Death is an inevitable part of life. We will all have to face our own death at some point, and almost all of us will have the unfortunate experience of losing someone close to us. Death is one of the few “definites” in our lives. However, it is a subject that often gets avoided, on both the personal and the professional level. The subject of death is pertinent to mental health and medical professionals, yet it has been largely ignored in the literature (Wass, 2004). The avoidance of the subject may help facilitate the idea that it is not an important discussion to have. As professionals in this field, we have an obligation to patients who are facing death or grieving the death of a loved one to be comfortable talking about death. It is especially important to be open to discussing death within the context of an individual’s culture. Being open to learning about cultural beliefs surrounding death as well as maintaining an open, nonjudgmental stance regarding these beliefs may be of utmost importance to patients dealing with death in some way. Assuming that our patients’ beliefs are similar to ours limits our abilities to have these discussions.
This discussion will examine the death practices and beliefs of two cultures: Aboriginal Australians and Native Americans. This is not meant to be an exhaustive discussion covering these cultural traditions in full; rather, examples will be given to demonstrate the diversity of beliefs surrounding death. Beliefs and practices discussed are also not intended to be generalized to all members of these cultural groups, as individuals often have deeply personal beliefs about death that may differ significantly from the overarching cultural traditions.
Native American communities have specific beliefs surrounding death that differ from Western traditions. In some Navajo cultures, for example, four days are dedicated to preparing a body for burial, a time during which the family is given space to mourn the dead by disposing of the deceased’s belongings, among other practices (Celements, Vigil, Manno, & Wilks, 2003). In Sioux cultures, a hatchet is often buried along with the body, a practice believed to protect the dead from demons (Cacciatore, 2009). Often, these rituals are important to the grieving community and family members, allowing them to live sacred lives by respecting the dead or dying individual (Ramirez, 1999). If not allowed the opportunity to practice these important traditions, there is a valuable aspect of both the dying and the grieving processes that goes missing.
In rural Alaska, there has been a shift in location of where Alaskan Native Americans die. While traditionally, dying at home has been an important practice for individuals in these communities, more and more are dying in hospitals, often following stays in nursing homes (DeCourtney, Jones, Merriman, Heavener, & Branch, 2003). The displacement of being moved away from home is likely disruptive to everyone involved. The practical difficulties of needing to travel to get to the hospital as well as being unable to follow traditions complicate the emotional difficulties inherent to dealing with the death of a loved one. Feeling separated from one’s community and land may also conflict with one’s own already difficult prospect of facing death.
Aboriginal Australians have a strong preference for dying at home rather than in a hospital. Within this culture, there is a belief that there is a tie between one’s spirit and his or her homeland, and the desire to maintain this relationship in death is strong. Away from home, there is a disconnect between the soul and the land, causing a sense of rupture in a time when the connection is most important. There is also a tradition in the Aboriginal Australian culture of imparting sacred knowledge to another person when close to death. Being in an unfamiliar space during this time (e.g., a hospital) does not provide a comfortable environment in which to pass this information on (McGrath, 2007).
Aboriginal Australians have many cultural practices surrounding death that often get overlooked (or perhaps even forbidden) in hospitals. Intricate funeral rites are traditional in many Aboriginal societies (Sansom, 1980), and may not be feasible in hospitals. There is also a cultural taboo on referring to the deceased person by name (Weeramanthri, 1998), a practice that may get ignored in a hospital. Although disregarding these cultural beliefs by hospital staff may not be malicious or intentional, ignoring the importance of these practices limits (and likely impairs) the family’s ability to grieve.
Regardless of one’s culture, death involves grief. However, grief may be exacerbated when one’s death does not occur within the framework of the culture. When an Aboriginal Australian individual dies in a hospital, for example, the family is affected both by the loss of a family member and by the unfamiliarity of the bureaucracy of the hospital procedures (Benoliel & Degner, 1995; Weeramanthri, 1998). Similarly, when Native Americans are moved from the familiarity of their homes to the unfamiliar surroundings of hospitals and nursing homes, both the dying individual and the family have the added stress of being unable to practice traditions acceptably (DeCourtney, 2003). There may be a sense of a loss of control over how the death is handled, and ultimately, there may be unresolved grief that may have been resolved had the death process been allowed to proceed within the context of the culture. The personal meanings of death for each family member get lost within the Western approach to death that is customary in Australian hospitals (Baydala, Hamptom, Kinunwa, Kinunwa, & Kinunwa Sr., 2006) and hospitals in the United States.
References
Baydala, A., Hamptom, M., Kinunwa, L., Kinunwa, G., Kinunwa Sr., L. (2006). Death, dying, grieving, and end of life care: Understanding personal meanings of aboriginal friends. The Humanistic Psychologist, 34(2), 159-176.
Benoliel, J. Q., & Degner, L. F. (1995). Institutional dying: A convergence of cultural values, technology, and social organization. In H. Wass & R. A. Neimeyer (Eds.), Dying: Facing the facts (117-141). Washington, DC: Taylor & Francis.
Cacciatore, J. (2009). Appropriate bereavement practice after the death of a Native American child. Families in Society: The Journal of Contemporary Social Services, 90(1), 46-50.
Celements, P, Virgil, G., Manno, M., & Wilks, J. (2003). Cultural perspectives of death, grief, and bereavement. Journal of Psychosocial Nursing and Mental Health Services, 41(7), 18-26.
DeCourtney, C. A., Jones, K., Merriman, M. P., Heavener, N., & Branch, P. K. (2003). Establishing a culturally sensitive palliative care program in rural Alaska Native American communities. Journal of Palliative Medicine, 6(3), 501-510.
McGrath, P. (2007). ‘I don’t want to be in that big city; this is my country here’: Research findings on Aboriginal peoples’ preference to die at home. Australian Journal of Rural Health, 15, 264-268.
Ramirez, R. K. (1999). Healing through grief: Urban Indians reimagining culture and community. American Indian Culture and Research Journal, 22(3), 305-333.
Sansom, B. (1980). The camp at Wallaby Cross: Aboriginal fringe dwellers in Darwin. Canberra: Australian Government Publishing Service.
Wass, H. (2004). A perspective on the current state of death education. Death Studies, 28, 289-308.
Weeramanthri, T. (1998). Practical guidelines for health professionals dealing with death in the northern territory Aboriginal Australian population. Mortality, 3(2), 161-172.
