Death: The Diseases And Cures of the 1800's in Grenada

There is so much history on the Island of Grenada also known as the Spice Island. The visits that was taken over the past  couple years took me this time to the parish of St.Patrick's to a town called Sauteurs and a historical site, well known to the inhabitants of Grenada. In Sauteurs is a place known as Leapers Hill, on this site it is a known fact the Carib's who were inhabitants of the island in that time period jumped, to their death, off the cliff rather than surrendering to the French army at that time , and did not want to be slaves to anyone.

y searching began on Leaper's Hill, walking through the grave site, and recording the names of individuals born in the 18th century, and who died later in life as the years went by.What I wanted to know  was which disease were the most prevalent in that time period. It so happened that after doing research in the Public Library archives  in St. George's (Grenada) it turned out that the diseases in those days were also in that time period.(century)

They were many advertisement about cures, for all the different disease, and conditions known that were prevalent during that time, one of the most advertised medicine was Sarsaparilla Pills developed by Dr.  Jacob Townsend, claimed to cure all, during the  time period of 1888, from Scrofula,Scorbutic Disorder, Gout, Skin and Blood Disease plus a great number of conditions.

Along with Dr.Jacob Townsend cure all medicine were the invention of Chlorodyne by Dr. Browne, he stated that his medicine can help in the cure of Dysentery, Cholera Fever, Ague, Cough, and Colds, no actual claims were made saying that this was true, but one can only imagine in those days that someone in particular may have actually be cured using this medicine.

From my research I found that in 1882, the medical officer for the poor house at that time was P.F. Mac Leod, and the house surgeon was Edwin F. Hatton no account of written words were found on these gentlemen except, they held highly responsibility jobs at the time.

They were responsible for any medical issues that may have arise at that time, but as far as I can see they were no reports written on any patient that may have died in either the poor house or hospital for those years. Also running rampage at that time period were the following diseases Cancer, Consumption, and Epilepsy, what is amazing is the different types of pills, and Elixirs that claimed to work on so many diseases. 

If one was suffering from Liver Complaints there were a sugar pill that named Bristol Sugar Pill that works, but they were no direct claims, that said it works. In going through the many newspapers of the 1800's printed in Grenada at the time, death was more frequent to younger children, raging from ages six (6) months to four (4) years that died of Hooping Cough.

While it was not so for the older children who died from Measles, Mumps and other related diseases, what I found was people especially the elderly between the ages of thirty-six (36) to fifty-two (52)  who died from a long illness was never mentioned in the obituaries that I researched and was available.

Some people died suddenly, which I based it due to a heart attack, but it could have been any kind of disease, also during that period some inhabitants died from a protracted illness ( long illness after suffering  )   which was not given. The true cause of and what that illness was, and it may have another name for it in that time period, prevalent in homes influenza, followed by measles, the mumps and whooping cough, which at times had too frequently fatal results and lingered among families.


The scarcity of medical men lead to high charges which had people questioning whether it was a good policy for the state to provide medical attention to the masses of the people, since the upper class people could pay for medical attention, while the lower class could not pay, and was not getting the medical attention as needed or deserved.

An obituary that was recorded in the St. George's Chronicle of 1852 read the following:
January 30   Children of prominent men dies from whooping cough, between the ages of (8) eight months to (2 1/2 ) two and a half years.

July 23  A (1) one year old died instantly of whooping cough

                Elderly gentleman dies instantly due to heart  failure

October 8   34 year old gentleman died of a disease called Apoplexy

All this lead to the government forming a board of health, commencing on October 29, 1852 on it sat two doctors Dr. Brown and Dr. Aquart  and other prominent men of the various committees, they saw what was needed to be done health wise and reported what was needed in order to help, and stop the spread  of the disease that was on going at the time.

Scientist and Doctors had done experiments on a wide range of medicine, and thought, through the process of their inventions  came up with the right medication, for every disease in the centuries but in most cases they only mask the symptoms which  did nothing much for some patients and good for others.

It is not our opinion to judge what the medication did, but to understand what it helped, and what disease it cured, and what was the benefit from each medication, that were given to the patient, in order for them to be cured. As always they must have been a great deal of talk about some medications that did not work, and perhaps viewed as a scam, and  all that it was seen as the inventors of these so call cure medications  was making the money from the ordinary man.

And so centuries past the generation of those era thought that the Scientists and Doctors had the medication, and the cure for the disease that was raging havoc on its citizens, may have been questioning themselves if they had the correct medicine to cure the various diseases. It was not until the nineteenth century that we began to see the advance in medical cures, where doctors and scientists began making advance strides in the prevention of the various diseases that ran rampart in the past centuries.

The same diseases that was prevalent then is still around although some names may have been call differently, but they are now controlled due to advance understanding of the disease and how it is caused. We now have a cure for most of the disease but we as a people must adhere to the warnings of the doctors and scientists when they sound the alarm about a disease.

Although we now have a cure for almost all the diseases possible we are still haunted by the fact that we have not yet conquered the cure for the most severe know cancer, liver and another that is running amok in this century AIDS but scientist are working hard to find a cure.

Disease in the past centuries have not changed, the same then is still here, and is also accountable for deaths in the present, although they are new names for different strains of colds and influenza they are well advance in this century to find a cure.

Most of the medicine for the various conditions, and diseases that were showing up on the island at the time came from England, and other countries when they were any outbreak of a disease. The time it took for that medicine to reach the Island many deaths had occurred, since it was being transported by boat, which was the mode of transportation then.

They were no records kept on the death of any disease or unfamiliar conditions, we cannot say for sure how many people died from what disease or condition, if the death of each year have to be compiled it would be hard doing so since records only went back to the nineteenth hundreds.

What did not happen in the 1800's would not have been possible trying to keep those many recorded deaths, and the diseases that took their lives, what is and should be done to have an estimate of those that had a serious medical issue or condition, and what he or she died from should be  a must so that as a civil society we can actually compare the deaths of the people from previous generations.

If we as a people are so much into genealogy we must in some way start recording and preserving our history so that the next generation can actually see and compare the disease then and now to see if the death of a deadly disease have reduced or increased.

In order for these records be preserved and its inhabitants counted the present Government must make a conscious effort to have all records on the computer, making it accessible for the general public to access charging a small fee of some kind. It have been a sort of a tedious time trying to get as much information on some of the individuals that I was researching, but  was possible to obtain death certificates because they died during the time record keeping started.

From what i have researched it seems that when doctors did not know what illness the patient died from it was either suddenly or after a long illness, they did not mention what type of illness or what condition they died from. What this is saying to you and me is that doctors or whoever looked at the deceased did not do a thorough examination to see if the patient had other complications along with the illness  his or her family physician had diagnosed.

From all this one can only imagine if you died alone in the hospital,poor house or where ever, and if no one can pinpoint what type of disease or condition the patient had then the doctor would write what he thought they died from. It makes this very hard to get a true diagnoses of the condition what the patient died from, since most of the death that may have been recorded could be false, that I cannot tell for sure, so I have to go  with what I saw or what I have written to paper.

To really get to the true facts this generation of doctors and physicians along withe the pathologist have to make the right decision of the cause of death, and must be properly recorded by Parishes, so that if there is an outbreak of any fatal disease it can be pinpointed and medical teams put in place to take care of those that are sick.

Enough said it is now up to the Grenada Government, and the Ministry of Health along with the doctors that issues the death certificates to record the right diseases or conditions the patient died from, with proper records it would be easier for researchers to actually see what patients of this generation especially those of the 19th century and the centuries to come for future researchers.

In all respect to the scientists. doctors and physicians in the 18th century, and before them for giving names to diseases and their understanding of what the symptoms were, but most of all the dedication of the scientists, pharmacist, and inventors of medication that were obtained to cure a specific disease at the time, with all the diseases, and conditions that was prevalent for that time. In spite of all the medication that were made available to the people and doctors for prescribing the dosage.

In spite of all these medication, and the cure some of them claimed that worked, although it might not have been so, I realized that those same diseases and conditions exists today in the 21st century, with the diligent work of all who are involved in the science of medicine, illness and diseases will continue to persist, and so the cycle will continue, where they are new strain of diseases, and the diseases of the past century will remain with us for years to come. I hope that all diseases that is plaguing the people of the world a cure will be found if not, disease of the past centuries would live on.

Taken from The Grenada Chronicle & Gazette

January 12/1895
 Dr. Churchill's, syrup of Hypohopnite of lime -- Cure for Consumption,Chronic Cough, and General Debility.

