Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying” Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life 1 5. The workshop participant will be able to identify examples of how Native cultures perceive death and dying. Module Objective #5 “The mystery of all endings is found in the birth of new beginnings. There is no ending to the journey of the four directions. The human capacity to develop is infinite. The medicine wheel turns forever.” Phil Lane, Jr. p. 71
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Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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5. The workshop participant will be able to identify examples of how Native cultures perceive death and dying.
Module Objective #5
“The mystery of all endings is found in the birth of new beginnings. There is no ending to the journey of the four directions. The human capacity to develop is infinite. The medicine wheel turns forever.” Phil Lane, Jr. p. 71
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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5. The workshop participant will be able to identify examples of how Native cultures perceive death and dying.
Module Objective #5
NOTE: Although the medicine wheel is not used by all tribes, its concept is familiar to most tribes and is used within this module.
Palliative care - to provide comfort and relief without curing
Which of the following is TRUE?
1. Most Natives die in their homes.
2. Most Natives have plenty of pain control medication when they die.
3. Preparation for dying ceremonies primarily focus on physical issues.
4. Traditional Indian funerals are illegal in most states.
5. Don’t want to answer
19%15%
4%
58%
4%
1 2 3 4 5
Which of the following is TRUE?
1. Neither the Medicine Wheel nor the Circle of Life include “death”
2. All cultures have death ceremonies that are very serious and somber
3. Almost all Native tribal Nations use the same death ceremony
4. Preparing the dead body for burial or disposal is usually regarded as a high honor by most tribes
5. Don’t want to answer
4% 0%
85%
12%
0%
1 2 3 4 5
Which of the following is NOT TRUE about how many tribal Nations
describe death or dying?
1. “Walk on”2. “Cross the river” 3. “Down Under”4. “Gone to the spirit
world”5. Don’t want to answer
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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The
medicine
wheel
“The medicine wheel teaches us that the four elements, each so distinctive and powerful, are all part of the physical world. All must be respected equally for their gift of life.”
Phil Lane Jr., The Sacred Tree, Four Worlds Development Press, Lethbridge, Alberta, Canada, 1984 p. 11
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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The
medicine
wheel
variation from Phil Lane Jr., The Sacred Tree, Four Worlds Development Press, Lethbridge, Alberta, Canada, 1984
Birth / childhood
Elders / End of life / death
Adults
YouthDeath is part of the Medicine Wheel … and the “Circle of Life”
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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7%
93%
0%
1 2 3
Have you ever been to a funeral for a family member?
1. No2. Yes3. Don’t want to
answer
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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helps with the grieving process for family and for the person who is dying (i.e., preparing for death ceremonies)helps community recognize and honor the loss of a valued individual
Query: Why do you think death ceremonies are
important?
thank you January Scott!
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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helps the family and grievers know that they are supported by the community.
Importance of death ceremonies (continued)
thank you January Scott!
helps grievers “express” and not “repress” their grief
Death is part of the / wheel / “circle” …
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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What is the underlying theme?
• Non-Native cultures frequently perceive death as a very separate part of the life cycle.
• But all cultures have special ceremonies that accompany the death of a loved one.
QUERY: What are some examples of things other cultures, religions, or people do to acknowledge the death of a loved one?
Like “funerals”
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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Stereotypical examples of how cultures “respond” to the death of a loved one
Irish funerals?
the wake
food, alcohol
sharing of good stories about the
deceased
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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Catholic funerals?
solemn mass: colonnade from
church to mortuary
food at family’s home
Stereotypical examples of how cultures “respond” to the death of a loved one
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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New Orleans funerals?
music / parade in streets
group praying / crying
Stereotypical examples of how cultures “respond” to the death of a loved one
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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Example of 1 SW tribe
3 day mourning
period
no mention of the person’s
name
So what are examples of how some Native cultures “respond” to the death of
a loved one
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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Another SW tribe
Special ceremony to prepare the
body for mother earth
So what are examples of how some Native cultures “respond” to the death of
a loved one
body is placed in sitting up
position in the grave and must be buried within
24 hours
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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How do Native communities discuss the “death” process?
• Death and dying are referred to using different words / phrases by Native communities – a lot of differences!
“cross the river” “walk on” “move on”
“passing on to the other side”“gone to the spirit world”
and of course the one popularized by Hollywood,
“gone to the happy hunting grounds”
Question: What are some ways you’ve heard Natives use to describe death?
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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How do Native communities discuss the “death” process?
As diverse as Native cultures are, most refer to dying as part of the "Circle of Life".
The
medicine
wheel
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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0%
26%
74%
0% 0%
1 2 3 4 5
If the dying person asked you to help prepare his/her body for burial, how
would you feel?
