Spiritual and compassionate care focuses on a patient's spiritual wellbeing by connecting them to spiritual traditions, rituals and practices as they experience a health crisis. Rev. Donald Stikeleather, a staff chaplain for IU Health Methodist Hospital and an ordained Buddhist through Dharma Ocean Foundation, provides insight into this topic of spiritual care for patients who practice Buddhism.
What is the value of spiritual care?
The hospital team generally meets the patient's physical needs, but the emotional and spiritual needs are often hidden, helpful or a hindrance to the healing process. A chaplain nurtures the whole person so that the team can understand their patient in a holistic sense, to heal fully instead of curing temporarily.
A hospital chaplain witnesses the suffering of patients and those who love and care for them. This witness is more than observation since some grief is hidden. The chaplain has the opportunity to uncover the pain that might be unnoticed, discounted and neglected so that the person can become whole. There are board-certified chaplains, chaplains seeking certification, chaplaincy students and volunteer chaplains.
How can chaplains support physicians?
Chaplains alert doctors to misunderstandings and confusion about diagnoses and care. Through charting, chaplains address deep meanings of the illness the team is focusing on; this helps the doctor understand the patient holistically.
During Goals of Care meetings, chaplains can address spiritual and emotional issues which concern the patient and family. Chaplains teach the entire team to empathize with the patient's unique experience of illness.
An exploratory conversation about the patient's experience can often trigger a needed conversation about code status, goals of care, or the need for palliative care or hospice.
During the end of life periods, the chaplain can explain the patient's cultural and spiritual needs so that the team can understand what is meaningful.
Chaplains and doctors work together to help patients and families express the patient's needs using different ways of explaining, gaining wisdom from the spiritual to enhance the physical care, and then understanding the physical and emotional from exploring the spiritual. Often when a patient/family is at an impasse about goals of care, a chaplain can tease apart family wounds that impede the process. Understanding the family system can help communicate the family’s and patient's common goals.
What should providers know about Buddhism to better serve patients of that faith tradition?
Like other faith traditions, there are many expressions of Buddhism. The practice of meditation works with the mind and is actually a preparation for death, much like the worship of God prepares Christians for salvation. A Buddhist patient's readiness to talk about death might be misinterpreted as depression when the patient has spent time in this preparation.
If devout, the patient might ask to stay in the hospital three days after death, which is not usually possible. Negotiating to have end of life care at home, to die in a manner appropriate for this ritual, would be helpful.
Some Buddhists are vegetarian and abstain from the use of alcohol, and others eat meat and imbibe.
Buddhists are either Monastic, the Asian laity (non-monastic), or meditators who own homes (the latter is typical in the West). The laity might not know what they believe but may participate in holidays, and may or may not meditate.
What are some ways providers can uniquely care for patients practicing Buddhism?
The patient may wish to have possible meditation times during the day, perhaps half-hour periods where there are no planned tests or visits.
The patient may wish to have a Buddhist monk perform a ceremony such as "Medicine Buddha" at a local temple.
It is customary for people to sit in meditation on behalf of a person dying. They may sit on the floor or cushions. If someone doesn't know this, it could look like a protest or sit-in, but allowing space is quite generous and inclusive.
It is a custom in parts of China to die in your street clothes, for these are the clothes worn in the afterlife.
When a patient is dying, they might want absolute silence or chanting. They might not wish to have a person cry in the room because of the belief that it might distract the patient from his realization and an unwanted reincarnation might occur.
What are the most fundamental aspects of Buddhism?
The Four Noble Truths:
We are all suffering.
We suffer because we grow attached to ideas, objects, people and self-identities.
The way to avoid suffering is to look at and remove the hold on attachments.
The way to live in such a way to avoid attachments is the eight-fold path: Right Understanding, Right Thought, Right Speech, Right Action, Right Livelihood, Right Effort, Right Mindfulness and Right Concentration.
A unique aspect of Buddhism is that God is not spoken of or worshipped in ritual.
What are some of the religious traditions, rituals and holidays?
Bodhi Day (1/20/21): a day of remembrance and meditation
Shambhala Day (2/12/21): day of renewal where shrines are cleaned
Chinese New Year (2/12/21): an Asian celebration with lights
Magha Puja Day (2/26/21): Commemorates the date when the four disciples traveled to join the Buddha
Wesak or Buddha Day (4/8/21): Celebrates the Buddha's birth, usually in a festival
Hospital chaplains are available and willing to provide support. Check in with your clinical site to learn more about their compassionate care services.
The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
Nikki Livingston is a Marketing and Communications Coordinator for Faculty Affairs, Professional Development, and Diversity. She earned a B.A. in Theatre Arts and Drama at Spelman College.
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