In China, death is a very taboo topic. We are often full of expectations for newborn babies but full of fear, anxiety, and hesitation about the passing of life. With the growth of China’s aging population in the last three to five years, many families have faced the situation of sick and dying elderly members. Many older adults need care in the previous two stages of illness and death, and many children are unfamiliar and helpless because the elderly are about to die. Therefore, society must realize the importance of hospice care and death education.
Recently, three scholars and Christians from Shanghai, Jiangsu, and Guangdong shared their experiences on this topic in the first-person narrative.
Millennial scholar Li Daonan: the urgency of the church’s participation in hospice care at present
I think hospice care is a natural and urgent need in Chinese society. Society and the church need to see the urgency of this demand, and the church can better participate in it so that people can have dignity in the face of death. Death should not be a regular topic, but the church should show sincere concern and provide services to society.
Christianity introduced hospice care. During the Roman Empire, death brought by the plague came to all people, whether they were nobles or enslaved people or were high priests of official religions, or Christians, but only Christians did not fear death and plague. Regardless of their status, those who died of the plague were given a decent funeral. Those who were seriously ill and dying believed in entering the kingdom of heaven after death. Under the comfort and care of other Christians, they showed more splendid courage and hope than other pagans in the face of death. Their firmness in the hope of eternal life after death even surprised the emperors of the Roman Empire.
Let people have dignity in death, which is precisely what the Christian faith should do. When death is discussed as a public event, everyone who talks about it discusses this event that has nothing to do with himself as an absent person, and they are all talking about other people’s deaths for their interests. At this time, religion shows the most extraordinary disregard for individuals.
In China, people fear death, so they have a lot of ghost culture and folk religions that connect ghosts and gods. Because of this, we lack hospice care in our culture. We regard death as a painful fact that we have fallen into the underworld and separated from the world. We end our lives in nostalgia for the world and fear of death. Therefore, China is a country with minor hospice care.
Hospice care is about individuals because death comes to specific individuals. Currently, the Christian community in China is extremely short of hospice care, and most continue the traditional culture’s recognition of death, avoiding death and clinging to the world. Therefore, the church can continue the routine visits and explain the meaning of death with teachings, and still regard death as a public event. Hospice care is not one visit or two visits but a continuous process. This process requires constant care from the time when believers face death, which may take weeks or months.
Hospice care not only tells the dying to believe in eternal life but also gives the family members comfort in the face of the death of their loved ones. This is comprehensive care, so it cannot be done by one person but by a team.
Hospice care is not trying to change each other, nor trying to persuade them to accept their teachings, nor does it believe that Jesus will go to heaven and not believe in the threat of going to hell, but respecting the dying person so that he will be peaceful and warm with the company of his caregivers, full of faith in eternal life. People will come crying but end with a smile.
Therefore, the hospice care team needs members who are firm in faith, tolerant, and patient. They should know not only the Bible and theology but also learn knowledge of medicine and psychology. They should understand the patient’s psychology and condition well, appreciate his physical pain and establish mutual trust in communication with patients.
What Christianity needs most at present is not to tell the story of death full of theological theories, but to establish a perfect hospice care system and its hospice care teams, so that death will become a process of life and an ordinary event in eternal life instead of being terrible in its belief in eternal life.
Church worker Shi Canaan: Who will care about hospice care? The church must step forward.
“It is the savior Jesus who can bring comfort to the soul, so the church should stand up to the needs of hospice care.”
Nowadays, it can be seen in many hospitals that under the condition that patients’ diseases are incurable. Their survival time is limited (six months or less), hospice care advocates giving up active treatment, paying attention to patients’ dignity and spiritual needs, alleviating patients’ suffering, improving their quality of life, and extending to support patients’ families.
Overseas, the emergence of hospice care is closely related to over-treatment. Saunders, a British nurse, worked in a terminal cancer hospital and witnessed the suffering of countless dying patients. Determined to change this situation, Saunders founded the world’s first hospice hospital in 1967. She believed that we should respect the patient’s choice and the law of natural life and wait for the end of life without relying on a life support system.
Volunteers in hospice care hope to learn to face death through service. Sister Dong is a volunteer in the service team and has been doing voluntary service since 2005. More than a year ago, she began hospice care service and mobilized twenty or thirty elder sisters to do it together. Sister Dong was once seriously ill. During that time, her heart was full of fear and anxiety. By serving many dead partners and neighbors, she considered making them walk more comfortably and let their relatives and friends deeply remember and live happily instead of fearing guilt.
