will be as they, a mere memory. Birth leads to death; meetings lead to partings; gain leads to loss; and construction leads to destruction. The beneficial effects of meditating on impermanence are that by understanding the nature of composition and decomposition, one learns to detach from this life. The teachings, far from being pessimistic as some people think, lead to ultimate peace of mind because they cause us to drop attachment to that which, being impermanent, bring no lasting happiness. They support the motivation to achieve Enlightenment, and help free one of hatred. With them, one has the chance to realize the equanimity of Dharma-as-such.

Impermanence and death are like the spreading shadow of sunset at the mouth of a pass.
It approaches without stopping for even an instant.
Apart from Dharma, nothing will help.
This is my heart's advice.

Thank you, Peter, for that wonderful passage on impermanence. It of course can help us in our attachments to so many other things we will lose, in addition to this body.

I wanted to respond to this dilemma:

QUOTE

I was in my ISKCON years troubled with a similar question on another illness: Which is better to a Gaudiya Vaishnava? Being in an advanced stadium of Alzheimer's disease, which inhibits ability for remembering, or to commit suicide, thinking of Krishna and Radha?

I myself always believe that it is better not to take the route of suicide. I would instruct those around me to simply surround me with holy sound vibration at or near the time of death if I could not chant myself. In a situation such as this, one is being given the chance to trust in one's relationship with Krsna and Gurudeva to carry one through. (With the help of Godbrothers and sisters, Aunts and Uncles too.)

Several Eastern teachings agree on the following point: committing suicide never brings about any benefit. Throwing away your body results in not getting another one for a long time, that is, one is trapped in a ghostly state of existence.

Others believe that on the subtle plane, your thoughts create thought-forms--in other words, determine the reality of what is around you, and if you die in a state of despair you create your own hell because all you can imagine is a negative outcome. The longer you stay stuck in that state, the longer it will be before you take birth again.

Another way to look at it is that we are being handed these experiences, heart disease or Alzheimer's disease, in order to learn something, to progress, to work on something you need to work on in order to make spiritual progress. If you take yourself out of the situation prematurely, you just have to re-take the test.

We may think these lives are just suffering, from a KC viewpoint, and that taking birth is not desirable. Certainly if you've achieved liberation in some manner (according to your own view of what that entails) then you don't have to take birth. But until then, these bodies are where we go to learn what we need to learn, in order to finally reach that state. These bodies are also what self-realized souls who have volunteered to come here must take, in order to help save us all.

Either way, we must honor and take care of them as best we can, in order to learn what we must, and then be able and willing to discard them without attachment when the time comes.

Don't be afraid, I don't plant to commit suicide for now.

QUOTE

But some other Eastern teaching tells that I should commit suicide if I break my renunciation wows, or if my husband dies.

I was at that time the practicioner of that teaching, that's why I entertained the thought of suicide in case of Alzheimer's - because I was taught that it is essencial to remember, and I knew Alzheimer's makes one unable to do so.

QUOTE

Very Krishna conscious! I see you have nothing to fear about when you go.

QUOTE

But some other Eastern teaching tells that I should commit suicide if I break my renunciation wows, or if my husband dies.

Even the orthodox Gaudiyas would not tell you to do that. It is there in the old books, just like so many other things that very few actually believes in.

I ran into this today:

QUOTE

13. Srila Prabhupada once told us to pray for a devotee right after he or she (I can’t remember which) passed away. I was told that Srila Prabhupada said that it was like serving as a favorable witness at a trial.

Source: Unknown, but it was probably stated in Los Angeles in 1972 or 73 when I was living there in the temple, and Srila Prabhupada was visiting there.

at this site: http://www.pratyatosa.com/PrabhupadaSaid.htm

Interesting. Our tradition also emphasizes the value of prayer for those who had passed away, as well as a crossing over ritual to ease the way.

This book came up in conversation with someone recently and I realized it would be an excellent resource for anyone interested in this topic.

A Soul's Journeyby Peter Richelieu is the story of a mysterious Indian teacher called "Acharya" (which we would understand as redundant usage) appearing to a grief-stricken man after the death of his brother. The teacher takes him on a journey of different levels of the astral plane and teaches him about what takes place after death. The man meets his deceased brother and others he has known and loses all grief and fear of death. My understanding of thought forms comes originally from this book, which I read even before encountering Vaishnavism, as a teen. It is an easy and interesting read and introduces one to many basic concepts, some of which Vaishnavas are already familiar. (Translate astral as subtle, for instance, and the astral body is called the subtle body in some Vaisnava literature.) It is said to be a true story but the author uses a pseuodnym and nothing is known about him. It is available through Amazon.

If death really is like this, not only would I never fear it, but I would welcome it. Unfortunately I won't know until I actually leave my body.

I wanted to post something here yesterday, but the Cyberspace gremlins boobytrapped my thirty minutes of accumulated profundity.

