In China, death is a very taboo topic. We are often full of expectations for newborn babies but full of fear, anxiety, and hesitation about the passing of life. With the growth of China’s aging population in the last three to five years, many families have faced the situation of sick and dying elderly members. Many older adults need care in the previous two stages of illness and death, and many children are unfamiliar and helpless because the elderly are about to die. Therefore, society must realize the importance of hospice care and death education.
Recently, three scholars and Christians from Shanghai, Jiangsu, and Guangdong shared their experiences on this topic in the first-person narrative.
Millennial scholar Li Daonan: the urgency of the church’s participation in hospice care at present
I think hospice care is a natural and urgent need in Chinese society. Society and the church need to see the urgency of this demand, and the church can better participate in it so that people can have dignity in the face of death. Death should not be a regular topic, but the church should show sincere concern and provide services to society.
Christianity introduced hospice care. During the Roman Empire, death brought by the plague came to all people, whether they were nobles or enslaved people or were high priests of official religions, or Christians, but only Christians did not fear death and plague. Regardless of their status, those who died of the plague were given a decent funeral. Those who were seriously ill and dying believed in entering the kingdom of heaven after death. Under the comfort and care of other Christians, they showed more splendid courage and hope than other pagans in the face of death. Their firmness in the hope of eternal life after death even surprised the emperors of the Roman Empire.
Let people have dignity in death, which is precisely what the Christian faith should do. When death is discussed as a public event, everyone who talks about it discusses this event that has nothing to do with himself as an absent person, and they are all talking about other people’s deaths for their interests. At this time, religion shows the most extraordinary disregard for individuals.
In China, people fear death, so they have a lot of ghost culture and folk religions that connect ghosts and gods. Because of this, we lack hospice care in our culture. We regard death as a painful fact that we have fallen into the underworld and separated from the world. We end our lives in nostalgia for the world and fear of death. Therefore, China is a country with minor hospice care.
Hospice care is about individuals because death comes to specific individuals. Currently, the Christian community in China is extremely short of hospice care, and most continue the traditional culture’s recognition of death, avoiding death and clinging to the world. Therefore, the church can continue the routine visits and explain the meaning of death with teachings, and still regard death as a public event. Hospice care is not one visit or two visits but a continuous process. This process requires constant care from the time when believers face death, which may take weeks or months.
Hospice care not only tells the dying to believe in eternal life but also gives the family members comfort in the face of the death of their loved ones. This is comprehensive care, so it cannot be done by one person but by a team.
Hospice care is not trying to change each other, nor trying to persuade them to accept their teachings, nor does it believe that Jesus will go to heaven and not believe in the threat of going to hell, but respecting the dying person so that he will be peaceful and warm with the company of his caregivers, full of faith in eternal life. People will come crying but end with a smile.
Therefore, the hospice care team needs members who are firm in faith, tolerant, and patient. They should know not only the Bible and theology but also learn knowledge of medicine and psychology. They should understand the patient’s psychology and condition well, appreciate his physical pain and establish mutual trust in communication with patients.
What Christianity needs most at present is not to tell the story of death full of theological theories, but to establish a perfect hospice care system and its hospice care teams, so that death will become a process of life and an ordinary event in eternal life instead of being terrible in its belief in eternal life.
Church worker Shi Canaan: Who will care about hospice care? The church must step forward.
“It is the savior Jesus who can bring comfort to the soul, so the church should stand up to the needs of hospice care.”
Nowadays, it can be seen in many hospitals that under the condition that patients’ diseases are incurable. Their survival time is limited (six months or less), hospice care advocates giving up active treatment, paying attention to patients’ dignity and spiritual needs, alleviating patients’ suffering, improving their quality of life, and extending to support patients’ families.
Overseas, the emergence of hospice care is closely related to over-treatment. Saunders, a British nurse, worked in a terminal cancer hospital and witnessed the suffering of countless dying patients. Determined to change this situation, Saunders founded the world’s first hospice hospital in 1967. She believed that we should respect the patient’s choice and the law of natural life and wait for the end of life without relying on a life support system.