Dr. John .P. Gray ( Utica  N.Y 25 yrs) Combination of Glycerin  Sherry Wine Gentian Taraxcum and Phosphoric Acid and Carminatives --  Cures General Disability, Nervous Prostration, Anemia Wasting Diseases, and Promotes the Appetites.

Dr.J.Collis Browne's  Chlopodyne Assuages  Eases pain of Every Kind, Invigor Nervous System when Exhausted Cough Colds Asthma Bronchitis Diarrhea, Dysentery and Cholera.

January 26 / 1895
Clarke's Blood Mixture - Cures Scurvy, Eccema  Skin and Blood Disease, Bad Leg Pimples and Sores of all Kinds.

 A Caribbean Funeral Of Previous Years

Looking back at the time, or should I say the past thirty odd years when someone dies, especially in a small village, before the science of embalming came along, it was the  custom that the  deceased body  was washed by the people in the village at that time period if they knew the individual. The carpenter at the time would be asked to take the measurements of the deceased and build the coffin.

The washing of the body was done by male and female depending on the deceased individual, they were dressed and laid out on the bed for visitors to view the body later in the evening before the funeral, and burial
next day. At that time, during visitation prayers and singing were performed, and as the night continued it turned into what was called a wake and is still called so today.

A wake can go on for quite a while sometimes into the wee hours of the morning especially if alcohol is consumed, and coffee (strong) is served, and if the funeral services  are in the afternoon. In order to keep the body from decomposing rapidly it was placed in a make shift icebox, made of an inner and outer part. the outer part of the icebox was formed with galvanized, with a space between the inner part  wide enough to place ice between the groves all around the icebox coffin which the body was placed, in order to keep it cool.

The day of the burial it was removed and placed into the the coffin that was made by the village carpenter, and taken to the church, depending on how far the pallbearers had to walk to the church, two men with chairs would accompanied them. The coffin was placed on the chairs, and a new set of pallbearers would take over, until they reached the church.

During the funeral service the burial rites would be performed with the usual singing and they would always be a favorite song of the deceased sung then to the cemetery, which in some cases at the persons backyard if there is enough lands for the grave site. The gravediggers would lay the coffin in the grave after everyone left the site, if it was in a church cemetery.not so today.


After everything is over the congregation would return to the home and partake in some eats and refreshments that was prepared and talk about the deceased before setting out on their jurney to their respectful home's especially if they had to travel a great distance to attend the funeral.

Colon Cancer

A Silent Killer:  My Story

I was diagnose with Colon Cancer in August 2002, they were no signs or any symptoms that indicated me having cancer. The only symptom at the time was a sharp pain on the inside of my left shoulder , which I thought was gas pain. taking every thing possible to ease the pain that I think would work was useless.I walked to the Hospital which was not far from where I lived at the time.

 I arrived at the Emergency Station at 3:00pm, was placed into a room, and waited for about five hours before being attended tom the only reason it happened I told them that I was  a Diabetic and immediately the Doctors, and nurses started running test on me.

I had blood work done to make sure that my sugar level was not below the critical level, it was followed by an ultrasound, and was sent home to wait on a phone call from a Doctor from the Hospital. The following morning I waited for the call and about 9:00 am I received the call, it was the oncologist, saying that she wanted me to come to see her at the hospital, and to have some more test done.

I complied with the request because it was in my best interest, I had a couple test done within  three days, more blood work, two ultrasounds, a barium enemer, which was very invasive, and the most important one a Colonsocopy. After the last test was done I had to wait a couple day for the  biopsy results, it was not what I wanted to hear. the results came back positive, and had the pleasure of hearing that I had Colon Cancer.


When the doctor told me that news all that I could do was take a moment to compose myself, and asked the question where do we go from here? her answer was surgery. I went home and headed straight to the bathroom looked into the mirror and cried for a while.

Because my Cancer was caught early my chances of having it removed was good.  The surgery was done in three weeks after the diagoneses and spent seven(7) days in the hospital, according to the doctor account we removed five feet of your colon and reattached everything back everythink is okay, and we managed to get all of the cancerous colon eradicated, it was quite a relief to hear, i was discharges  from the hospital and started my recoupation at home.

In the early part of February I received a call from the Cancer Clinic, stating that i am scheduled for Chemotheraphy, with the date set  I arrived at the Clinic for my first treatment, it was not what I had in mind that it was going to be. First there were blood work, xray, before seeing the Doctorthen the Chemotheraphy Treatment can begin.

 I did not know what to expect, the doctor never told me that I had to take a special tablet before the treatment begun to prevent nausea. the needle was placed on the back of my hand and I felt the coldness of the solution as it went through my vein. My treatment lasted about fifteen (15) minutes, and had to have this treatment for thirty (30) sessions five (5) days straight with three weeks off.

Anyone who had Chemotheraphy would or may attest to the fact that it takes away your taste of food and the damage it does to your finger nails. It has been nine (9) years since my cancer and during my first  years had to undergo a colonscopsy every year, now my colonoscopy is done every two years. I am watching what I eat, getting lots of exercises, like walking and bike riding, and spending time with my daughter and grandchildren.

I make sure to keep my appointment when my time arrive for my colonoscopy examination it is all to make sure that it does nit return. My advice to all if you have not taken a test before please do so I am talking to men in partricular because I know that most mnen hate to talk about their health problems talk to your Doctor about having that test. To learn more about Colon cance visit www.Ontario.ca.

Death of a Homeless Person: It's Effects on Others

If you have not experience death in a homeless environment you have not seen the effects it has on that population. If you have then you know what I am talking about, especially to the individual that died close  friends or room mates

The death of any roommate in any residential environment takes a profound hardship on everyone living at the residence, those who knew the individual, the staff that knew or worked with that individual,or any other staff; that knew where they lived or slept during the night.

Having seen the effects and witnessing the death of such, and the amount of anger and disbelief that the residence showed, made it hard for them to really comprehend at first, by asking questions about the individual, how they died made it a little better for some, just knowing some of the facts was what most of them wanted to know, although some of t had to be kept  private.

The ones mostly affected were roommates, and closest friends, who had a very hard time coming to terms with the death of a friend. If you can imagine losing your roommate that you have just talked to that night, and the individual died while you were asleep, to find out that they died what would you think, is it going to have  a serious on you or not, if you say no, I think you would be lying to yourself.

Each individual is different  how they handle the death of someone or their grieve. It is how they choose to handle the death and the grief ,if it is difficult for them they would  need help, coming to terms with it. I cannot imagine how each individual feel because I have never walked in the shoe of  a homeless person, regardless to say it is something all of us in society have to deal with when death occurs; only they deal with it in different ways to main stream society.

It is not something that can be ignored, when it comes to the homeless, we all have a part to play in our community when death happens to anyone. The community would miss that individual and so would their friends, and all who knew the individual, my sympathy goes out to any individual, and the family remember that all individual's whether homeless of not do have families.

Caring For The Dying Person: What is Right

Mr Jones died a senseless death, if the family had a Living Will and Health care Proxy the doctors,and nurses would have known in advance what his wishes were, instead of asking his wife. She states he did not want to be resuscitated, all this led to a major propitiatory distress, although morphine was called for by the nurse the resident in charged refuse to administered

 Was it wrong that the doctor withheld the morphine, I would say no, reason in his judgement he taught by administering the medication it would cause more damage to the patient, compounded by the lack of a health care proxy, which inhibited him from doing what was right.

 After much discussion about the patient status it was determined that due to the lack of a health care proxy a no code status was handed down and the patient died. They were no intention to hurt the patient or the family, but the lack of a health care proxy tied the doctor, and hospital hands, this is why not only patients, but all people need to have an Advance Directive made out, along with a health care proxy which should be taken to the hospital or brought in after the patient is admitted,so that doctors and nurses are on the same page

As I said they were no bad intention of neglect, genuine decision had to be made so that the patient had the right treatment. The end results was a dying process of intense suffering, feeling of helplessness on the part of the family, and lack of candid communication between doctor and patient depriving the patient some how of the gift of their last days.

This scene is seen very often, and is played out not only in the United States but also in Canada people have sense that there is something wrong with the way patients are cared for. If we look at the whole health care system it is made up of doctors, nurses, family caregivers, patients and the bereaved, all being an intricate part of the system.

What the patient focuses on is living rather than dying, seeing this as hope he or she can think of their well being, and if they sense they cannot be cured wants the family involve in their care. On the other hand the family caregiver feels they are very much part of the illness, which affects them as much as the patient.