Though this is not directly related to any specific comments on this thread, it is very much related to the title, so I hope the individuals who have written here will not take offense at what may seem a non sequitur.

My mother is 87 years old, my father-in-law, 91. Though I am not directly involved with the care of either of them, I see them both fairly often.

My mother is in fairly good physical health for her age—she has always been a strong woman, coming from vigorous Dutch stock—but there has been definite deterioration on the mental side. She often fails to recognize people, even her own children, and confuses past with present, loses time and place orientation, etc. Though she frequently appears to be lucid, this can quite often be illusory, as she keeps a smiling face. At other times, though, she is quite aware that her memory is going and she falls into depression. She is being medicated against this and is being quite well taken care of, so her distress is minimal.

Even so, in the hospice where she stays, it must be hard to find a meaning to life. In the main communal areas, there are many other residents, most far less physically fit than she, who seem to be silently awaiting the inevitable. The last time I was there to see her, my mother tried to keep up her conversation, but eventually realized that she wasn’t able to make any sense and fell silent, abandoning the sense of obligation to chatter that company forces on everyone. I gave her a back rub and held her for about fifteen minutes in silence, just trying to surround her with love, something that most of this chatter seems to just be cluttering up and distracting us away from anyway.

Old people clearly don’t get hugged enough.

On Christmas Day, I was at my in-laws. I have known my father-in-law since he was a vigorous 72-year-old, still playing tennis and skiing, and have watched him slowly wane, gradually losing his faculties, until now his ability to speak is severely hampered. For a man who enjoyed current events, politics and philosophical discussions, he is visibly saddened by this loss. He cannot seem to remember even simple words, making all expression hopelessly frustrating.

My mother-in-law, twelve years his junior, is his sole caregiver, and she seems to find it burdensome, even though he sleeps sixteen hours a day. Her love is carefully hidden under a veil of cantankerous complaining and inexplicable resentment for some unrealized self-fulfilment.

On Christmas, my brother-in-law’s ex-wife had given him a CD of Romanian Christmas carols, which my father-in-law had not heard in years. We played it during desert after supper. The first carol left him unaffected, but the second seemed to touch the very depths of his being. He falteringly tried to sing along and tears began to stream over his face. His wife, however, immediately rose up and said, « Turn it off! » She thought that the strong emotions would set off another heart attack or stroke, perhaps the final one. She knows that his death is inevitable, but she is afraid, nevertheless.

For me, however, there was something sadder about the moment. My mother-in-law, with her uptight Swiss Calvinist samskara and its superegoistic fear of strong feeling, seeing her husband’s emotion as a danger rather than a fulfilment. If he were to die in that moment of sweet childhood memory of his lost homeland, would it not have been more meaningful and glorious than more years of patient nothingness, living death? Of course, there are spots of meaning in that life—the sight of children and grandchildren, the cataclysmic current events, just « seeing what happens next » pleasure of observing the world around us. As long as the body is not causing untold suffering, then isn’t this reason enough to go on living?

Nevertheless, it was that « turn it off! » that turned me off. How cut off and isolated we become when no one shares in the intimacy of our core. At least this is where we must have God, if there is no one else to share or to hold us in silence.

My thoughts turned to Bhakti Promode Puri Maharaj, who though I never met personally, had occasion to meditate on as a result of working on tapes of his darshans and lectures dating from 1994 to 2002, the year of his departure. It is perhaps unfair to compare the old age of my parents with his, and yet there is something about his last years that marks them as exemplary.

Though Puri Maharaj often complained about failing memory, it appeared to be no worse than mine. He forgot verses when trying to remember them during a speech, but who doesn’t? And yet, the vigour of his expression remained unabated until his final days. But perhaps more instructive is that he created sufficient meaning in his own life that until his last days he was surrounded by people who hung onto his every word, who found his emotional life salutary and admirable, who wished to share in it, to become participants in his realm, in his consciousness.

I would like to reflect on this, but unfortunately, this world is beckoning like a unavoidable call of nature and I must leave them aside for a time.

review:

QUOTE

Talking About Death Won.t Kill You
by Virginia Morris,
Workman Publishing Co., New York, 2001.

Let me begin by saying the title of this book is what really caught my eye. I have a great passion for grievers in our world. In my own corner of the world, I spend every Tuesday night helping grievers find relief.

I found this book to be plain, down-to-earth . the kind of book that just makes sense. Virginia began this book out of her experience and pondering as it related to her pregnancy with her first child and the death of her father 3 months before her child was born. She shared that she had gotten so much advice on preparing for her child.s coming and nothing to prepare her for her dad.s leaving. How true that is for all of us!

The heroic procedures of the medical community can do much to prolong .life. as medical personnel may define it. And in the process, the dehumanizing machines end up cutting us off from each other and from the spiritual rite of death itself.

