Spiritual Care: A Vast Perspective

By Christine Longaker

Even if the dying do not actively practice in a spiritual tradition, we can support them by bringing to their bedside the presence, clarity, and profound compassion generated from our daily spiritual practice--thereby creating a "sacred environment" within which they can die.

View of sea at Dzogchen Beara What characterizes spiritual care is its long-term vision, one which embraces the complete picture of the dying person and their future, and recognizes that we can help someone long before they die, at the moment of death, and even after they are dead.
--Sogyal Rinpoche

David, an emergency room doctor in a major city hospital, told me how stressful his job used to be, and how his experience has changed since he began integrating his spiritual practice at work. He wrote:

"Families panic at the time of death, call 911, and bring their loved one to the emergency room to die. When they arrive, they're not prepared in any way for what is about to happen. What I see is enormous fear, confusion, anxiety and helplessness. The way I used to deal with the situation was through detachment. Outside of doing my best for the patient, I figured there was no way I could impact their situation at all.

"Telling a family that their loved one has died or is dying was one of the things I hated most about my job. Often the family reacted to me with hostility and anger. The work was fearful and unpleasant for me.

"Since I started doing spiritual practice in the emergency room, I've watched the person's expression in the final few minutes of life change to one of acceptance, sometimes even a gentle smile, replacing the fear and anxiety. It looks like an opening, a release. Then, when I have to go and tell a family that their loved one has died, I notice an enormous difference in their reaction. Family members often will thank me and even come up and hug me. This new experience I'm having since doing my spiritual practice in the hospital has transformed my life and my medical practice." (From pages 227-8 in Facing Death and Finding Hope)

Viewing life from a spiritual perspective, we recognize that within each person is an innermost, spiritual essence that is unborn and undying. Suffering physical disability, cognitive dysfunction or emotional pain does not destroy or diminish a person's essence in any way. This essence is the "bottom line" of every being, which is called our true nature of mind in Buddhism, or the "divine spark within." Because each being has this undying essence--which is skylike, luminous and radiant with infinite compassion and love--every person who is suffering or approaching death is worthy of our respect--no matter now they might appear on the surface. We should remember always that any charged emotions, physical disfigurement or questionable behavior we might witness are only temporary, like a mist on a mirror.

Quote: Learning to see the good heart...

By recognizing and becoming familiar with our true nature of mind while we are alive, we will be able to recognize and unite with it when the truth dawns at the moment of death, like a clear and cloudless sky. Through this familiarity and recognition, we can be liberated at that moment. This is why death is described as an extraordinary spiritual opportunity

As death approaches, it is important to really listen to and respond to the dying person's anguish--not only physical complaints, but emotional and spiritual pain as well. The teachings of Tibetan Buddhism say that what is in our mind at death becomes our reality after death. Therefore, skillfully and appropriately, we can encourage the dying to conclude their life well, heal their relationships, and prepare spiritually for death, so that they might die feeling genuine peace of mind.