Care of the Muslim Patient
Rebecca Minor, Aida Mansoor, Ann Minor
November 19, 2013
The Connecticut Charter Oak Chapter of HPNA
Hospice & Palliative Nurses Association
• Special Education teacher in Farmington• Born in Bristol• UConn RA• Converted to Islam 5 years ago• MCCT• Berlin mosque
There are…
• 1.7 billion Muslims on earth – this is 1 out of every 4 people.
• Approximately 7 million Muslims in the U.S.
• 100,000 Muslims in the state of CT.
The chances of caring for a Muslim in the hospital are increasing.
The Holy Quran
The word of God revealed through the angel Gabriel to the prophet Muhamad (pbuh). It was revealed over a period of 23 years.
Today,1400 years later, it remains unchanged, still in its original Arabic language.
The Hadith
Words and traditions of the prophet Muhamad(pbuh) ~ peace and blessings be upon him
“The merciful bestows mercy to those who are merciful. Therefore show mercy to those on earth and the One in heaven will show mercy on you.”
Islam
• Arabic word
• Means peace and submission to the will of God (Allah).
• Those who follow Islam are called Muslims.
The 3 major religions are followers of the prophet, Abraham. These religions are monotheistic – all believe in the same, one God.
Muslim• A Muslim is one who follows the way of Islam.
• A Muslim submits to the will of God so that they can live in peace.
EIDMuslims have 2 festivals:
•One at the end of the month of Ramadan.•The other at the time of the Hajj pilgrimage.
1. God
The word for God in Arabic is Allah.
Christians and Jews living in Arabic speaking countries also use the word Allah when referring to God.
2. AngelsIn Islam, Gabriel is considered one of the four archangels whom God sent with his divine message to various prophets, including the last prophet Muhammad (pbuh).
3. Prophets
A prophet in Islam is a male human, from the sons of Adam; who received revelation from God in the form of Divine instructions.
• Adam• Noah• Abraham• Lot• Ishmael• Isaac• Jacob• Joseph• Job• Aaron
• Moses • David • Solomon• Elijah• Jonah• Zechariah• John the Baptist• Jesus• Muhamad
4. Holy Books Revealed to: In:
• Taurah Moses Hebrew• Zaboor David Hebrew• Injeel Jesus Aramaic• Qur’an Muhammad Arabic
1. Declaration of Faith
• When someone becomes Muslim he or she states the Shahadah:
“La ilaha il Allah, Muhammad-ur-Rasool-Allah”
• As a person says the Shahadah they bear witness that there is one God and that the prophet Muhamad is the last Messenger of God.
2. Prayer - Salah
• Pray five times a day• Prayer rug• Ablution – washing before prayer• Jum’ah – Friday prayer
3. Charity - Zakat
• All things belong to God, therefore wealth is held by human beings in trust.
• “Purification” and “Growth”. Possessions are purified by setting aside a proportion for those in need. This cutting back balances and encourages new growth (wealth).
• 2.5% of ones income and wealth.
4. Fasting - Saum
Fasting helps to purify the soul, refocus attention on God, and practice self-sacrifice.
Ramadan •No food, drink or intimate relations from dawn until sunset for approximately 30 days.•The ninth month of the Islamic lunar calendar.•Ramadan 2014 ~ June 28-July 27
5. Pilgrimage - Hajj
• Mecca – Saudi Arabia• 5 days• Once in a lifetime• 4 million people perform the Hajj annually• Hajj 2014 ~ Oct. 1-6
• Muslim Chaplain at HH and SFH• Born in England as a Muslim• Studied at Kings College in London• Graduate of the Hartford Seminary• President of MCCT• Berlin Mosque
Take the time to know your patient
The Muslim population in the U.S. is very diverse. Cultural background may influence the way they respond to illness and other life crises.
Illness
During illness, Muslims are expected to:
•Seek God’s help with patience and prayer;•Increase remembrance of God to obtain peace;•Ask for forgiveness;•Give more in charity and;•Read or listen to more of the Qur’an.
Patients, especially those who are terminally ill, are encouraged by family members to recite the Shahadah as it reaffirms ones connection with God.