The caregiver feels that they are a burdened with the responsibility, isolated, do not get help, the need to balance multiple roles, time constraint and lack of sleep, caregivers have to know when to ask for help, although they asked to be placed in that role it can lead to exhaustion and burn out.

The bereaved is often seen as complicated, which at times it can be, no one can say that they are over grieving the death of a loved one this can take quite a while. It is not that you have to forget the person when the time comes for you to move on with your life, most important for the bereaved is friends, to be there to lend an ear, hug them when they cry and to laugh, just simple being there without an agenda is all that is required.

The professional caregiver acknowledges that they lack training in end of life care, resulting of feeling inadequate when dealing with dying patients, and their families which lead to emotional withdrawal, self destructive coping mechanisms, and denial telling one " thank God we don't have time to bond with families anymore" how sad.

Bonding all systems together is a process that can take a long time. it is important for doctors to remember although they are there to help heal the patient other needs are required, that of spiritual and social which require the help of clergy and other professionals.

When life care can adopt all that is deemed acceptable to all dying patients it would be a success, without all players on the team discussing the issues at hand the system would fail.

Personal Health

Simple Acts goes a long way in Comforting the Bereaved

The terminally ill patient has died, the funeral arrangements made, visitation , and burial rites are over, so you attended the funeral, because one of your co-worker died now what.? What do you say to the widow or widower, is it sorry about the lost of your wife, or husband he /she was a good person, shake hands and you leave never to see or hear from the widow or widower again.

The question about what to say when someone dies to the relatives has long been a problem for most of us, but as you attend funerals you will pick up on words people say, and do after the death of a friend. I cannot tell you what to say or do, but as a human being lending a hand to that individual or doing little things for them goes a long way.

Since the individual that died was either a co-worker or friend you may have heard them mentioned what they were planning to do around the house, and did not  finish the project, here is the opportunity for you to say to the widow, that I can finish that job for you since it is not completed.

By simple extending your services to the grieving person whether she hears you is one of the many acts that are comforting to the bereaved. The mere fact that you can take time out from your busy life to help someone that is grieving goes a long way, the task does not have to be big, little things like asking the person out for lunch, shopping,going for coffee, playing bridge, potlucks, baking a cake and popping by and making a phone call would be appreciated.

Most men do not know what to say in times like this, but doing yard work especially if you live next door to the bereaved driving to the grocery store, to the grave site for a visit, also helps the person, this would be a compassionate thing since the person is still not functioning and up to par.

One have to show patience with the grieving person, they would be down days where all he/she wants to do is talk, and cry this is healthy for the person, by letting them verbalized would help release stress, simple acts of kindness goes a long way, and would always be remembered by the bereaved person of the kind acts that was done for them while in their grieving stages of the loss of their loved one.

Personal Health: A Doctor's Duty When Death is Inevitable

It send chills up my spine, to think of what this doctor did to her patient after being involved every step of the way , for the seven years she had known the patient. The letter addressed to this particular doctor outlined how hurtful it was to the entire family, that the doctor needed a wake up call, to bring this to her attention and also her behavour towards her patient.

I hope with this in mind that the doctor sees this as an eye  opener, and have the decency to reply to the letter, and apologize to the family about her behavior, and why it took so long to respond to the patient calls and test results.

The abandonment of patients by doctors seems to be a distinctive pattern, which must be addressed by hospitals, nursing homes, and hospices. A patient care is foremost, and must be treated in the way that it would bring peace of mind to all sides of the spectrum.

When doctors abandoned patients it is due to failure, which shows that they cannot care for them, so they leave them hanging in the balance, while their patients search for answers as to why the doctor walked away from treating their illness.

Doctors need to be educated when it comes to End Of Life Care, if not we would see more doctors walking away from patients when they have failed tremendously as the letter that was written to this particular doctor.

Doctors need to tell patient the truth, and let them know that they had done all they can,but still need to be connected to their patients if and when the go into a hospice for care at the end of life doing little things for the patient and responding to their needs will and should improve relationships.

Once a relationship is broken by a doctor word spreads, and the doctor would feel isolated, and patient along with relatives would not want to be associated with that doctor at any given time. A good doctor relationship with a patient is a must, and when the patient respect your advice that respect will be returned.

Patient also need to let their doctor know when they fail it is not their fault it is due to the disease, and that they appreciate all that they have done in the past, but the patient needs assurance that the doctor would not abandon them when they are  needed.

Palliative Care At Home

Dying at Home: An Increasingly Important Trend

There ia s trend that is seen as more patients who are dying of cancer preferred dying at home with loved ones, but the families of those patients makes it hard on most palliative care givers because families would like them to do house chores instead of being the caregiver as outlined in their job description.

It is also imperative that Doctors, Hospitals, and  Caregivers work in conjunction with each other in order that the dying patient be made comfortable as they begin the progress through the last stage in their life. If this trend continues with the rise of terminal patients dying at home , more palliative caregivers would be needed, and less hospital beds would be available in the future.

 If doctors fail to provide care for their patients, especially home visits, then a rise in hospital beds would have to be increased.The lack of doctors refusing to be team players in palliative care would mean dying patients would have less access to medical treatment at home. Communication plays a significant role here, among doctors, patient, family members and palliative caregivers. Where I see the breakdown in communication is between the family, and palliative nurses where the roles are reversed. (palliative nurses are doing house work instead of the family)


Dying at home is an expectable right, since people are choosing to do so. If they are not enough palliative nurses to visit these patients the system would fail. The patient has choices to make together with the family, when the burden becomes too much to handle, and the decision yo move the dying patient to a hospital, hospice, or short term nursing home is the only choice they have.

Certain conditions must be reassess by the various health professionals that are involve with the dying patient, and family. Dying at home is very demanding, not only to the family, but the patient as well, the patient have to  be comfortable, and family members have to be relatively fit to perform the many duties, and chores that come along, with the job of caring for the dying at home.

When Death Occurs: What is left to be Done

Many of us today have not given too much thought of where our  bodies will be resting or how it is going to be disposed off, be it cremation, burial or entombed. If it is left up to our children to make that decision for us they may not really care how they disposed of the body. It is up to us to make our final arrangements with a reliable source fore disposal.

We may think that it is something that must not be thought about, but our life can be snuffed out in the blink of an eye, take a look at the cartoon, and you tell me those strips are funny. If it is then you should think very seriously about what advise the daughter is asking her parents.

It is all well and good to make fun of  someone else demise, but when it come to your own it is no laughing matter. We have to give the idea a lot of thought as to where, what and how we are going to have our bodies disposed.

In keeping with the times let us make not forget to plan for our last days on earth, do not wait for the last minute when there is no time left for you.  Death can be suddenly or prolong, so make the sacrifice to plan your final exit route today Death is not a laughing matter.                                                                                  

A Mother's Grief: The Death of a Young calf

If I had not witness it for myself they would be doubts in my mind, especially when there is a loss be it a human being or animal no matter where it took place especially if it is your pet who became  a mother  for the first time this loss took placed on a farm.

I had the opportunity of helping a good friend of mine,  I grew up with, my vacation was spent on his farm helping him do some chores  he needed to complete. on this particular sunny  morning as I entered the pasture one  of the cows ( Miserable) gave birth to a beautiful black and white (bull) calf  weighing around a hundred pounds.

I witnessed first hand the interaction between mother and son whenever she came to be milked both morning and evening with the rest of the herd, on the fifth day after giving birth on a rainy morning while doing some gardening one of the cow in the herd butt the young bull in the midsection which let out a loud moo, and within seconds slump to the ground lying helpless and not moving.

Within a couple of minutes the calf died. The mother (Miserable) came over where her son (the Calf) laid, started mooing loud and constantly  for a long time, sensing something was wrong stood at the side of her son licking him as if to say get up it's time for your milk.

This mooing went on for three days during the milking period  she (the mother cow) would walk over to the spot each time  and stand where her son died and mooed until it was time for her to join the rest of the herd and return to the pasture.

This type of behavior expressed by a mother cow for the loss of her calf showed me that animals do mourn whenever their young dies, regardless of what people might say, they do not believe animals grieve take it from me seeing it first hand they do.

The doubts that I had about animals mourning or grieving call it what you want for their young is in fact true, in the animal world  we may not see it ourselves but when we hear stories of people saying that their pets mourn when there is a loss of a young do not doubt them at all.