Volunteers in hospice care hope to learn to face death through service. Sister Dong is a volunteer in the service team and has been doing voluntary service since 2005. More than a year ago, she began hospice care service and mobilized twenty or thirty elder sisters to do it together. Sister Dong was once seriously ill. During that time, her heart was full of fear and anxiety. By serving many dead partners and neighbors, she considered making them walk more comfortably and let their relatives and friends deeply remember and live happily instead of fearing guilt.
Chinese-style hospice care is another advocacy of filial piety. Let family members accompany the dying person, recall the patient’s preferences, recall the life, alleviate the fears, and make them clean, tidy, stable, and indifferent at the last moment of this world. Many hospice care volunteers have certain beliefs and fear of life before participating. In the eyes of ordinary citizens, hospice care is still a strange term as people avoid talking about death. Some churches are also doing it for hospice care, but the strength is not enough, and no special service team has been formed. Therefore, the church is a good contact point with social services for hospice care.
Brother Xiaogang: People who do not respect death and do not know how to fear life, please give hospice care to the elderly.
Recently, I heard the news that many people around me who were over 80 years old died one after another. It is said that concerning death education in China, the Chinese society is simply pupils because there is no death education.
The meaning of hospice care is: it refers to providing physical, psychological, and spiritual care and humanistic care services for terminally ill or elderly patients before dying, controlling pain and discomfort symptoms, improving the quality of life, and helping patients die comfortably, peacefully, and with dignity. The service object of hospice care is everyone who will die, mainly the elderly.
I want to discuss this topic through three perspectives of hospice care: psychological care, physical care, and social care.
Psychological care
We need to spend more time with the dying elderly, chat with them more easily, remember the past and their little things, listen patiently, and guide them to express their feelings in time. Try your best to help the elderly to establish an average mentality. You cannot take care of the elderly with the mindset of waiting for death but spend every day happily with them. We can try our best to communicate with the elderly in a positive and soothing tone, and avoid excessively negative words, to minimize the patient’s negative mood.
In terms of physical care, if possible, have physical contact with the elderly as much as possible, such as holding each other’s hands and touching their backs, so that they can feel the love of their families more. Hearing finally disappears, and you can talk to the patient until the last moment. I think the source of fear is that they do not know where they are going. If they know they are sure to go to a beautiful place, the aged patients will not be afraid.
Physiological care
Most older adults cannot walk in the later stage and can only lie in bed. Skin problem is a huge problem. Bedsore will happen if you are not careful. Do not let the patient lie in one posture for a long time. Help them turn over every few hours. Always wipe the body with a towel for the elderly to keep the skin clean and dry.
For facial care, use a wet towel to relieve eye dryness. Apply lip balm or wipe the lips with a cotton swab dipped in water. Many will have some phlegm in their throats in the last few days. We should not force them to drink water unless they want to. For patients to live a few more days, many people will cause them to eat. In fact, people’s metabolism has slowed down or stagnated in the last few days, and they can no longer digest and absorb food. If the patient can eat, they must be fed. If they cannot, do not force them to eat.
The dying will finally have a death roar, and the patient’s throat will make a loud noise in the last few days because their oral muscles will become slack, the liquid in the throat will accumulate, and they will purr when they breathe, which is called “death roar” in medical terms.
Regarding the phenomenon that the patient lifts the quilt, I learned that patients could not stand the heavy pressure in the last few days. At this time, even a silk scarf will make them unbearable. Do not cover the older man with a quilt freely.
Through many observations, the International Near-Death Experience Association found that some dying patients will feel near death. When the near-death feeling appears, they may see their dead relatives or have other hallucinations. The International Association of Near-Death Experience suggests that this situation is normal. The sense of near-death is to help the elderly prepare for death. The purpose of near-death will have excellent guidance and comfort. At this time, keep calm, do not break their illusion or talk, pay attention to what they say and want to express, and help them realize some wishes as much as possible.
Social care
In social care, we need to help the elderly sort out three kinds of relationships:
The first is to help the elderly deal with their self-relationships. We must actively communicate with the elderly: How do they spend their last time? What do they want to do with their legacy? In what way do they like to bid farewell to this world? What wishes have not been fulfilled? Self-relationship and psychological care have a sense of perspective, and there will be overlapping elements.
