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http://www.UrbanDharma.org ...Buddhism for Urban America

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The Urban Dharma Newsletter... April 1, 2003

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In This Issue:

1. A Buddhist View of Life, Death and Rebirth
2. Responding to the Needs of the Dying
3. Benefits of Serving the Dying
4. After Death Care
5. Self Care for the Bereaved Caregiver, Next of Kin or Close Friend
6. Self Care for the Hospice Worker
7. Recommended Reading List

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"A Special Issue of the Urban Dharma Newsletter on Buddhist Death, Dying and Care Giving."

Amitabha Hospice has the following Mission Statement:

* http://www.amitabhahospice.org/

Amitabha Hospice Service offers free practical home help and compassionate companionship for the elderly and the incurably ill of any age and their families with specially trained and supervised Caregivers throughout the greater Auckland area. Based on the Buddhist principals of love, integrity, equanimity and service, each family member and staff member is accorded equal respect and compassion with regard to their individuality and uniqueness as members of the larger universal human family. Amitabha Hospice Service is dedicated to developing and maintaining the highest quality of compassionate care in co-operation with other professional community services.



1. A Buddhist View of Life, Death and Rebirth

* http://www.amitabhahospice.org/hospice/rebirth.htm

Buddhism is one of the oldest world religions. It was started by an Indian prince named Siddhartha who was born 544 years before Christ. He renounced his family and kingdom and studied and practiced all the spiritual teachings of that time, until one day, he vowed not to move from his seat under a Bodhi tree until he discovered the truth of all existence. He did this by examining the nature of his own mind.

To a Buddhist, the word "mind" does not mean brain or merely cognitive ability. Mind is formless, shapeless, colourless, genderless and has the ability and potential to cognise all phenomena which is called being "Enlightened". The word Buddha means Awakened (One). Like the sky, the mind’s basic nature is pure, luminous and knowing but like clouds obscuring the sun, one’s mind is obscured by delusions. However, through virtue and meditation one removes the delusions and becomes awaken, a Buddha. In other words, everyone has the potential to become a Buddha.

The mind also has three levels - gross (for example the mind we are using now to understand each other) subtle (roughly the unconscious mind and very subtle mind which could be described as the essential energy of the mind). It is the very subtle mind that is usually only experienced at the time of death or in advanced meditation practices.

What bearing does this have on life and death?

Buddhists believe every action created with either our body, our speech or our mind leaves a subtle imprint on our mind which has the potential to ripen as future happiness or future suffering, depending on whether the action was positive or negative. This is a very simplistic description actually it is not black and white, it is very complex - maybe it is best thought of as different grades of grey. For example, if one learns to play the piano, one automatically has the potential to become a pianist depending on so many factors (such as: how much one practices, the tutor, one’s talent, etc) So basically these imprints remain on the very subtle mind until they ripen or until they are purified by spiritual practices. This is called the Law of Karma, or the Law of Cause and Effect.

It is the very subtle mind which continues like a stream from one so called "life" to another. This is called Reincarnation. The type of rebirth one takes is determined by the cause, in other words, the strength and direction of one’s karma. Because of the continuation of this very subtle energy or mind, it is the state of one’s consciousness at the time of death which usually determines one’s rebirth. If the mind is calm and peaceful and carries positive thoughts then the natural outcome is a happy rebirth. If one’s mind is in a state of anger, fear or has strong desire this generates an unhappy rebirth. The mind that arises at the time of death is usually the one that the person is most habituated to. People tend to die in character, although this is not always so.

Therefore, the Buddhist teachings strongly emphasise that the time to prepare for death is now, because if we develop and gain control over our mind now and create many positive causes then we will have a calm and controlled mind at the time of death; we will be free of fear and have no regrets. An advanced meditator even looks upon death as a potentially rewarding experience to gain higher realisations and even Enlightenment. So he or she will make all efforts to understand and prepare for death in order to make the best possible use of the experience. In fact any practicing Buddhist will want to know as early as possible the probability of imminent death for these reasons and also to prepare one’s family.

Death has been described as being "as difficult as a turtle separating from its shell!" Usually what we think is "me" includes a concept of our body as part of ourselves. Losing what is most familiar and precious to "ourselves" is a wrenching and agonising process. So the Buddhist tries to cultivate the attitude that the body is like an old car which the driver has to abandon.

Since the quality of the future rebirth is said to depend largely on the quality of the final moment of consciousness, the Buddhist will also want to be as alert as possible, some may even refuse pain relieving drugs if it makes them feel intoxicated. So it is important to find the right balance between being free of pain and in control of the process.