Is it Important to discuss End of Life Issues

The answer to the question when is it important to discuss end of life issues varies, amongst the population, and  different cultures. In Western civilization, we are hearing that more serious discussions are needed to take place within the family homes,more so in the present, than in the past. The reason is that the vast majority of people travel, more to their jobs, vacations, and simple driving for pleasure,which makes sense that discussions on the matter of end of life issues must  be discussed, more so now than ever.


There are no set times when to discuss the important issues of end of life. It was not customary for many families to talk about death, or talk about the issues of life illnesses, the making of living wills,these were not something many families were willing to discussed among relatives, and the power of attorney was not written down most of the time, parents knew what they would do to save their love one's in case of grave illness.


Today it  is not so, the individual have to make a decision before any illness is foreseen, and must have the power of attorney ready in case he /she cannot make decisions for themselves. In most cases it is best to say that the proper time to start a discussion  about end of life is when that individual leaves home to start a family, in this way they both know what each other wants in case they are incapacitated due to a serious accident or a terminal illness.

By doing so they would have every thing in place especially, if young children are involve, they would know who is going to take the children and care for them, if both parents dies, too many incidents take place when families go against one another as to who would raise a siblings children, if a will is not made out.

The head of the family need to raise, and discuss the end of life issues the word DNR, Power of Attorney (Health Care Proxy) and, living Will, are all legal papers, that takes care of an individual, who are not able to make decisions on their own if incapacitated.

Perhaps if the general public educate themselves more about what the advance directives entails, it would help individuals, or families make wise decisions to make an effort to have a Will and Health care proxy filled out making it easier for everyone,  that are involved with a love one, making life less complicated when discussing the End of Life Issues.

The whys of discussing this topic is not on the forefront of everyone mind, for those that have discussed the end of life issues with their love one's is great. The many that were unfortunate to, must   ask themselves why is it important to discusses these issues,  it may have been they were not educated , or have  been told that it was costly to have a Will, and Health proxy made out, the truth is it is not.

The best defence one can have is to discuss the issues, and take the necessary steps to make sure that it's what you and your family wants, knowing the truth about what is important puts you in a position of security, and knowing this makes it feel right that you have done the right thing. What matters now is that the family is at ease because of the discussion.

Since we know that death is inevitable, and that we will have to come to terms facing the death of a loved one, should we not prepare for what we know is certain, and have the understanding as to why it is important to discuss the end of life issues.


To be able to discuss this issue we need to come to the understanding, death is not an easy thing to discuss or a place to be, but neither is it horrible as we imagine, that is why it is very important to discuss the end of life issues, by preparing ourselves well in advance, we will be able to deal with issues that may arise, and be comfortable discussing them.

IS MOURNING NECESSARY? AND WHY?

Purpose:

It is necessary for all humans to mourn, from the time and day we were born we all had that instinct that if we cry as babies, we will get what we want. Instinct that is built in us are ways of asking for help, that we are hungry, or I want you to be close to me. Close relationship plays a major part of the mourning process not only amongst babies, but teens, adolescences and adults.

If we took a trip back in time when we were babies we would see the need we had as little boys or girls, while growing up, we cry when left alone, in a room while our mothers, or caregiver left the room for any long period, although we were able to see or hear the voice of that person.

It is not being in the same room that may have a lot to do with how much we had bond with that individual (Mother,Father) the close bonding may be strange at first, but it was the only way a baby knew he/she could keep mother or father at arms length, by getting the attention they deserved.

Children cry for many reasons, when the attachment between parents and child is great it makes it very difficult to leave the child with anyone. It is worst when that baby grows to be a toddler, and have to attend preschool, and mother may have to leave him/ her with someone the child is not familiar with.

The child mourns for his/her mother because the separation is great, that they may cry for a long period of time before settling down, and adapting to the familiar surroundings.Everyone mourns, which is necessary, not only for our health but society expects that of us, when loss has occurred. This is true especially those that we loved, and had a strong relationship with.

The facts are most of us that have a healthy attachment usually had a good relationship with their mother, while on the other hand, those with an unhealthy attachment may have had a bad relationship with their mother, that may not be true in all cases.


                                ATTACHMENT  THEORY (Bowlby 1979)


The term attachment is the strong emotional bond that develops between infants and caregiver, providing the infant(s) with emotional security. It can be said that it is an active, affectionate, reciprocal relationship specifically between two individuals, as distinguished from all other persons. What this says is the interaction between the two parties continues to be reinforced and strenghten while their bond.

In (1969) Bowlby applied the idea to the infant caregiver bond, which was inspired by Lorenz (1952) studies of imprinting in baby geese. He believed that the human baby, like the young of most animal species, are equipped with a set of built-in behaviors that help keep the parent nearby, increasing the chance that the infant will be protected from danger, and contact with the parent also ensures that the baby will be fed, but Bowlby was careful to the point out that feeding is not the basis for attachment.

Virtually any activity on a baby's part that leads to a response from the adult is an attachment behavior: sucking, crying,smiling, clinging, choking, hiccuping, moving the body, changing the rhythm of breathing, sneezing, burping, and ,looking into the mother's eyes. (Richards,1071: Robson, 1967: Bowlby, 1958)

According to Bowlby, (1969) the infant's relationship to the parent begins as a set of innate signals that call the adult to the baby's side. As time passes, a true affectionate bond develops, which is supported by new cognitive and emotional capacities as well as a history of consistent, sensitive, responsive care by the parent.
Out of this  experience, children form an enduring affectionate bond with their caregiver enabling them to use this attachment figure as a secure base across time and distance.

The inner representation of this parent child bond becomes an important part of their personality. It serves as an internal working model, or set of expectations about the availability of attachment figures, the likelihood of receiving support from them during times of stress, and the interaction with other figures. This image becomes the basis for all future close relationships during infancy, childhood, adolescence, and adult life.

Bowlby's (1969) attachment theory appears to be quite sound. Although it looks right our earliest relationship becomes an important part of our lives, and that the internal  working models guides us throughout any future relationships. However even though Bowlby's (1979) theory makes good sense, we have to evaluate the evidence that was used to support it.

Using the attachment theory to explain the question is Mourning necessary? And Why?: Let's look at the definition of mourning  ----- It is the process of adapting to the losses in our lives. I will go one step further and say ----  It is the losses of everything we may have acquire throughout our life, which have been loss, and which have been significant to us over time.

Since separation is a high cost to pay for any child the mere idea of a mother leaving a child for any length of time is a loss given that built in instinct. The child thinks, that his /her mother is gone and may not return, and begins to cry until  mother has returned.

If we talk about the loss of people we have loved, not those from whom we are emotional disengaged. I am talking about losses that gives us good cause to grieve, the weight of our grief could crush or drive those around us away, making all our earlier losses to resurface. How do we know that we are fending off mourning, and not just what is untouched by the loss? According to Bowlby, (1969) there are many clues; we may be tense and short-tempered, or had and formal, or cheerful, or withdrawn, or drawn excessively to abuse, alcohol or drugs.

We may have physical symptoms, trading in psychic for bodily pain, we may have insomnia and bad dreams, and may not be able to tolerate any discussion of loss. Though out life each one of us in some way form or fashion have to mourn. It may be for a pet, husband, wife, job or siblings, no matter what or how the loss came we have to mourn.

People form attachments through relationships,forming a strong bond, at times, when that relationship ends we find ourselves mourning, because of what was meant to each other. According to Bowlby (1969) he said that, the bereaved doesn't need consolation, condolences, encouragement, solace or support; he /she needs information.

In his book "Loss" Bowlby (1982) does not describe what therapy would be like, he explained that attachment behavior, separation behavior etc, can be useful, especially if adults talked about their own situation, and own mode of dealing with the inadequate help after the loss of someone they were closed to.

It is therapeutic, in a small way, knowing that "chronic mourning" or "disorganization" is part of nature and is mostly related to the behavior of primates in the wild, which relieves the bubble of isolation that the chronic griever may be stuck in.

The crucial point Bowlby make entails the  notion that the bereaved doesn't know his life has radically changed after his/her attachment figure is loss. He/she will attempt again and again to deal with everyday situation as if his/her world worked the same as usual, when in actual fact everything has changed, new and unknown.

That is why the mourning process develops healthfully when the bereaved painfully learns that his .her life is hinged round his/her attachment figure, and that what made sense with him/ her before doesn't make sense any more.