Chinese-style hospice care is another advocacy of filial piety. Let family members accompany the dying person, recall the patient’s preferences, recall the life, alleviate the fears, and make them clean, tidy, stable, and indifferent at the last moment of this world. Many hospice care volunteers have certain beliefs and fear of life before participating. In the eyes of ordinary citizens, hospice care is still a strange term as people avoid talking about death. Some churches are also doing it for hospice care, but the strength is not enough, and no special service team has been formed. Therefore, the church is a good contact point with social services for hospice care.
Brother Xiaogang: People who do not respect death and do not know how to fear life, please give hospice care to the elderly.
Recently, I heard the news that many people around me who were over 80 years old died one after another. It is said that concerning death education in China, the Chinese society is simply pupils because there is no death education.
The meaning of hospice care is: it refers to providing physical, psychological, and spiritual care and humanistic care services for terminally ill or elderly patients before dying, controlling pain and discomfort symptoms, improving the quality of life, and helping patients die comfortably, peacefully, and with dignity. The service object of hospice care is everyone who will die, mainly the elderly.
I want to discuss this topic through three perspectives of hospice care: psychological care, physical care, and social care.
We need to spend more time with the dying elderly, chat with them more easily, remember the past and their little things, listen patiently, and guide them to express their feelings in time. Try your best to help the elderly to establish an average mentality. You cannot take care of the elderly with the mindset of waiting for death but spend every day happily with them. We can try our best to communicate with the elderly in a positive and soothing tone, and avoid excessively negative words, to minimize the patient’s negative mood.
In terms of physical care, if possible, have physical contact with the elderly as much as possible, such as holding each other’s hands and touching their backs, so that they can feel the love of their families more. Hearing finally disappears, and you can talk to the patient until the last moment. I think the source of fear is that they do not know where they are going. If they know they are sure to go to a beautiful place, the aged patients will not be afraid.
Most older adults cannot walk in the later stage and can only lie in bed. Skin problem is a huge problem. Bedsore will happen if you are not careful. Do not let the patient lie in one posture for a long time. Help them turn over every few hours. Always wipe the body with a towel for the elderly to keep the skin clean and dry.
For facial care, use a wet towel to relieve eye dryness. Apply lip balm or wipe the lips with a cotton swab dipped in water. Many will have some phlegm in their throats in the last few days. We should not force them to drink water unless they want to. For patients to live a few more days, many people will cause them to eat. In fact, people’s metabolism has slowed down or stagnated in the last few days, and they can no longer digest and absorb food. If the patient can eat, they must be fed. If they cannot, do not force them to eat.
The dying will finally have a death roar, and the patient’s throat will make a loud noise in the last few days because their oral muscles will become slack, the liquid in the throat will accumulate, and they will purr when they breathe, which is called “death roar” in medical terms.
Regarding the phenomenon that the patient lifts the quilt, I learned that patients could not stand the heavy pressure in the last few days. At this time, even a silk scarf will make them unbearable. Do not cover the older man with a quilt freely.
Through many observations, the International Near-Death Experience Association found that some dying patients will feel near death. When the near-death feeling appears, they may see their dead relatives or have other hallucinations. The International Association of Near-Death Experience suggests that this situation is normal. The sense of near-death is to help the elderly prepare for death. The purpose of near-death will have excellent guidance and comfort. At this time, keep calm, do not break their illusion or talk, pay attention to what they say and want to express, and help them realize some wishes as much as possible.
In social care, we need to help the elderly sort out three kinds of relationships:
The first is to help the elderly deal with their self-relationships. We must actively communicate with the elderly: How do they spend their last time? What do they want to do with their legacy? In what way do they like to bid farewell to this world? What wishes have not been fulfilled? Self-relationship and psychological care have a sense of perspective, and there will be overlapping elements.
Second, help the elderly to deal with the relationship with others. We can express our gratitude to the elderly and tell them what they have done in the past that greatly influenced themselves and others and even others’ life trajectories. The general purpose is to appreciate older adults’ lifelong achievements and make them feel they have not lived in vain. Some people will take some family photos when the elderly are still in normal activities, then frame them and put them in a conspicuous place, and intentionally or unintentionally reveal that they will be treasured forever. This will also be very comforting to the elderly.
Third, help the elderly deal with their relationship with the God they believe in. When my husband’s grandmother was dying, we told her that God was very happy with what she had done and she had worked all her life diligently. When she was old, she would come to God and become a glorious child. When most old people die, they will have things that are hard to give up. If one pile cannot be put down, it will cause a dying obstacle-desperately not wanting to die. Therefore, a very important task of hospice care and nursing is not to let patients leave with regrets and questions. We should fulfill the wishes of the elderly as much as possible and make some promises when necessary so that the elderly can leave without any attachments.
(The above three scholars and Christians are pseudonyms.)
- Translated by Charlie Li