Second, help the elderly to deal with the relationship with others. We can express our gratitude to the elderly and tell them what they have done in the past that greatly influenced themselves and others and even others’ life trajectories. The general purpose is to appreciate older adults’ lifelong achievements and make them feel they have not lived in vain. Some people will take some family photos when the elderly are still in normal activities, then frame them and put them in a conspicuous place, and intentionally or unintentionally reveal that they will be treasured forever. This will also be very comforting to the elderly.
Third, help the elderly deal with their relationship with the God they believe in. When my husband’s grandmother was dying, we told her that God was very happy with what she had done and she had worked all her life diligently. When she was old, she would come to God and become a glorious child. When most old people die, they will have things that are hard to give up. If one pile cannot be put down, it will cause a dying obstacle-desperately not wanting to die. Therefore, a very important task of hospice care and nursing is not to let patients leave with regrets and questions. We should fulfill the wishes of the elderly as much as possible and make some promises when necessary so that the elderly can leave without any attachments.
(The above three scholars and Christians are pseudonyms.)
- Translated by Charlie Li
在中国，死亡是一个非常忌讳的话题。我们常常对于新生命的到来充满期待，而对生命的逝去却充满了恐惧、不安和彷徨。随着中国人口老龄化进程的增长，在最近的3至5年间，许多的家庭都面临着家里老人卧病在床以及老人离世的处境，很多老年人在疾病和死亡的最后两个阶段里，其实需要关怀，许多儿女面对老人即将要逝去的事实也有许多的陌生和无助，因此，全社会需要认识到临终关怀与死亡教育的重要性。
近日，来自上海、江苏与广东的三位学者和基督徒对此话题，分享自己的心得：
80后学者，李道南
——当下基督教会参与临终关怀的迫切性
我认为，临终关怀对于中国社会来说，是有着真实且迫切的需要。社会和教会都需要看到这个需求的迫切性，教会可以更好地参与其中，让人在面对死亡的时候有尊严，死亡不应该成为被消费的谈资，而是真实的活出基督教会该有的怜悯与事奉。
实际上临终关怀的真正发明者是基督教，在罗马帝国时期，瘟疫带来的死亡临到所有的人，不论贵族还是奴隶，不论是官方宗教大祭司还是基督徒，但是只有基督徒们做到了不惧怕死亡和瘟疫。那些因瘟疫死去的人，不论有怎样的卑贱身份，都有一个体面的葬礼，那些身染重病，奄奄一息的人，都相信死后进入天国。他们在其它教徒的安慰和照顾下，表现出了比其它异教徒在面对死亡时更大的勇气和盼望，他们对死后永生盼望带来的坚定甚至让罗马帝国的君主惊讶。
让人在面对死亡的时候有尊严，正是基督教信仰应该做到的。当死亡被作为公共事件谈论，每个谈论的人都以不在场的身份讨论这个与自己无关的事件，都在按照自己的目的消费着别人的死亡，这个时候是宗教表现出的对个体最大的漠视！