                                    
                                         Three phases of  Separation
                    
      Protest :  Related to separation           
     
      Despair:  Related to Grief and mourning

      Detachment or Denial :  related to defense / isolation


                                          Task of Mourning

       Denial / isolation / shock;         Anger;     Depression;   Bargaining ;   Acceptance

     
Mourning is necessary if we are too remain healthy, if and when we have any loss, and we do not mourn or grieve it can have  mental, and physical implication in our lives, which can be detrimental.  With these ailments bad thoughts can manifest itself through dreams, which may or may not lead us to hurt our self.
      

Jewish Culture : Views on Death, Funeral Rites, and Burial

                                                     Contents


1.   The Purpose of this paper
      Why it is written
      What is its purpose?

2.   Jewish Law ( Halakha)
      The facts about Burial
      Why is this done?

3.    Visiting the Sick (Bikur Cholim)
      Who can visit?
      The purpose of visiting the sick
      Is Confession mandatory?

4.    Care for the Dying
      What care is given?
      Where is care given
      Who cares for the dying?

5.    After Death
       Who takes care of the body?
       What happens to the body?
       How is it transported?

6.    Preparing the body for Burial
       Who prepares the body?
       How is the body prepared for burial?
       How is the body handled?
       How is the body washed?
       What is the coffin made of?

7.    Funeral Service
       Where is the service held?
       Who conducts the service?
       Who says the Kaddish?
       Is there a eulogy?
       What is the eulogy purpose?
       Why is the garment rendered?
       Why are flowers and music prohibited?

8.    At the Cemetery
       What takes place?
       Who participate burying the Coffin?
       What happens after the coffin is covered?

9.    At the Grave site
       What happens before everyone leaves the Cemetery?
       Is it customary to wash hands after partaking in the Burial?

10.  Sitting Shivah (Seven days of Mourning)
       What is the purpose of  Shivah?
       When does Shivah begin?
       What happens in the home that is sitting Shivah?

11.  The first thirty days (Shoshim)
       Who is expected to participate?
       What happens during this period?
       What is observed during the thirty days period?


The purpose of this Article

The purpose of my article about the Jewish Culture views on Death, Funeral Rites, Rituals and Burial is to familiarized myself,and all who have the chance to read the article, to try and have an understanding, what the Jews have taught been taught throughout their lives, and to gain some insight into what their faith, and belief systems are. in doing so it will also give other readers and myself a clear indication, about their cultural heritage. By writing this paper my hope is that I will have a better understanding of their funeral rites, rituals, and the way that the Jewish Community have close communal ties with their congregation.

I hope by writing this article I have gained the knowledge, and respect of the Jewish Community, special thanks to the Rabbis that gave me some of their insights on their customs. My purpose therefore is to overcome what my thinking was about the Jewish faith, and accept their ways, and customs, and in doing so I can say that I have opened my mind to some of the ways about their rituals, and see how the Jewish congregation have  strong ties with each other.


Jewish Law (Halakha)

It is often said that the Jewish people buried their dead within twenty-four hours after a death have occur. This is a law which was handed down to them since Biblical times, with Moses, and is  still  done at the present. The Jewish law states, that the body must return to the ground from whence it came, without disturbing any organs, within the body with the exception of an autopsy, if ordered by a medical Doctor, or the family,and the occasional organ donation. 

The Jewish law prohibits cremation and also embalming, within the perimeter of this law, exception are made for autopsy and organ donation, it is in keeping with the requirements of fulfilling the law that the body be buried intact the way he/she was born. The law also states, that the body be buried in a traditional grave in the ground so that the body return to the ground. The burial of a body in vaults, above ground mausoleum, and crypt are forbidden.

Why is this Done?

The Jewish law mandates that funerals takes place within this twenty-four hours period after death, it is concerned with the K'vod Ha-met, leaving the body unburied for any length of time is considered disrespectful. What is also mandated by Jewish law is that the body be not cremated, but returned to the earth, its intention is also to show respect for the dead.


Visiting the Sick ( Bikur Cholim)

The only people to visit the sick is the immediate family, however the Rabbi laid down strict rules governing when visits should take place. The Jews shows remarkable respect to the sick along with attentiveness. The failure to visit the sick is seen as the actually shedding of blood. One of the primary functions of visiting the sick is to make them as comfortable as possible, visiting the sick is prohibited during the early morning hours or late afternoon hours, since the attendants are busy with the patient, and visits should not be long.

The Jews look at visiting the sick as a Mitzvah, and carries great weight in Jewish tradition, because  it is a Mitzvah  the observation ensures them a place in the world to come. According to the Talmud visits are encourage especially the seriously ill, it states that " he who visits the sick eliminates one-sixtieth of the ill person pain." It is suggested that during the first three days of a serious illness are the most critical, and that immediate family members should pay a visit at that time.


Confession (Viddui)

The law does not require that confession (Viddui) be recited, but that it is encouraged, before the person dies, the Sherma must be recited. It is important for the sick if he or she is dying to recite the confession (Viddui) if they have the mental capacity to do so.


Care for the Dying

 Care for the dying takes place at the Jewish Hospice, medical services are  not duplicated as non-sectarian hospices, instead it provides spiritual, and communal support by sending Rabbis and trained lay people to visit individuals, and family that need the service.  Care is given either at home in a hospital or hospice, and particular attention be paid to the sick. The Jewish law have in place a guideline that must be followed as the life of the sick begins to depart, Talmud teaching states that the Shechinah ( Devine Presence) stands at the head of the Goses ( Dead Person)

The individual person must be treated with respect, as thou they were still alive, and not as an object or to be avoided, and at no time that the dying person is to be left alone, a guard, (Shomer) must remain with the body from the moment of death until the funeral and burial. All visitors must be respectful, and that any idle conversation, and eating must not be done. You are permitted to leave the room only when they have to or it's necessary to do so.


After Death

When death is confirmed the eyes are closed, along with the mouth of the deceased. The arms and legs are extended,  and the lower jaw is bound. The body is then placed on the floor with the feet facing the door. The body is then covered with a sheet, and a lighted candle is placed near the head, from the moment of death, each member of the immediate family is called an Onen  (One who is distressed) this phrase of mourning, known as the Aninut period, ends when the body is buried, at which time all of the regular laws of mourning in Avelut  are in effect.

The family calls the Rabbi or the synagogue  functionaries, the synagogue takes over, and see too many of the details. The funeral parlor is contacted so that arraignment of the body can be transferred to the premises, and to set the time of the funeral, burial takes place the same day or the next.


Preparing the body for Burial (Taharah)

Volunteers known as the  Chevra Kaddisha  or ( The Holy Society) care for the dead which is an organization found in many community synagogues throughout the world. This is one of the most important elements of the proper Jewish burial known as the Tahara. 


A proper Tahara includes cleaning, ritually washing, and dressing the deceased body. The Sacred Burial Society consists of three or four persons that perform the pre-burial  purification of the body. (Taharah)  The body is washed thoroughly with warm water from head to foot, including all orifices, turning it from side to side while washing, which is a sign of respect, never having the body face down. The finger nails are cleaned, hair brushed then the body is dressed in Tachrichim  ( a single white linen or cotton shroud) simple  not to distinguish between rich or poor, prayers are recited, during the preparation of the body for burial, men attend to me , and women attend to women.

According to Jewish traditions it requires that all deceased be buried in a plain modest casket (Aron) the casket must be made of biodegradable materials that will disintegrate in the ground,  which would allow the body to return to the earth as quickly as possible. It is a Torah commandment that the body return to the earth, upon passing, as it is written "unto dust shall you return" (Genesis 3:19).


Metal casket is never used, and nails are not used in wooden caskets instead wooden pegs are used to seal the casket. The interior of the casket is plain with no ornaments, before the deceased is finally sealed in the casket the  Chevra Kaddisha  places earth from the land of Israel in the casket, if he or she is buried outside of the country, holes are sometimes found at the bottom of the casket, bringing the body in direct contact with the soil, which hasten the decomposition process.


Funeral Service

After the body have been purified by the Chevra Kaddisha,  the funeral plans can proceed. The family and friends along with the Jewish community gather for the service either at the funeral home, synagogue or the cemetery, depending on the family wishes, and present at the service, and burial at least a Minyan (Quorum of ten Jews required for public prayer) usually adult males.