The dying Buddhist would also be likely to request the services of a monk or nun in their particular tradition to assist in making the transition of death as peaceful and free of fear as possible. Before and at the moment of death and for a period after death the monk, nun or spiritual friends will read prayers and chant from the Buddhist Scriptures. In many traditions, this death bed chanting is regarded as very important and is ideally the last thing the Buddhist hears.

Death is seen as a highly complex and interdependent process in which both body and mind disintegrate simultaneously. There are two parts: an outer dissolution when the senses dissolve and an inner dissolution of the gross and subtle minds. Thus even after a person dies from a clinical point of view, the inner process of dying continues for some time. Ideally its preferable to die at home or in a Buddhist hospice where one can have a peaceful meditative atmosphere and the body can remain undisturbed for a while after death.

This is especially important in the case of an advanced practitioner who may be resting in meditation. But it is also important for an ordinary person. If the person is disturbed or upset at the moment of death it can have an adverse effect on the mind’s migration through death into the next rebirth.

Generally speaking, for a Buddhist, awareness of death plays and important part in their philosophy of life although for some older Asian Buddhists it is considered taboo to talk about death. Death however is certain, no one has escaped it. But the duration of our life time is uncertain. Disease and accidents can happen at any time. Therefore, to a Buddhist, life is short and precious, so it's wise to make the best use of it by practicing loving kindness, patience and other virtues.



2. Responding to the Needs of the Dying

* http://www.amitabhahospice.org/hospice/respond.htm

While there can be many ways of classifying and discussing the needs of the dying; the following are what we have found to be essential and universal for all people (in bold text) and a few suggestions (in lighter text).

Honesty - be yourself (It's not who you are but how you are!

* The best is all we have to give.

* Listen with your heart.

* Admit your feelings.

Understanding - comes from open-hearted listening -

* letting go of self,

* listening without a sense of "I know"

* allowing the other person to be as they are

* abiding in empathy like the earth which supports all life

Freedom - 'holding on' verses 'letting go' - may be assisted by any of the following:

* having permission to die from family and friends

* gaining reassurance that survivors will be OK

* receiving help with unfinished business (physical and mental)

* finding meaning in life and death, making sense of suffering

* aspiring to a positive direction - e.g. to complete one noble act, to die in grace, to be the best one can be, to die without regrets

* getting in touch with their own strengths of faith & spirituality through inspiring poetry, music, memories, quotes, etc.

Acceptance

* moods & downs are OK; the patient feels safe to express them

* repressed emotions - anger, grief, jealousy, guilt are all empty of being self-existent, cultivate a non-judgemental attitude

* remember we are all the same, in wanting to be free of suffering, wanting happiness and awaiting death

Respect

* remember inherent Buddha /God-like nature/the essential goodness of the person

* acknowledge their courage > can inspire others, family and friends

* celebrating their good deeds - what will live on after they are dead

Love

* built on the fore-mentioned, from empathy and true compassion

* sharing laughter makes hearts light and free

* compassionate touch - the nonsexual intimacy of unity with another human being or animal

* bonding with eye contact, with touch or laughter, goes beyond mortality, beyond words, heart to heart in universal oneness

3. Benefits of Serving the Dying

* http://www.amitabhahospice.org/hospice/serving.htm

"The purpose of being born as a human being is to eliminate the suffering of others and to bring them happiness." - Lama Thubten Zopa Rinpoche

Offering service to the dying:

Teaches us the meaning of life - helps us see what we've learned as a person in regards to suffering, love and loss, happiness and unhappiness, relationships etc.

Reminds us of our own life/path, death/mortality - like a mirror we can examine:

* How much we harm others - regret and redirection means growth. Guilt is self-absorption, depreciation and regression.

* How much we can love others. Loving kindness is wishing happiness for others

* How much we can let go, like an open hand rather than a closed fist.

Seeing ourselves in others naturally produces equanimity.

* As St. Thomas Moore said, "We are all in the same cart going to the execution".

We are all the same, we are all going to die, and we are all facing death every moment. Therefore, how can I get angry or hate anyone or wish them harmed.

* Everyone wants happiness and wants to avoid suffering and we all make mistakes trying to achieve it.

* Based on the recognition of the universal equality of all (without discrimination or bias) we develop true empathy. This true empathy is the basis of true compassion.

Compassion is not true compassion unless it's active -

* Not just a warmth of heart or a recognition of others needs.

* It is a sustained, determined practical determination to do whatever is possible and necessary to help alleviate suffering. Offering our time, our skills, our being, our selflessness.

