End of life care and death rituals

End of life care

End of life care and death rituals will tend to be culturally determined and can vary considerably. Check requirements with each family.

In Chinese culture there are traditionally five stages:

1. A familial obligation is that all family members will visit a dying relative. Larger numbers of visitors at the hospital may need accommodating.
2. Once someone has died, this needs to be announced to the community. Death is a more public affair than in Western cultures that tend to value privacy to deal with grief.
3. The deceased needs to be bathed with clean water in order to facilitate the passing on to the next world. Buddhists may require chanting just before and through the death process. Check with families whether they wish to bathe the body at home, or whether this should be done in the hospital. Some families may wish for a religious or spiritual practitioner to be present or consulted during the process.
4. In the fourth stage, a plant-oil lamp is placed at the feet of the deceased when mourners visit. This may be done in the hospital if the deceased is to be buried directly from there.
5. The fifth stage is burial. This only takes place after three to five days of rest, as it is believed that the spirit remains in the body for that length of time. Family will usually take the body home, however for those without family, alternative arrangements may need to be made.

For those who follow Confucian principles closely there is a Book of Rites with rules for rituals after death and clear guidelines on how mourners should behave and the body should be prepared. They do not believe in focusing on life after death but followers are encouraged to focus on their present. Taoists and Buddhists on the other hand believe that the way in which a person lived their life has consequences in the after life, and the relationship between the living and the dead is seen as continuous. It is the responsibility of the family member to provide care to those who have passed on (an aspect of filial duty). East Asian clients may subscribe to a combination of beliefs (as well as from other religions) since they may not identify with any particular spiritual system, but see their beliefs as cultural. Christians may include traditional beliefs and practices in their framework. So each family should be asked for their preferences.

For most traditional East Asians death and burial rites are important and meeting obligations in this regard vital for a person's sense of health and wellbeing. It is believed that failure to provide for the deceased appropriately will bring bad luck. If guilt about unmet obligations in this regard is at the source of health or mental health issues, clients can be supported to revisit the issue and complete obligations unmet.

Organ donation and Autopsy

There are no rules about organ donation or autopsy, but given concerns about invasive procedures and harmony issues, clients may not favour either of these procedures. There are concerns by some clients about disfigurement of the body after autopsy. If an autopsy is required, this may need working through with families.

After death

Death rituals will tend to be culturally determined and can vary considerably. Check requirements with each family.