在中国，重生轻死的化充斥其间，人们对死亡充满恐惧，因此有着丰富的鬼文化，也有着众多的通鬼神的民间宗教，正是如此，我们的文化中才缺乏临终关怀，我们把死看成坠入阴间与世相隔，那是个痛苦的永远无法改变的事实，在对阳世的留恋和对死亡的恐惧中，我们结束生命。因此中国是个最缺乏临终关怀的国度。
临终关怀是对个体的关怀，因为死亡是降临到具体的个体身上。而现在的中国基督教界对临终关怀的事工却极其缺乏，大多延续传统文化对死亡的认同，回避死亡而留恋人世，因此面对躺在医院里重病而频临死亡的信徒，教会所能做的是延续常规的探访，并用教义阐释死亡的意义，依然把死亡当做一个公共事件。实际上临终关怀，不是一次探访两次探访，而是一个持续的过程，这个过程从信徒面对死亡开始，便要进行持续的关怀，可能几个星期，也可能几个月。
临终关怀并不仅仅告诉他要相信永生，也包括给予他的家人在面临亲人死亡中的安慰。这是个全面的关怀，因此这不是一个人能完成的，而需要一个团队。
临终关怀不是试图改变对方，也不是试图说服对方接受自己的教义，更不是信耶稣进天堂，不信下地狱式的恐吓，而是对即将死亡者的尊重，让他在关怀者的陪伴下，安详而温暖，充满对永生的信念，让人由哭而来，含笑而终。
因此，这个临终关怀的团队，需要一群信仰坚定，宽容而耐心的同工，他们除了具备圣经和神学知识，还要学习医学和心理学知识，他要把握病人的心理，要掌握临终者的病情，从而能理解他身体的痛苦，在与病人的交流中，建立彼此的信任。
基督教当下最需要的不是是对死亡充满神学理论的讲述，而是建立完善的临终关怀体系，建立自己的临终关怀团队，让死亡对永生的坚信中而不再可怕，而成为人生的一个过程，一个在永生中的普通事件。
主内工人，施迦南姐妹
——面对死亡的惧怕：谁来关心临终关怀？教会须挺身而出
“真正能给灵魂带来安慰的，是救主耶稣，所以面对临终关怀的需求，教会当挺身而出。”
现在许多医院里面可以看到，在人们的疾病已无法治愈、生存时间有限（6个月或更少）的情况下，临终关怀主张放弃积极治疗，注重病人尊严和心灵各方面的需要，减轻病人痛苦，提升病人的生存品质，并延伸到给病人家属以支持。
在国外，临终关怀的出现，与过度治疗有密切关系。英国护士桑德斯在晚期肿瘤医院工作，目睹无数垂危病人的痛苦。桑德斯决心改变这种状况，于1967年创办了世界第一家临终关怀医院。她认为，应尊重病人的选择和自然生命的规律，不依靠生命支持系统，安然等待生命的结束。
参与临终关怀的志愿者们希望从服务中学会面对死亡。董大姐是服务队的一名志愿者，自2005年开始做志愿服务。一年多以前，她开始做临终关怀的服务，还发动了二三十个老姐妹一起做。董大姐曾经得过重病，那段时间她内心满是恐惧与忧虑。她通过服事许多过世的伙伴和邻舍，就想如何能够让他们走得更安乐些和让亲友深沉地追思、快乐地生活，而不是恐惧、愧疚。
中国式的临终关怀，是人伦孝道的再一次倡导。让家属陪伴着临终者，回忆他的喜好，讲述他的一生，减轻他的恐惧，让他们在这个世间的最后时刻里，干净整齐，安定淡然。许多临终关怀志愿者都有一定的信仰，敬畏生命，才参与其中。在普通市民眼中，临终关怀还是一个如此陌生的词语，人们并不愿意去谈论死亡的事情。对于临终关怀，有些教会也在着手做，但是力度还不够，没有形成专门的服事团队。因此，教会对于临终关怀这一方面，是与社会服务很好的接洽点。
晓刚弟兄
——不尊重死亡的人，不懂得敬畏生命 请给老人做好临终关怀
最近，我听到周围很多身边80岁以上的老人相继去世的消息，有人说，中国人谈论死亡时，简直就是小学生，因为没有死亡教育。
临终关怀的意义为：安宁疗护，是指为疾病终末期或老年患者在临终前提供身体、心理、精神等方面的照料和人文关怀等服务，控制痛苦和不适症状，提高生命质量，帮助患者舒适、安详、有尊严地离世。其实临终关怀的服务对象是全部将要去世的人，主要是老人群体。
我想通过临终关怀的三个视角：心理关怀、生理关怀和社会性关怀来聊聊这个话题。
——心理关怀
我们需要多多陪伴临终老人，多和老人轻松聊天，回忆过去和他们的点滴，耐心聆听，及时引导老人表达自己的心情。尽力帮助老人建立平常心态，不能用等死的心态去照顾老人，而是愉快度过每一天的心态陪伴他们。我们可以尽量用积极、舒缓的语气和老人交流，避免过度消极的词汇，以防加强对方不良情绪。
肢体关怀的方面，如果可以，尽可能多和老人有肢体接触，比如握住对方的手，抚摸其背部等，这样他们更加能够感受到家人的爱。听觉最后消失，可以和老人说话到最后一刻。我自己觉得恐惧的来源是因为他们不知道自己要去哪里，如果他们知道自己很确定要去一个美好的地方，老人们是不会恐惧的。
——生理性关怀
大部分老人在后期就走不动了，只能躺在床上。皮肤问题是一个非常大的困扰，一不小心就会生出褥疮，不要让老人一个姿势久坐久躺，每隔几小时就要帮助他/她翻身。经常用毛巾为老人擦拭身体，保持皮肤的清洁和干爽。