The casket is usually there before the deceased family arrive at the service wherever it is held, if in a synagogue prior to the funeral the family meets with the Rabbi or Cantor in his study, or special room that is arrange for this occasion. It is a private time for the mourners to gather any thoughts, and for the Rabbi to review the order of the service. Meeting with the Rabbi before the funeral is common, a time and place for K'riah. ( The rendering of garments)

At this point the casket is staked, and is not opened for viewing; there are no flowers or music present at the funeral, which in the mind of the Jews are association with festivals and joyous occasions, while this is an occasion of solemnity, the Rabbi or cantor begins by reciting Psalms.

There is a eulogy (Hesped) but it is not said by the family that is mourning, instead it is said by the Rabbi or Cantor who meets with the family to get a sense of who the deceased was. The Jewish eulogies are honest, and Jewish law prohibits any exaggeration and invention, moving tributes comes from people who knew the deceased well, there are real stories that may evoke genuine emotions, phrases and jokes used by the departed that was their favourite.

The purpose of the eulogy is to "lament the dead in words that break the heart" not seen at the Jewish funeral service are flowers, this is seen as a pagan custom, because this is a joyous celebration amounts friends, and associates of the deceased, they are encourage to contribute to a Tzedakah fund, important to the deceased or family if they wish to express condolence wishes.

The rendering of garments is a physical enactment of feeling that the dead has shattered the world apart, the ripping of garment or fabric is the sound of a breaking heart.  The sound of music is also seen as a pagan custom, the same as flowers; a somewhat distraction from grief, and a non-Jewish tradition; if required the Rabbi or Cantor may lead the congregation in singing a sombre ( Niggum) wordless melody or Psalm 23.


At the Cemetery

After the service the coffin or casket is carried out to the hearst by the pallbearers, it is then driven to the cemetery followed by the family, congregation and guests. The coffin is then carried to the grave site by the pallbearers following the same order as when it left the synagogue, followed by the Rabbi, and the immediate family, as a symbolic gesture saying the last farewell the procession may move slowly, making ritual stops on the way to the grave site.

The coffin is placed on the brier above the ground, in some cases the graveside liturgy will include a few Psalms, Biblical readings, and short prayers, just as the eulogy is seen as the liturgical heart of the funeral service, Kaddish is the emotional peak of the graveside, saying this prayer (Aninut) ends and the mourning period begins. After the coffin is placed in the ground the family, and mourners throw a shovel of dirt on the coffin. The most striking part of the Jewish funeral is filling the grave, it is painful yet it is seen as the most healing. First to leave the grave site are the deceased children,spouse, parent and siblings passing the rest of the community which forms into two rows; a gauntlet of loving compassionate faces.


At the Gravesite

After the body has been interred it is customary that the hands be washed as a symbolic act of purification, after coming in contact with the dead. In Judaism, immersion in water is seen as a change of personal status. After the funeral the mourners stop being in Onem and become an Avel. The washing of hands symbolizes the separation between the work of burying the dead and the work of grieving.


Sitting Shivah ( Seven days of Mourning)

The purpose of Shiva is to sit with their grief, this is done while sitting on a low stool, while remembering, weeping, dreaming, telling stories and sharing memories. Although every Shivah is different there are times bitterness of the loss is tempted by the smoothness of memory; when death follows a long and active life, and sometimes Shiva feels like a razor edge, whatever the details, the weight of grief can be overwhelming. Shivah therefore is a practical way of mourning according to Jewish law, it gives the mourning individuals all the time in the world within the seven days period to deal with their loss before returning to the outside world.

Shivah starts when the mourners return home from the funeral. The ritual of mourners sitting are:

 Shoes; are removed; leather shoes not worn - wearing cloth slippers, sock or even barefoot are signs of being humbled by the loss.

Water; A basin of warm water, and a towel are left outside the door for people to wash their hands.

Light; It is customary to light a large Shivah candle, which is also called a Ner daluk (burning light) which burns for seven days.

Food; Serving a meal to mourners upon returning from the cemetery is a gracious act of condolence, although the bereaved may not be interested in eating.

Jewish law requires that the immediate family,and the seven closes relatives are obligated to begin this period. The immediate family spends the week mourning which includes adults, children, parents, siblings and spouse only. The mourners are forbidden to leave the house or do any cooking or cleaning, most of the food preparing is done by friends or ordered in from a Jewish caterer, Kaddish is said three  times a day in the presence of a Minyan.

Shivah supplies communal support, morning, and evening, day in day out, but the presence of family members, friends, and neighbours make the burden more bearable. Therefore Shivah works best when mourners understand the how and why of the ritual, and when the bereaved are members of a community that knows how to care for them. Shiva can be shorten if the Shivah falls within the Jewish holidays.


 The First Thirty Days (Shloshim)

Jewish law obligates official mourner's children. spouses. siblings. and parents to continue with some of the observances of Shivah for thirty days after a funeral. During this peeriod mourners return to work and to see about family responsibilities, traditionally maintaining a fence which permits grieving to continue. This period of grief, concerns mostly with the public obligation, protecting the mourners from rushing or being rushed through their sorrow. Distractions, and everyday pleasures are limited, the listening of music or attending concerts, plays, movies or sport events are some of the things that is traditionally not done by the bereaved.

Shloshim is not a period of self-deprivation, but mourners do resume many private pleasures, like reading and studying, visiting friends, exercising and playing with children. What is required is that the bereaved get out of the house to attend services, and to say the Kaddish.



 This period of the first thirty days of Shloshim may be ended by the observance of Rosh Hashanah, Yorm Kippur, Sukkot, Passover, and Skavout this mourning observance during the holidays are best discussed with a Rabbi. During this period mourners wear a ribbon or (K'riah) or a torn garment for a full month, although tradition allows it to be removed at the end of Shivah.

    What the ribbon or (K'riah) indicates is a silent announcement of the mourners emotional state during the first month, signalling to colleagues, friends, and acquaintances that the one who is wearing the ribbon is still fragile, and is not ready to face the work day world. The ribbon also sends a signal to other people who did not know of the loss to offer condolences, and those who have experience bereavement themselves, to empathize, this period in time, widows and  widowers night can feel empty, new symptoms related to grief may surface, leading to sleep disturbances, which are very common.


                                          The Final Confession (Viddui)                      

                        I acknowledge before the source of all
                        That life and death are not in my hands
                        Just as I did not choose to be born,
                        So I do not choose to die.

                        May it come to pass that I may be healed
                        But if death is my fate,
                        Then I accept it with dignity
                        And the loving calm
                        Of one who knows the way of all things.

                        May my death be honourable,
                        And may my life ba a healing memory
                        For those who know me.

                       May loved ones think well of me
                       And may my memory bring them joy
                       From all those I may have hurt,
                       I ask forgiveness.

                       Upon all who have hurt me,
                       I bestow forgiveness,
                       As a wave returns to the ocean
                       So I return to the source from which I came.

                       Shema Yisrael Adonai  Elohenu Adonai Echad
                       Hear, O Israel that which we call God is oneness itself.

                       Blessed is the way of God
                       The way of life and death,
                       Of coming and going,
                       Of meeting and loving,
                       Now and forever.

                       As I Blessed with the one,
                       So I am Blessed with the other.
                       Shalom Shalom Shalom


                                                   The Mourners Kaddish

                         Exalted and hallowed be God's greatness
                         In the world of your creation
                         May your will be fulfilled
                         And your sovereignty  revealed
                         And the life of the whole house of Israel speedily and soon
                         And say Amen.

                        May you be Blessed forever,
                        Even to all eternity
                        May you, most Holy One, be Blessed,
                        Praised and honoured, extolled and glorified,
                        Adored and exalted above all else.
                       
                        Blessed are you
                        Beyond all Blessings and hymns, praise and consolations
                        In the days of our lifetime,
                        And say Amen.

                        May peace abundant descend from Heaven
                        With life for us and for all Israel,
                         And say Amen

                        May God, who makes peace on high,
                        Bring peace to all and to all Israel,
                        And say Amen.


                                      Mourner's Kaddish for every Day

                        Build me up of memory
                        Loving and angry, tender and honest
                        Let my loss build me a heart of wisdom,
                        Compassion for the world's many losses
                        Each hour is mortal
                        And each hour is eternal
                        And each hour is our testament
                        May i create worthy memories
                        All the days of my life

The Importance of Preparing For End of Life

I first met Mary twelve (12 ) years ago, through one of her daughters, she was eighty (80) years of age with three daughters and two sons. Mary was short, and a little plump, full of life, and active in the community where she lived. The years that I visited a relationship developed, but really, got to know her with each visit. A couple years later, her husband made the decision to move, from an apartment, to a Nursing Home, where their every needs could be met, but still have the freedom to come and go as they pleased, soon after the move her husband died, and one of her daughters also. Although it was painful for her she had a very good support system in place. Within the time of her husband's death and moving they both made out a Living Will, and all the necessary legal paper work.