Compassion has benefits for the dying person:

* An open heart and unbiased mind gives unconditional love, acceptance, respect.

* Embodying compassion creates an atmosphere of peace that supports and inspires.

* This atmosphere of peace at the deepest level helps the dying to find their own answers, to heal themselves spiritually and even sometimes physically.



4. After Death Care

* http://www.amitabhahospice.org/hospice/afterdeath.htm

Care for the Deceased

Although death is definite for all that lives, the time of death can come suddenly from trauma or slowly after a long illness. Often the time after a death in the family is a busy one, planning the funeral, but care for the body immediately after death and that which leaves, whether you call it spirit, soul, subtle mind or energy is very important.

Many Asian cultures and Buddhist philosophies recommend not touching the body after the last breath. They believe that this life force, spirit etc. is still present for a time and if the body is moved then a smooth transition to the afterlife cannot take place. Also an outward gushing of emotion is not recommended because it may cause the spirit, or subtle mind to regret dying and be more attached, making letting go and leaving harder.

However this is not the time try to stop someone from crying as this would cause more tension and unrest. On the contrary it is best to keep the atmosphere as peaceful as possible and this is best served by generating love and compassion for all present. Sometimes these arrangements can be made beforehand with medical staff and family, but remember the dying (like infants) sense the vibration if there is discord among people.

A simple practice for the dead that is appropriate for Christians, Buddhists or a person of any spiritually, is to visualize God, Buddha (or whoever) on the top of the head of the deceased and while saying out loud or silently to the deceased "Now you have died and will leave your body, your work here is finished, there is nothing you can take with you, let go of everything including all regrets and be your true self, a being of light and love for all those you have known and not known. You are pure, unstained, free, and full of radiant love. Soon you can learn everything you need, generate supreme faith and devotion to your refuge and the wish to be unified with your (divine source, your God, your spiritual master, the Dharmakaya, Amitabha Buddha, etc)." Then the caregiver visualizes the dead person’s consciousness as this being of light (with a very strong wish to unite to the heart of their refuge). The caregiver visualizes that it goes straight from the dead person’s heart and ejects out the top of their head into the heart of their refuge and they experience the mind of (God, Buddha, whomever is their refuge). Then depending on the caregiver’s understanding and beliefs (s)he meditates on that peaceful experience. This can be done even after the body has been dead for some hours but it is best done before the body is cold.

In the days and weeks following the death especially for the first 49 days one can help the dead person’s mind by avoiding harming others, generating love and compassion, doing kind actions, making charity and specific prayers and practices that their spiritual teachers recommend and dedicating this positive energy to the mind or soul of the deceased, wishing only peace and happiness for them and rebirth in the presence of their God or Buddha.

Self Care for the Bereaved Caregiver, Next of Kin or Close Friend

Be kind to yourself. If you have been the primary caregiver for the dying, often there are feelings of relief, as well as deep pain, sadness, anxiety, loneliness, lack of concentration, tiredness, anger, guilt, regret, anger, waves of emotions, ideas that seem true, truths that look like fantasies. You may want to be alone; you may want to party. Some thoughts are hard to deal with; things can get way out of perspective. When there is more space in the mind because its not occupied with the tasks of caring for the dying or settling the estate, a lot of memories and commentaries on the past may arise.

What works: Basically each person grieves in their own way, but there are some methods that help when it seems like life will never be the same (it won’t be the same) but different can be better than the heartache you feel at the moment.

* Talking and accepting the help of a good friend, sharing your burden, does lighten it.

* Having a ‘good cry’- yes it helps both physiologically and psychologically.

* Be kind to yourself, have compassion for yourself, what is done is done, accept your and others’ limitations of the past and the present. Replaying old hurtful scenes will not improve them but every time you judge yourself or others it will take on your current temperament and view. It is only your view, painted as you see it – others will see it differently –make room for another way of seeing the past.

* When we hold one view too tightly, its going to cause us or someone else pain. Let go of wishing to change the past and accept what can’t be changed. The present is the only time we have. The future is created by present moments.

* When the pain of loss and desire is overwhelming there are some Buddhist techniques that are very powerful.

One is to imagine all the people in the world, just like you who have strong grief, and think "Just as I want to be free from this pain so do they – Since I am presently experiencing this suffering then may I experience it for the sake of all these people, on their behalf, that their suffering is immediately finished." Hold that thought as strong as you can. It can be done with the breath – inhaling in the form of black scoot all the suffering of loss and grief in the world (thinking of individual people or nations at war, in famine etc). When this blackness reaches your heart think that it explodes your own pain and loss and transforms into white light which then you breath out freeing everyone from their grief and every form of suffering.