对于脸部护理，用湿毛巾缓解眼部的干燥。用润唇膏涂抹嘴唇，或用棉签沾水擦拭嘴唇。当老人喉咙有痰很多老人在最后那几天，喉咙都会有一些痰，我们不要强迫老人喝水，除非他们愿意。为了病人能多活几天，很多人会强迫或勉强老人进食。实际上，人在最后的时间里，新陈代谢已经放缓或停滞，无法再消化和吸收食物了。如果老人吃得下，就一定要给他们吃东西，如果吃不下，千万不要强迫他们吃。
临终者最后会有死亡咆哮声，老人最后那几天喉咙会发出巨大响声，是因为老人的口腔肌肉会变得松弛，喉咙中的液体就会积压在咽喉，一呼吸就会发出咕噜声，医学上将其称为“死亡咆哮声”。
关于老人掀被子现象，我看到有资料说最后几天的老人是很无法忍受重压的，这时哪怕是一条丝巾，都会让他/她无法忍受，不要盲目给老人盖被子。
国际濒死体验协会通过大量观察，发现有的临终病人会出现濒死感，当濒死感出现时，他们可能会看见已经去世的亲人，或者出现其他一些幻觉。国际濒死体验协会建议，这种情况其实很正常，濒死感存在的目的，就是为了帮助老人做好迎接死亡的准备，这种濒死感会有很大的导引和安慰作用。这时要保持镇定，不要去打破他/她的幻觉或者说话，留意他/她说话的内容，以及想表达的意思，尽可能帮助他/她实现一些意愿。
——社会性关怀
在社会性关怀中，我们需要帮助老人梳理好三种关系：
第一个是帮助老人处理自我关系，我们需要主动与老人沟通：最后的时光怎么度过?希望以什么方式处理遗产？希望以什么方式告别这个世界？有什么心愿没有完成？自我关系和心理性关怀有点视角透视的感觉，会有重叠的成分。
第二，帮助老人处理与他人的关系。我们可以多和老人表达感恩之情，告诉老人过去做过的哪些事情对自己和其他人有很大的影响，甚至影响别人的人生轨迹。总的目的是要让老人一辈子的成就得到赏识，觉得自己这一辈子没有白活。有些人会在老人还正常活动的时候拍一些全家福，然后裱起来，放在显眼处，并有意无意透露会永远珍藏。这样也会很安慰老人。
第三，帮助老人处理与所信的上帝的关系。我丈夫奶奶过世时，我们会告诉她上帝很喜悦她所做的事，一辈子勤恳地做事，到年老的时候，愿意来到上帝面前，成为荣耀的孩子。大部分老人临终时，都会有一些难以割舍的人事物。只要有一桩放不下，就会造成临终障碍-拼命不想死去。所以临终关怀和护理很重要的一项任务，就是不要让病人带着遗憾和疑问离开。我们要尽可能完成老人的遗愿，必要时需要作出一些承诺，让老人可以无牵无挂地安心离开。
（以上三位学者和基督徒均使用化名）
圆桌间｜社会人口老龄化与临终关怀的迫切需要 教会如何回应？
In China, death is a very taboo topic. We are often full of expectations for newborn babies but full of fear, anxiety, and hesitation about the passing of life. With the growth of China’s aging population in the last three to five years, many families have faced the situation of sick and dying elderly members. Many older adults need care in the previous two stages of illness and death, and many children are unfamiliar and helpless because the elderly are about to die. Therefore, society must realize the importance of hospice care and death education.
Recently, three scholars and Christians from Shanghai, Jiangsu, and Guangdong shared their experiences on this topic in the first-person narrative.
Millennial scholar Li Daonan: the urgency of the church’s participation in hospice care at present
I think hospice care is a natural and urgent need in Chinese society. Society and the church need to see the urgency of this demand, and the church can better participate in it so that people can have dignity in the face of death. Death should not be a regular topic, but the church should show sincere concern and provide services to society.