Virginia Morris argues that it doesn.t have to be this way if we stop, take a deep breath, and start talking about death instead of denying it will happen. She has taken a wealth of personal stories and woven them throughout bits of practical advice. The reader would have a difficult time not having a .good death. for themselves or a loved one after reading these pages. In a good death, patient and family are fully informed and their decisions are respected. Pain relief, both spiritual and emotional, is not considered an alternative to invasive medical treatment but rather an essential part of care. Whenever feasible, death occurs where the patient is most comfortable and has the most control.

The only point at which I would beg to differ is when Morris mentions the stages of grief. From my own experience and in my work with grievers, grief cannot be tidied up into stages. I do believe Elisabeth Kubler Ross. stages of death and dying work for those with terminal illness. I do not believe they work with grievers. (For that, I would refer readers to The Grief Recovery Handbook by John James and Russell Friedman.) However, that alone would not keep me from adding this book to my library because that is a small difference of opinion in the midst of tremendous wealth. I applaud Virginia Morris for allowing her personal adventure to give us something we can use!

Elaine Henderson

I got this book a few weeks ago and really loved it. It opened my eyes to the dilemma people face when they confront various medical situations of their loved ones with only the vague instruction, "I don't want to be on machines." Sometimes those "machines" are needed in a short term situation such as systemic infection. Morris gives a great deal of insight as to how these medical scenarios may play out and some of the specific guidelines you should give your next of kin or what to ask your doctor about in terms of your illness. She also encourages us to define what we believe a "good" death would be and have good communication with doctors and family about our wishes in those regards as well. I really found this book helpful in trying to decide for myself at what point I want to stop medical interventions.

She also co-authored a book on taking care of aging parents: How to Care for Aging Parents by Virginia Morris and Robert M. Butler.

Thank you Jagat for bringing up the issues you raised--yes they are appropriate to this topic!

I hope we can discuss all of these issues and more, as we and our parents are all aging and approaching death. How can we do so with meaning, love, and grace? That is the question.

My mother will be 83 next month; I hope she will make it up to her birthday, because Alzheimers has wiped her out in a very short time. Last summer she suddenly failed to recognise her sister, who was visiting her and whom she has known for 76 years. Not just once, but each day that she was her guest! Then she started serving food to persons that were not there, and then she even failed to recognise her own husband (my stepfather)!

On December 9, when I was on a stopover from India to the USA, I visited her. She had totally lost the way. During my subsequent presence in the USA my mother totally and definitely blacked out, but somehow the Supersoul inspired me to take the final action on December 9. I gave her a big kiss. I walked away from her. She asked me: "Do you want to ask me anything more?" I said: "Yes - I want to know that you love me." "Of course I do" she said.

The Supersoul, who knows past present and future, inspired me, because that was the last chance I had to communicate with her. I find that important, because before any acquaintance passes away one should please that person so he/she will not leave the body with any grudge towards you. She is still in her current body, but as little more than a plant.

Last Saturday she almost left her body because she failed to drink or eat. Her deterioration has gone so fast, it astonished everybody. Just 7 months ago she was a lively soul, into culture, philosophy, arts and politics, but she is now little more than a plant. She will be a great loss to me because she was the only one in my family who sympathised with my spiritual quest....

Dear Advaita das,

Radhe Radhe!

Very touching and insightful story.

I had an interesting experience with my Grandmother. I was never particularly close with anyone in my family. In all respects I was the "black sheep" in both sides of the family. For whatever reason I never emotionally bonded with anyone in my entire family and always felt detached from them.

When my Grandmother, on my father's side, became gravely ill I received a call from my father asking me to travel to Florida as she was about to pass. My initial thought was "why" but I felt I should go since it was important enough for my family to ask. I called my wife, who was pregnant with our first child at the time, and asked if she would like to go. She said yes and prepared everything for our trip in hopes of arriving for her passing which would allow us both time to speak with her as well as chant with her and give her tulasi and dust from Vrindavan.

We arrived at the hospice at around 11 pm that evening and my father drove us straight to the hospice. My grandmother was no longer responding to anything besides maybe moving her hand or slightly moving her head. It was a bit awkward as I didn't know what to say or do. I wanted to offer something spiritual but it was awkward with family present. So I simply read to her from Bhagavad Gita for about 30 minutes. We then returned to her home to sleep and would return in the morning.

The next morning I went to the hospice with my father, aunt and her husband. When we arrived they decided to get something to eat so I went to her room on her own knowing that I now had a window to do something spiritual. As I was alone I decided to have kirtan for her. So I softly sang. After about 20 minutes she tensed up, took a deep breathe and was gone. I wasn't sure if she was indeed gone so I continued to chant for a few minutes when the nurse arrived. She checked her and she had indeed left her body. The nurse remarked that she was waiting for me to see her so that she could leave peacefully and that whatever I was chanting had eased her pain and allowed her to go.