The Diagnosis:

Mary was diagnose a year later after her husband's death, with bone Cancer, and yes it was a blow to her, and could not imagine how she got Cancer, especially bone Cancer, but talking to her, she said that it ran on her side of the family, because two of her sisters, died from cancer.

The Treatment:

 Mary had to undergo radiation treatment twice a week  for twelve weeks, and it showed every time she finished a treatment, which left her weak at times, after the treatment she regular checkups to make sure the cancer was not spreading too fast, after two years, the Doctor's were satisfied that the cancer, had reduced in sized.

After the radiation treatments, Mary had regular check ups, at the Cancer Hospital, to see if the cancer was spreading, but found out that it was not, and was given the okay to continue doing what ever she wanted to do, with help from medication it helped with keeping the cancer at bay. Mary knew that the cancer could return at anytime, but continues to live her life the way she  had always done. Two and a half years ago the cancer returned, and progressed to the point, that Mary did not want to undergo any radiation treatment knowing how it had affected her energy level.

 Side Effects:


Mary showed signs of that of a sick person, lacking energy,and not wanting to do anything or go anywhere. She was contented to satay in her room, watch TV, read and knit, she said that she feels okay, but the signs on her face said otherwise, all that was due to the heavy medications she has to take to help her through the day.

My  Observation:

 I visited Mary about twice a week, and on one of my visits with her daughter, noticed she was looking rather pale and was not up to par, and mentioned it to her daughter whom I went with that day, she immediately made an appointment for her to see the doctor. Mary was told that  the cancer had returned and progressed faster than ever, and gave her about four months to live.


Advance Directives:

The progression of the cancer gave Mary a scare, and had asked her eldest daughter to get her Living Will updated, and make any changes that were needed, and also to be the Power of Attorney. The other form that was also written out was  the Values History Form, which addresses all that was needed in case of any serious implications knowing that she had only a few months to live. 

Technology Equipment:

 The look on Mary's face said it all it showed signs of frailty, and her breathing was helped with the aid of pure oxygen, which helped in a way, but was uncomfortable having by the air hose in her nostrils. Mary also had the use of an air mattress, which helped her to feel comfortable while laying on her back to ease any pains.


Medical and Caregivers:

Although Mary was given medication for her pain, she also had a good team of Caregivers that saw to her every needs, twenty- four seven (24/7 ) she had the best care that could have been provided, and was well 
looked after, she was waited on, and was granted anything that she wanted to eat or drink at anytime day or night.

Family Involvement:

During the last couple weeks before Mary's death, she had round the clock attention by her family, everyone doing their part to be with her. I had the chance to spend twelve hours with her, tending to her every needs,and doing what ever I could to make her as comfortable as possible. They were always family around her, and music playing softly in listening range. As the time drew near the Priest from her Church was called, to anoint her with Holy Oil, which is part of the last rites for many Christians that were dying. The family made the decision that the oxygen should be unplugged, and let her breathe on her own which was one of the stipulations written in her Values History.

Death Song:

As Mary lay on the  bed of her last days, the death song were being played constantly, the gasping for air, wheezing of her lungs, the asking for something to drink, and that her lips be kept moist, what was most discomforting for her was the constant itching she had from laying on her back which had to be rubbed with cream to relieve some of the itching. It was so sad to see the person that was so active, and full of life lying on her bed awaiting death, the skeletal frame of Mary, with her eyes sunken into her sockets was seen as a fragile individual awaiting a death sentence. Mary died two days after, during the night in her sleep a good death knowing that her family was with her when she died.

Preparation:

Lets take a look at Mary's life and the planning  she did on or before her death. We know that she and her husband, made a Living Will, and that Mary had amended parts of it to reflect what she wanted happen after her death. Although they both planned ahead preparing for each other, and did not leave any burden on their children, which was well though of.

The consensus is that the general public on the whole, thinks that an Advance Directive is not required at the very moment. The thought then, is nothing is going to happen to me, for the most part is the way people think, until something major happens, like an accident where it is very serious, and they are facing the End of Life.

If we think, about what we know about illness, death and what there is to do, why? are so many of us fail to plan for the End of Life, is it that we need to be more educated on the subject, or are we just acting ignorant to the fact that we just don't care about those things right now. By planning for what may happen in our lives, it makes sense, to have in place Legal Documents, that our children knows about, and what our wishes are in case there is an emergency, when we cannot communicate or make decisions for ourselves.

 These legal documents include, a Living Will and Health Care Proxy also known as a ( Durable Power of Attorney.) Since wishes are communicated through the Advance Directive we should also have Values History Instructions which is optional. What is included in an Advance Directive?

Directions that lets the Medical Team knows the treatment that the patient want  done, and do not want in case of extending or shortening life in any terminal conditions.

That there is a person designated to make decisions for the person, if they are hurt in an accident or incapable of doing so.

The kind of comfort care he/she decided, such as reducing pain,and suffering.

Preference based on his/her religion.

Mary made sure that all Legal Forms were signed, and all that was needed to take care of the burden that was going to be left for the children to sort out. They can now look forward of taking care of her wishes,and desires that were on the Advance Directive.

Mary's story was simple, with all the Legal and Financial Documents signed, and other important papers made available to her eldest daughter, she could rest, and be assured that her wishes for everyone and herself would be carried out. We know that death is certain, but we do not know the time, place or how it is going to happen, when the river of life runs smoothly, and suddenly there is a stone (illness) that disrupts everything it is definitely not the time to start thinking about an Advance Directive.

The Advance Directives answered all of what Mary wanted, and together with the Power of Attorney every thing possible was done to make her very comfortable. Mary I must say died well, and had a good death, with her family gathered in her room, and had a Priest anointed her with Holy Oil, which is the last rites , for a dying person of Christian faith.

What I should point out here was the Caregivers understanding of the family concerns, and they catered to Mary and the family every needs, everyone that worked with Mary, showed such patience when she did not want the oxygen hose in her nostrils, which was removed no questions asked, because the answer to that question was already filled out in her Values History Instructions.

Managing pain was foremost on the mind of  children at this stage, and pain management was helped by medication. Mary's smile could be seen on her skeletal frame as her loved one told her how much she would be missed, and was loved. She left this world knowing she was loved, missed and her children, grand and great grand children would be taken care of, as stipulated in her will. I will say this, that it is very important to have all Advance  Directives made out ahead of time, and signed just in case some misfortune happens.

The Teaching of The Catholic Church on Death and Dying

Belief and Faith:
The Catholic Church  see it's teaching as a strong connection to the faith, and beliefs of its parishioners. The teaching on faith is so strong that it's many believers will agree, that faith, and belief plays a very important role in their every day lives.

This is due to the teaching, and the vast number of parishioners that have been educated in the Catholic schools, taught by Nuns, and Priests of which I was part of the teaching. The Church defines faith as " The act of the intellect asserting to a divine truth owing to the movement of the will, which is itself moved by the grace of God."

My own definition of faith is the understanding, of my circumstance given to anyone that would make a wise decision, about what needs to be done, and make it with a clear conscience with out doubts, to things that are right. Without belief there is no faith, if we do not believe then we have no faith, this is why Catholics profess their faith by saying "I believe" or "We believe" as |Catholics what do we believe in.? We believe that God became man born of the Virgin Mary, died, and was raised from the dead.

Since this is a mystery, we have to believe by expressing our faith with prayer, which sends a strong message to our faith, and beliefs, along with prayer, sacrifices, rituals, and meditation are all forms of our religious experiences.

Euthanasia:

The Catholic Church views euthanasia as wrong, any act of killing that deprives any individual the right to die. The Church social teaching declares the right of any individual or person, not to use unusual means that would prolong life, and at the same time rejects active intentional taking the life of a human being. It is seen as any procedure or  failure that by its very nature, or wilful purpose which causes death and having the authority of putting an end to the suffering of any person(s).

Every human being have the right to live  in a manner that is provided, since life is viewed as sacred, and is given by God. He alone has the right to pronounce death. It is written in the Bible " No man knows the time, place or where he will die" God alone knows that answer.

The Church expresses strong disapproval of euthanasia as morally wrong, it has always believed, and taught the complete and unchanging value, of the Commandment "Thou shall not kill." The Catholic Church has always said to its followers that nothing, and no one can in any way tolerate the killing of an innocent human being, whether be a fetus or and embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying.