At first glance this may seem to be adding more suffering to your misery but it dramatically has the opposite effect. Why, because the deeper our misery the more isolated and detached from the rest of the world we feel. This further increases our feelings of uniqueness, separateness and disconnection adding more misery and can also bring feelings of fear (how can life be good again etc). By remembering that we are not alone and generating good will for others opens the prison of selfdom and allows us to reconnect with our essential nature and the world.

Another technique is to look directly at the pain. Where is it? Does it have shape, colour, size? Can you find the feeling, see the thought or the see the mind thinking or find the "I" suffering? Every time you do this meditation the suffering may look less concrete, more hollow or dream-like. When the way it appears changes, it is easier to let go, when the pain comes back.

* Practice rejoicing in the good memories, enjoy the memories of mutual kindness and laughter and dedicate all these to the future success and happiness of the dead and those left behind.

* Focus on the positive, start with what’s near: a sunset, a summer breeze, a hot shower, a fresh flower, take a deep breath and let the beauty and enjoyment fill your being, giving you strength, comfort and healing. When you’re ready imagine sharing that liberating feeling with others on one or more of your out-breaths. Rest in the awareness of this experience.



5. Self Care for the Bereaved Caregiver, Next of Kin or Close Friend

* http://www.amitabhahospice.org/hospice/caregivercare.htm

Be kind to yourself. If you have been the primary caregiver for the dying, often there are feelings of relief, as well as deep pain, sadness, anxiety, loneliness, lack of concentration, tiredness, anger, guilt, regret, anger, waves of emotions, ideas that seem true, truths that look like fantasies. You may want to be alone; you may want to party.

Some thoughts are hard to deal with; things can get way out of perspective. When there is more space in the mind because its not occupied with the tasks of caring for the dying or settling the estate, a lot of memories and commentaries on the past may arise.

What works: Basically each person grieves in their own way, but there are some methods that help when it seems like life will never be the same (it won’t be the same) but different can be better than the heartache you feel at the moment.

* Talking and accepting the help of a good friend, sharing your burden, does lighten it.

* Having a ‘good cry’- yes it helps both physiologically and psychologically.

* Be kind to yourself, have compassion for yourself, what is done is done, accept your and others’ limitations of the past and the present. Replaying old hurtful scenes will not improve them but every time you judge yourself or others it will take on your current temperament and view. It is only your view, painted as you see it – others will see it differently –make room for another way of seeing the past.

* When we hold one view too tightly, its going to cause us or someone else pain. Let go of wishing to change the past and accept what can’t be changed. The present is the only time we have. The future is created by present moments.

* When the pain of loss and desire is overwhelming there are some Buddhist techniques that are very powerful.

* One is to imagine all the people in the world, just like you who have strong grief, and think "Just as I want to be free from this pain so do they – Since I am presently experiencing this suffering then may I experience it for the sake of all these people, on their behalf, that their suffering is immediately finished." Hold that thought as strong as you can. It can be done with the breath – inhaling in the form of black scoot all the suffering of loss and grief in the world (thinking of individual people or nations at war, in famine etc). When this blackness reaches your heart think that it explodes your own pain and loss and transforms into white light which then you breath out freeing everyone from their grief and every form of suffering. At first glance this may seem to be adding more suffering to your misery but it dramatically has the opposite effect. Why, because the deeper our misery the more isolated and detached from the rest of the world we feel. This further increases our feelings of uniqueness, separateness and disconnection adding more misery and can also bring feelings of fear (how can life be good again etc). By remembering that we are not alone and generating good will for others opens the prison of selfdom and allows us to reconnect with our essential nature and the world.

Another technique is to look directly at the pain. Where is it? Does it have shape, colour, size? Can you find the feeling, see the thought or the see the mind thinking or find the "I" suffering? Every time you do this meditation the suffering may look less concrete, more hollow or dream-like. When the way it appears changes, it is easier to let go, when the pain comes back.

* Practice rejoicing in the good memories, enjoy the memories of mutual kindness and laughter and dedicate all these to the future success and happiness of the dead and those left behind.

* Focus on the positive, start with what’s near: a sunset, a summer breeze, a hot shower, a fresh flower, take a deep breath and let the beauty and enjoyment fill your being, giving you strength, comfort and healing. When you’re ready imagine sharing that liberating feeling with others on one or more of your out-breaths. Rest in the awareness of this experience.