Christianity introduced hospice care. During the Roman Empire, death brought by the plague came to all people, whether they were nobles or enslaved people or were high priests of official religions, or Christians, but only Christians did not fear death and plague. Regardless of their status, those who died of the plague were given a decent funeral. Those who were seriously ill and dying believed in entering the kingdom of heaven after death. Under the comfort and care of other Christians, they showed more splendid courage and hope than other pagans in the face of death. Their firmness in the hope of eternal life after death even surprised the emperors of the Roman Empire.
Let people have dignity in death, which is precisely what the Christian faith should do. When death is discussed as a public event, everyone who talks about it discusses this event that has nothing to do with himself as an absent person, and they are all talking about other people’s deaths for their interests. At this time, religion shows the most extraordinary disregard for individuals.
In China, people fear death, so they have a lot of ghost culture and folk religions that connect ghosts and gods. Because of this, we lack hospice care in our culture. We regard death as a painful fact that we have fallen into the underworld and separated from the world. We end our lives in nostalgia for the world and fear of death. Therefore, China is a country with minor hospice care.
Hospice care is about individuals because death comes to specific individuals. Currently, the Christian community in China is extremely short of hospice care, and most continue the traditional culture’s recognition of death, avoiding death and clinging to the world. Therefore, the church can continue the routine visits and explain the meaning of death with teachings, and still regard death as a public event. Hospice care is not one visit or two visits but a continuous process. This process requires constant care from the time when believers face death, which may take weeks or months.
Hospice care not only tells the dying to believe in eternal life but also gives the family members comfort in the face of the death of their loved ones. This is comprehensive care, so it cannot be done by one person but by a team.
Hospice care is not trying to change each other, nor trying to persuade them to accept their teachings, nor does it believe that Jesus will go to heaven and not believe in the threat of going to hell, but respecting the dying person so that he will be peaceful and warm with the company of his caregivers, full of faith in eternal life. People will come crying but end with a smile.
Therefore, the hospice care team needs members who are firm in faith, tolerant, and patient. They should know not only the Bible and theology but also learn knowledge of medicine and psychology. They should understand the patient’s psychology and condition well, appreciate his physical pain and establish mutual trust in communication with patients.
What Christianity needs most at present is not to tell the story of death full of theological theories, but to establish a perfect hospice care system and its hospice care teams, so that death will become a process of life and an ordinary event in eternal life instead of being terrible in its belief in eternal life.
Church worker Shi Canaan: Who will care about hospice care? The church must step forward.
“It is the savior Jesus who can bring comfort to the soul, so the church should stand up to the needs of hospice care.”
Nowadays, it can be seen in many hospitals that under the condition that patients’ diseases are incurable. Their survival time is limited (six months or less), hospice care advocates giving up active treatment, paying attention to patients’ dignity and spiritual needs, alleviating patients’ suffering, improving their quality of life, and extending to support patients’ families.
Overseas, the emergence of hospice care is closely related to over-treatment. Saunders, a British nurse, worked in a terminal cancer hospital and witnessed the suffering of countless dying patients. Determined to change this situation, Saunders founded the world’s first hospice hospital in 1967. She believed that we should respect the patient’s choice and the law of natural life and wait for the end of life without relying on a life support system.
Volunteers in hospice care hope to learn to face death through service. Sister Dong is a volunteer in the service team and has been doing voluntary service since 2005. More than a year ago, she began hospice care service and mobilized twenty or thirty elder sisters to do it together. Sister Dong was once seriously ill. During that time, her heart was full of fear and anxiety. By serving many dead partners and neighbors, she considered making them walk more comfortably and let their relatives and friends deeply remember and live happily instead of fearing guilt.
Chinese-style hospice care is another advocacy of filial piety. Let family members accompany the dying person, recall the patient’s preferences, recall the life, alleviate the fears, and make them clean, tidy, stable, and indifferent at the last moment of this world. Many hospice care volunteers have certain beliefs and fear of life before participating. In the eyes of ordinary citizens, hospice care is still a strange term as people avoid talking about death. Some churches are also doing it for hospice care, but the strength is not enough, and no special service team has been formed. Therefore, the church is a good contact point with social services for hospice care.
Brother Xiaogang: People who do not respect death and do not know how to fear life, please give hospice care to the elderly.
Recently, I heard the news that many people around me who were over 80 years old died one after another. It is said that concerning death education in China, the Chinese society is simply pupils because there is no death education.