While the Church does condone the use of euthanasia in some countries it strongly advises its Priest, and Parishioners to  pray for those that are carrying out these deeds, that it sees as mercy killings. What the Church is not happy about is when Doctors play God, and take away the life of a human, it is a doctors Hippocratic Oath to save lives instead of killing one. The Church regards life to be a gift from God, which also is true , as we all know, is unavoidable. We must all be able , not to hasten death, but to accept it with openness, and a conscious, responsibility, and full dignity for death.

Suicide:

As Catholics we have been taught that God has given life to us, and that we are responsible for our lives, suicide therefore contradicts this natural tendency of the human being to preserve, and commit his life, this act goes against the love of our living God. By committing suicide with the intention of showing an example, to a young person takes on the implications of a grave scandal, any and all who are being compelled to go through is committing suicide does so in contrary to the moral law.

What is seen is the persons irresponsibility for not taking ownership for his or her responsibilities, which is in fact the lack of dealing with problems which he or she cannot face, this is terms give us a sense of great fear or hardship, suffering  or torture which can lead to the brink of carrying out this act. We know in years past, that the Catholic Church did not have funeral service for anyone that had committed suicide, or even allowed the burial in a Catholic cemetery. The Church strongly opposes suicide, especially assisted by a physician.

Feeding:

The Church see nutrition, and hydration as a grave matter when it comes to the dying patient, it should be a time when every thing should be done to help the patient. The failure to provide a patient with nutrition or hydration in speeding up the patients death is deemed an act of euthanasia. In cases where both nutrition and hydration does not help the patient, and may cause distress, it is best to let the patient die, say but this do happen to many.

The Church is clear that the guidelines of its teaching be followed without questions.

1. Nutrition and hydration, whether given artificially or orally are considered ordinary care.

2. Catholics are morally obliged to provide ordinary care.

3. Nutrition and hydration can never be withheld unless the person's death  
   is imminent and the use of such would be either harmful or of no benefit.

4. The wilful withholding of nutrition or hydration in order to bring about
     a patients death is Euthanasia.

To re-emphasize the fact, food and water are necessities of human life, the Church is clear on its teaching.  No one has the right to hasten the death of another human being terminal or not this action violate what we believe is the teaching of Christians life is sacred a gift from God. The Church is clear on what it sees as ordinary or extraordinary care. What all of us should expect when we are dying is ordinary care, from our physicians or loved ones, ands what is more natural that feeding one who is hungry.?

Pain Control:

We all at some point manage pain by popping a pill for headache, muscle pain, back pain or what other pain arises, but when the pain is severe after major medical surgery, the pills that we popped for minor pains does not work.  The Church recognises the need for proper pain management, which must be ensured in the clinical setting. From a moral standpoint, a physician has the responsibility to administer medication that control or ease pain even if it may hasten death.

However in saying this, the effect of pain treatment guarantee that no one will suffer a painful death. Health care providers have to make an effort, to ensure that the medicine that is available eliminates or control the pain that is being provided to the patient.The Church knows that although death is imminent, the ordinary care owed to a sick patient cannot be interrupted. The use of painkillers to ease suffering of a dying, can be morally in line with human dignity if death is willed as ends to a means, but is seen as inevitable.

Morality:

The Church definition of morality is that it is rooted in natural law, which is defined by social norms, the values of dignity, fairness, honesty, and integrity are universal in the human experience. Catholic morality is particular tradition, to understand how this may live out, Catholic morality seek to interpret the Christian experience through the scriptures, and tradition ( teaching of Church fathers, conciliar: magisterium, etc) it incorporates the duties towards its members of the Roman Catholic Church community. ( teaching Catholics morals )  What may be considered moral to you or me may not be moral to others, because of the teaching of the Catholic religion, since morality varies from one culture to another, the teaching of moral values may not be taught in communities, thus the lack of morality may exist.

Apart from religion the observance of the moral law  is impossible.  It follows as a necessary consequence from Church teaching, as to the nature of morality. The Church admits that the moral law is knowable to reason: being the regulation of our free actions, whereby morality consists, is simple their right ordering with view to the perfecting of our rational nature.

Ethics:

 Since morality is antecedent to ethics, it denoted those concrete activities of which ethics is the science. It may be defined as human conduct in so far as it is free, subordinated to the ideal of what is right, and uplifting. Ethics directs the activities of the will, that which must be good. hence ethics is seen as the science of moral rectitude of human acts in accordance with the first principle of natural reason.

Ethics is practical, and directive:  for it orders, the activity of the will, moreover ethics not only directs a man how to act, if he wishes to be normally good, but sets before him the obligation to do good and avoid evil. Since we know what is ethical, is it ethical for doctor's to withhold the truth from a dying patient? in most part the answer is yes, with respect to the patient they have the right to know what the diagnosis of their illness is, what the treatment would be to sustain life.

It is not right for the patient to know the truth, so that if the outcome of the diagnosis is fatal, they can get all the necessary papers in order, and if death is imminent. If the doctors withhold this information from the patient, and the patient dies, then the doctor must be held accountable, and ethical responsible for failure of telling the truth.

Dying:
At some point in our lives, whether it's sooner or later, we are all going to die, but it does not have to be painful. The Church offers the sick, and terminal patients the comforting grace of anointing of the sick, and Eucharist, which is looked upon as the Sacrament of passing over from death to life, from this world to the next.

The Church shows compassion to the dying, as Jesus showed compassion to his people while on earth. As catholics we look forward to meeting Jesus face to face when we die, because Catholics believe, that there is a heaven, and Hell and when we die, if we were good on earth we will see Jesus in heaven.

As a person is dying the warmth touch of human hands is the form of being accompanied through the final mystery of life. Since none of us wants ti die deserted, and isolated from human hands that gives us a sense of peace as we leave this world, The Church also teaches us that confession is good for the soul, and stresses that the sick confess his or her sins to the priest for forgiveness before dying, in this way what ever is made known on earth is also made in heaven, and by doing so our sins would be forgiven.

Death:

We know that death is the end of life here on earth, but as catholics we believe that after death we are joined in heaven with our Heavenly father. Since our faith shapes our attitude towards death, the Church teaches that to respect life is to respect death. The Church vision of death is expressed in the funeral liturgy, when we pray " Lord for your faithful people life is changed not ended." When the body of our earthly dwelling lies in death we gain an everlasting dwelling place in heaven as Catholics.

As mentioned before Catholics believe in heaven and hell, but also in purgatory, this is a place for those who have died in a  " state of grace "   "that is they have committed a venial sin "  or forgivable sins, may not go straight to heaven. Therefore death is the end of our earthly life, and our lives are measured by time, in the course of which we change, grow old, and with all living beings on earth, death seems like the normal end of life. That aspect of death lends urgency to our lives, remembering our mortality helps us realize that we have only a limited time in which to bring our lives to fulfillment.

Funerals  (Rituals):

A Catholic funeral is different from the other Christian funerals, and can be with or without Mass considering the circumstances. There is a Virgil  for the deceased, which is a service of prayers or songs either at the home of the deceased or in Church, before the day of the funeral by friends or relatives, but in most cases that I know off  ( some Caribbean Islands ) it takes place after the burial.

Introduction To Rites:

At the funeral service the Priest greets the congregation and say " the grace of our Lord Jesus Christ, and the fellowship of the Holy Spirit be with you all " leading the coffin down the aisle Holy water is sprinkled, and there is an opening song and prayer. The liturgy of the word begins with a sermon passage from the Holy Bible, which is read out, as well as a Homily, and a Psalm ( Psalm 23: The Lord is My Shepard ) following the  liturgy of the word is the Eucharist; there is a preparation of gifts, a Eucharist prayer is said, and Holy Communion is received.

The Mass ends, after the final commendation prayers are said, and the coffin is taken out of the church, and is proceed to the graveside or crematorium, here the final resting place the rite of committal or the final prayers are said, before the burial ( lowering of the coffin into the grave or cremation ) this closes the curtain of the deceased. In some cases family return to the deceased home, and say prayers again hoping that the deceased finds his or her way home to God.

The Catholic Church defines what a funeral is as follows:
The Christian funeral is a liturgical celebration of the Church. The ministry of the Church in this instance aids at expressing efficacious communion with the deceased, the participation in the communion of community gathered for the funeral, and at the proclamation of eternal life to the community.