6. Self Care for the Hospice Worker

* http://www.amitabhahospice.org/hospice/self-care.htm

From the view of ordinary mind / ego - burn out is a 'real' danger.

From an understanding of selfless transcendent compassion, giving only produces more wisdom and bliss.

What view are we using? Being kind to ourselves helps us benefit others more!

* Keep in touch with your body, energy level and attitudes

* Relax well - music, bathing, nature, massage, meditation, walks, exercise, writing

* Nourish yourself- healthy food, rest, prayer & spiritual input (pastoral guidence, meditation, yoga etc)

* Set limits - making priorities, saying no, requesting time out

* Be willing to ask for and receive help and support

* Try to stay in the moment, letting go of the past, don't worry about the future

* Cultivate a vast perspective, awareness of our own suffering and that of all others

* Balance with humour and find joy in appreciating one's own and others' kindnesses

* Reinvest the positive energy by dedicating the experience, one's efforts, the results without judgement to the highest welfare of all, as extensive as possible

7. Recommended Reading List

* http://www.amitabhahospice.org/hospice/readin1.htm

BUDDHIST TEACHINGS ON LIVING AND DYING

A Still Forest Pool by Aachan Cha ed by Jack Kornfield

Bardo Teachings by Lama Lodo

Death and Dying, The Tibetan Tradition by Glen Mullin

Death and the Art of Dying by Bokar Rinpoche

Death, Intermediate State and Rebirth by Lati Rinpoche and Jeffery Hopkins

Glimpse After Glimpse by Sogyal Rinpoche

Graceful Exits: How Great Beings Die by Sushila Blackman

Only Don't Know by Sueng Sahn

Seeking the Heart of Wisdom by Jack Kornfield and Joseph Goldstein

Start Where You Are by Pema Chodron

The Door to Satisfaction By Lama Zopa Rinpoche

The Joy of Living and Dying in Peace by His Holiness Dalai Lama

The Miracle of Mindfullness, Being Peace by Thich Nhat Hanh

The Myth of Freedom by Chogyam Trungpa

The Tibetan Book of Living and Dying by Sogyal Rinpoche

The Tibetan Book of the Dead by Francesca Fremantal and Chogyam Trungpa

The Tibetan Book of the Dead by Robert Thurman

The Wheel of Death by Roshi Philip Kapleau

Transforming Problems into Happiness by Lama Zopa Rinpoche

When Things Fall Apart by Pema Chodron

Who Dies? by Stephen Levine

Zen Mind, Beginners Mind by Susuki Roshi

CARING FOR THE DYING

A Simple Path by Mother Teresa

Coming Home: A Guide to Dying at Home with Dignity by Deborah Duda

Facing Death and Finding Hope by Christine Longaker

Final Gifts: Understanding the ? of the Dying by Maggie Callanan and Patricia Kelley

Healing into Life and Death by Stephen Levine

Home Care by Evelyn Baulch

How Can I Help? by Ram Dass and Gorman

How to Be a Help Instead of a Nuisance by Karen Kissel Wegela

I Don't Know What to Say by Robert Beckman

Lessons from the Dying by Rodney Smith

Life To Death: Harmonising the Transition by Hulen Kornfeld

Living with Dying: The Management of Terminal Disease, Saunders, Cicely & Baines

Love is Letting Go of Fear, Teach Only Love, Goodbye to Guilt by Gerald Jampolsky

On Children and Dying by Elisabeth Kubler-Ross

On Death and Dying by Elisabeth Kubler-Ross

Peace, Love and Healing by Bernie Siegle

Perfect Endings: A Conscious Approach to Dying and Death by Robert Sachs

Questions and Answers on Death and Dying by Elisabeth Kubler-Ross

The AIDS Caregiver?s Handbook by Ted Eidson

The Private Worlds of Dying Children by Myra Bluebond-Langer

The True Work of Dying: A Practical and Compassionate Guide by Jan Bernard

To Live Until We Say Goodbye by Elisabeth Kubler-Ross

BEREAVEMENT

Good Grief by Granger E. Westberg

Helping Children Cope with Death and Bereavement by Charles A Corr

Seven Choices by Elizabeth Harper Neeld

Spiritual Care of Dying & Bereaved People by Penelope Wilcock (Christian)

The Bereaved Parent by Harriet Sarnoff

The Courage to Grieve by Judy Tatelbaum

To Comfort the Bereaved by Rabbi Levine Aaron (Jewish)

When Bad Things Happen to Good People by Harold Kushner

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