At that point I ran off to find my family. On the way I ran into my cousins, who particularly thought I was weird, and told them of her passing. They ran down the hall to her room and I continued on to find the rest of the family. When I found them I told them and we all proceeded to the room.

When we got there the nurse came in and instructed my family that "Grandma was indeed waiting for her grandson to speak some final words to her and that the mantras I sand allowed her to leave peacefully". Looking around at my family they were in a bit of awe over this statement.

In the next hour the rest of the family, including my wife arrived. At this point i had become bold and I told the nurse that my wife and I had some things for my Grandmother before they took her away. The nurse asked that we give my Grandmother what we had. So we put tulasi in her mouth, sprinkled Jamuna and Radha Kunda water on her head and dust from Vrindavan on her head and mouth. We then gave her a garland from Sri Radha Govinda deities in NY.

My family just sat there stunned as we did all this especially considering the nursing staff at the hospice was adamant that I was the reason she left so peacefully and that whatever I was doing was the key to her peaceful and successful passing.

Afterwards my Grandmothers siblings asked me about what we were doing. They were very funny, old, Jewish people. They asked if I was indeed in a cult which I happily answered yes. They had no problems with that and thanked me for whatever I did. I know this must have killed my father’s Sister and family as it validated, in some respect, who I was and what they weren’t.

I remember the pain I felt knowing I didn’t offer this same “goodbye” to my Mother. I was too young and too immature to know what to do. I was at least glad I had done this. As we returned to her home and watched everyone argue over who my Grandmother was, and for some, what they deserved to take home from her apartment, I was thankful that I was not so much a par of their world but that I was given the opportunity to say goodbye.

Aspiring to serve the Vaisnavas,
Rasaraja dasa

I think that both of these touching stories illustrate that even when the body and mind appear "out of it" that the spirit is aware and responding to what we say and do for our loved one. When my son was in a coma I always operated from the assumption that part of him might be aware of what I was saying. I noticed that some of the best nurses likewise always told him what they were doing when they attended to his needs, regardless of how unresponsive he appeared.

I am glad you were able to have those moments with your loved ones and I thank you for sharing your stories.

I know this will be somewhat out of place here:

I work on people and animals from a distance doing Sacred Energy Healing. I was working on a clients dog (more than 400 miles away) the other day and to communicate with the dog and perform the healing work was extraordinary - the sadness, agony and overwelm of the dog was extreme and yet consolable and that was a wonderful part of the healing. It was suffering from somekind of auto-immune distress and bleeding internally hence all the extreme worry, etc from the dog - it doesn't know what is going on. Yet when in contact with 'other' who was present for a loving communication there was consulation that was very healing!

QUOTE(JD33 @ Jan 11 2005, 11:41 AM)

Well, I started the topic and I think it is very appropriate. If even a creature of more limited consciousness benefits from loving contact with someone while suffering, how much more so can our loved ones and other humans? Thanks for sharing this!

I had a chance to talk to a chaplain from my hospital about what can be done to help my consciousness at the time of death. I was explaining that to me, a spiritual focus is very important at the time of death and I would like to be able to play music to help me focus. We got sidetracked into a conversation about my needing to be in control, etc., and he cited some Buddhist monks who were surrounding the bed side of one of their fellow monks and urging him to wake up, and how intrusive he thought that was. He wanted to talk about trusting in God if one is unconscious. I acknowledged that, yes, God's grace can come into play and I still would like to do what I can to have as conscious a death experience as I am able. I also pointed out that culturally, the monk's actions would bother him but the monk they were talking to was likely comforted by their actions. I also compared my wanting a conscious death experience to also having had a conscious childbirth experience by not taking medication, and he seemed to finally understand what I was getting at.

So after talking to him and also some cardiac nurses, I established that one can help facilitate this by telling as many people as possible about one's wishes, making it easy by, say, having a tape recorder or cd player, battery operated, all set up so that all they have to do is hit Play, with written reminders in one's room and on the player. They aren't likely to fool with head phones and such, but when one is conscious one can ask for them. In a situation where one has "coded" or gone into cardiac arrest, whether or not they do any of this stuff really depends on what is happening. Their primary focus is of course on saving one's life, not playing spiritual tunes.

They also said that yes, they are willing to allow pictures to be put up on the wall, the crucifix to be covered, and other steps to spiritualize the environment. I plan to put together a little portable kit to do so.

I also got a copy of a really wonderful document called Five Wishes, a medical directive that also has room for spiritual and other wishes in addition to the legal directive about medical care. You can get a copy by calling 1-888-594-7437 or by going to Aging With Dignity's website. I highly recommend it, especially for those of you with ill parents. It is the best and most comprehensive advanced directive document I have seen, and really helps one think about one's wishes very clearly.