1. I am not supposed to touch dead bodies and would have to refuse
2. I would have a hard time doing it, but I would do it
3. I would feel it is an honor to be asked and would do my best to do things in the right way
4. Don’t know /not certain5. Don’t want to answer
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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• Traditionally, ceremonies were implemented, sometimes over many months, for the chronically ill or dying patient. – Allows the dying patient make
peace with this world and prepare for the next.
Native communities and the “death” process
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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– Allows the loved ones to raise upsetting issues and consequently to address them with the help of others.
– The entire family is affected. – This includes the extended family
which can consist of adopted relatives and respected elders and healers within our communities.
Native communities and the “death” process
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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• Most Natives choose to ”go to the spirit world" while in their home setting, surrounded by family and community members.
• Many of the cultural support systems that help prepare for the passing existed a few decades ago. These may or may not be present in our local communities today.
Native communities and the “death” process
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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Native communities and the “death” process
Preparation for death by the individual and the family differs among tribal Nations
Preparation of the body
Preparation of the spirit
“Passing” ceremonies
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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Interactive Activity – Small Group
Please from groups of 3-5 individuals each
Please share with your group the following information for how your tribe / culture handles a family member’s death and dying process
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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Small group activity
1. How does your culture prepare for the death of a loved one?
2. How does your culture believe the body should be prepare for burial / burning, etc.?
3. How does your culture believe the spirit should be prepared for passage to the next life / world?
4. What types of ceremonies does your culture do to help deal with death and dying of a loved one?
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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Small group activity
Please take 15 minutes to share your answers with one another in your groups.After 15 minutes, we will ask for volunteers who are willing to share something they learned from their group.
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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This session provided an overview of different ways cultures perceive death and dying.
Summary
Our tribal Nations approach the death process very differently from one another.
Our death ceremonies help us grieve and confront the passage of a loved one from this place on earth to the spirit world.
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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No single ceremony related to death is “right” for everyone.
Summary
We each have our own private and public ways to deal with death.
All of us deal with both the death of loved ones and with our own death.
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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61%
0%
22%
13%
4%
1 2 3 4 5
Which of the following is TRUE?
1. Most Natives die in their homes.
2. Most Natives have plenty of pain control medication when they die.
3. Preparation for dying ceremonies primarily focus on physical issues.
4. Traditional Indian funerals are illegal in most states.
5. Don’t want to answer
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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0%
22%
0%
78%
0%
1 2 3 4 5
Which of the following is TRUE?
1. Neither the Medicine Wheel nor the Circle of Life include “death”
2. All cultures have death ceremonies that are very serious and somber
3. Almost all Native tribal Nations use the same death ceremony
4. Preparing the dead body for burial or disposal is usually regarded as a high honor by most tribes
5. Don’t want to answer
Native American Cancer Research (303-838-9359) EOL Obj. #5, “Native perceptions of death and dying”Part of NACR’s Cultural Modification to ELNEC Module #4 “Ethical/Legal Issues in End-of-Life Care”
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4% 0%
93%
4% 0%
1 2 3 4 5
Which of the following is NOT TRUE about how many tribal Nations
describe death or dying?
1. “Walk on”2. “Cross the river” 3. “Down Under”4. “Gone to the spirit
world”5. Don’t want to answer
Native American Cancer Research ARS polling question 32
0%
82%
18%
1 2 3
Was this information for you:
1. too difficult to understand?
2. understandable (I understood it)
3. too easy – I wanted more challenging information
Native American Cancer Research ARS polling question 33
0%
31%
69%
0% 0%
1 2 3 4 5
Was the Medicine Wheel helpful in the explanation of chronic care in this session?
1. No, it was not helpful or relevant to me
2. Yes, it was a little helpful to me
3. Yes, it was very helpful to me
4. Don’t know / not sure
5. Don’t want to answer
Native American Cancer Research ARS polling question 34
0%
29%
71%
0% 0%
1 2 3 4 5
Were you comfortable with the language used in this session?
1. No, the words were too difficult or unfamiliar for me
2. Yes, most of the words were understandable and comfortable for me
3. Yes, the words were very comfortable for me
4. Don’t know / not sure
5. Don’t want to answer
Native American Cancer Research ARS polling question 35
0%
59%
37%
4%
1 2 3 4
How did using the keypads influence your learning experience?
1. interfered with my learning
2. made no difference in my learning
3. improved my learning
4. don’t know / not sure
Native American Cancer Research ARS polling question 36
7%
83%
10%
1 2 3
Would you want to have a keypad system included in future education presentations?