The meaning of hospice care is: it refers to providing physical, psychological, and spiritual care and humanistic care services for terminally ill or elderly patients before dying, controlling pain and discomfort symptoms, improving the quality of life, and helping patients die comfortably, peacefully, and with dignity. The service object of hospice care is everyone who will die, mainly the elderly.
I want to discuss this topic through three perspectives of hospice care: psychological care, physical care, and social care.
Psychological care
We need to spend more time with the dying elderly, chat with them more easily, remember the past and their little things, listen patiently, and guide them to express their feelings in time. Try your best to help the elderly to establish an average mentality. You cannot take care of the elderly with the mindset of waiting for death but spend every day happily with them. We can try our best to communicate with the elderly in a positive and soothing tone, and avoid excessively negative words, to minimize the patient’s negative mood.
In terms of physical care, if possible, have physical contact with the elderly as much as possible, such as holding each other’s hands and touching their backs, so that they can feel the love of their families more. Hearing finally disappears, and you can talk to the patient until the last moment. I think the source of fear is that they do not know where they are going. If they know they are sure to go to a beautiful place, the aged patients will not be afraid.
Physiological care
Most older adults cannot walk in the later stage and can only lie in bed. Skin problem is a huge problem. Bedsore will happen if you are not careful. Do not let the patient lie in one posture for a long time. Help them turn over every few hours. Always wipe the body with a towel for the elderly to keep the skin clean and dry.
For facial care, use a wet towel to relieve eye dryness. Apply lip balm or wipe the lips with a cotton swab dipped in water. Many will have some phlegm in their throats in the last few days. We should not force them to drink water unless they want to. For patients to live a few more days, many people will cause them to eat. In fact, people’s metabolism has slowed down or stagnated in the last few days, and they can no longer digest and absorb food. If the patient can eat, they must be fed. If they cannot, do not force them to eat.
The dying will finally have a death roar, and the patient’s throat will make a loud noise in the last few days because their oral muscles will become slack, the liquid in the throat will accumulate, and they will purr when they breathe, which is called “death roar” in medical terms.
Regarding the phenomenon that the patient lifts the quilt, I learned that patients could not stand the heavy pressure in the last few days. At this time, even a silk scarf will make them unbearable. Do not cover the older man with a quilt freely.
Through many observations, the International Near-Death Experience Association found that some dying patients will feel near death. When the near-death feeling appears, they may see their dead relatives or have other hallucinations. The International Association of Near-Death Experience suggests that this situation is normal. The sense of near-death is to help the elderly prepare for death. The purpose of near-death will have excellent guidance and comfort. At this time, keep calm, do not break their illusion or talk, pay attention to what they say and want to express, and help them realize some wishes as much as possible.
Social care
In social care, we need to help the elderly sort out three kinds of relationships:
The first is to help the elderly deal with their self-relationships. We must actively communicate with the elderly: How do they spend their last time? What do they want to do with their legacy? In what way do they like to bid farewell to this world? What wishes have not been fulfilled? Self-relationship and psychological care have a sense of perspective, and there will be overlapping elements.
Second, help the elderly to deal with the relationship with others. We can express our gratitude to the elderly and tell them what they have done in the past that greatly influenced themselves and others and even others’ life trajectories. The general purpose is to appreciate older adults’ lifelong achievements and make them feel they have not lived in vain. Some people will take some family photos when the elderly are still in normal activities, then frame them and put them in a conspicuous place, and intentionally or unintentionally reveal that they will be treasured forever. This will also be very comforting to the elderly.
Third, help the elderly deal with their relationship with the God they believe in. When my husband’s grandmother was dying, we told her that God was very happy with what she had done and she had worked all her life diligently. When she was old, she would come to God and become a glorious child. When most old people die, they will have things that are hard to give up. If one pile cannot be put down, it will cause a dying obstacle-desperately not wanting to die. Therefore, a very important task of hospice care and nursing is not to let patients leave with regrets and questions. We should fulfill the wishes of the elderly as much as possible and make some promises when necessary so that the elderly can leave without any attachments.
(The above three scholars and Christians are pseudonyms.)
- Translated by Charlie Li
Roundtable: How Should the Church React to the Immediate Needs of the Aging Population?