Death
The Qur’an emphasizes that death is only a transition from this existence to a future life.
•“Every living creature will die one day”.
•“They (true believers) say: To God we belong and to Him is our return.”
Healthy Body
The prophet Muhammad taught that maintaining a healthy body is an individual’s duty. “Taking proper care of one’s health is the right of the body.”
Seeking Treatment
The sayings of the Prophet encourage patients to seek proper treatments in the time of illness:
•“There is no disease that Allah has created, except that He also created its remedy.”
•The prophet not only instructed sick people to take medicine, but he himself invited expert physicians for this purpose.”
Women
• Hajib• Loose, non-revealing clothes.• Some women may be clothed from head to
toe with the exception of the face.
Fasting
• The month of Ramadan
• Allowed exceptions:• The sick, the old, the young• Menstruating women• Pregnant women, nursing women• Travelers
• Blood Transfusions• Organ Donation• Abortions & Stillborn• Assisted Suicide and Euthanasia• Autopsy• Cremation
Advance Directives
• The Imam should work closely in discussion with medical staff.
• DNR order is acceptable but it should be carefully explained.
• Prolongation of life by supportive machines is strongly discouraged for those who are terminally ill – when the quality of life is poor.
Ventilators
• If the patient is on a ventilator and there is total organ failure the ventilator can be withdrawn.• If the patient then breathes alone or stops
breathing that is considered to be the will of God. • The ventilator cannot be withdrawn to end
the patient’s life.
Death is defined as the departure of the soul from the body – however neither the Qur’an nor hadith give clear signs of the soul’s departure.
•“Brain death’ may not be accepted as death by some Muslims.
•Most Muslims consider death as a cessation of all bodily functions.
• Face toward Mecca.• Mouth and eyes closed.• Arms and legs straight -
toes tied together.
• Clothes removed by person of same gender.• Ritual body wash.• Wrapped in white cloth.
Preparation of the Body
• Hospice & Palliative Care Nurse ~ Holistic Nurse• Born in Norwich • Converted to Islam 3 years ago• Berlin mosque• So much to learn!
• Strong support system• Parents & elderly• Visitations from family and friends
"If a Muslim visits his/her fellow Muslim who is ill in the morning, then 70,000 Angels pray for that person until the night and if that person visits at night then they pray for him/her till the morning, and due to his/her good intentions he/she gains a garden in Paradise."
The Medical team should call a Muslim chaplain or the Islamic center if they are not familiar with the Islamic traditions.
Muslim Coalition of Connecticut
Food
Although the sick do not need to fast they may want to. A Muslim physician may be useful in advising and counseling the patient.
Halal foods ~ Jewish Kosher or VegetarianHaram foods:• Jello• Pork• Broth, Chowder, Soups, Gravy• Animal shortening - breads, puddings, etc.• Lard• Alcohol – vanilla extract, Dijon mustard
Prayers
• Let patient know the direction toward Mecca.• Position bed towards Mecca.• Get prayer schedule from the internet.
• Play a recording of the Adhan.• Help them perform wudu.• Provide privacy.
Nov. 2013 Prayer Schedule
Nov. FajrDawn Sunrise
ZuhrNoon
AsrAfternoon
MaghribSunset
IshaNight
3 29 Sun 4:51 6:26 11:35 2:19 4:43 6:17
4 30 Mon 4:52 6:27 11:35 2:18 4:42 6:16
5 1 Tue 4:53 6:28 11:35 2:18 4:41 6:15
6 2 Wed 4:54 6:29 11:35 2:17 4:39 6:14
7 3 Thu 4:56 6:30 11:35 2:16 4:38 6:13
8 4 Fri 4:57 6:32 11:35 2:15 4:37 6:12
9 5 Sat 4:58 6:33 11:35 2:14 4:36 6:11
Dying Process
At the last moments before death, Allah sends the angels of death to get the soul from the human body.
Allah says, “He is the irresistible, supreme over His slaves, and He sends guardians over you, until when death approaches one of you, Our messengers (angel of death and his assistants) take his soul, and they never neglect their duty.”
Surat Al-An’am, (verse 61)