CARE OF THE DYING

There are large number of increasable diseases like cancer, dementia, motor neuron disease etc., in which both patient and the relatives know well in advance that the death is in the near future. There are many issues that are to be addressed in such a situation ‘Hospice’ is the name of the medical control which provides medical help for these terminally sick persons who are in ‘waiting list’.  There are many discussions amongst the medical professionals on issues such as

Other issues include pain relief, nursing, bladder lowel management etc., to keep the patient as comfortable as possible physically , mentally, emotionally and spiritually.

What is the role of yoga and yogic philosophy in such a situation?
Working at the physical level: simple sukshma vyayamas are performed either supine, sitting or standing postures depending on the capacity of the patients. They help in
1. preventing bed sores 2. improve general muscle tone and prevent muscle wasting. Specific practices to relieve pain, congestion, inflammation etc., in local areas is valuable. They work on the principle of providing deep rest to the part after intense focusing while stretching the part gently. Deep Relaxation Technique (10 min) and Quick Relaxation Technique (3 min) and Instant Relaxation Technique (1 min) may be incorporated in the practices several times.

At the Pranamaya Kosa level: for a person who is terminal it is important to keep his/ her quality of life as good as possible. Pranayama and pranic energisation technique are very useful for pain management. Cleansing breath (Kapalabhati) is very useful to clear the toxins and purify the blood (by washing out CO2) and give to the person inner strength to handle the situation. Kapalahati improves the autonomic nervous system activity to help in coping with the stressfully demanding situation. Nadanusandhana is the mainstay in yogic management if terminal patients.

At Manomaya Kosa level: it is the layer of Mind and emotions. Having known that ‘I am terminal’ different patients react in different ways’ the most common and the most difficult one is the emotion of ‘fear’. The fear of facing the end of ‘me’ and all my ‘belonging’, my desires, wishes. Fear of loosing the entire support system. The next work I had created around me. I have met several patients whom I served, terminal cancer by their self effort; one was ostegenic sarcoma, two cases of multiple mychoma, one secondanies spead allover abdomen, one renal cancer. All these persons told me one thing in common; the most difficult step was to overcome the fear of death. In these cases it took about one week to one month to completely accept death fearlessly.

Mr Tarayama said “I have a few weeks with me. Let me enjoy this precious time with my family and went away to a holiday resort in Fuji Mountains with my wife and children. The miracle happened through my wife who accepted my end first and made me get out of the fear”. The fear leads to depression, frustration, aggravation of pain, repeat progression of disease. We may remember Socrates after he had drunk the poison, who said “I must die, must I Cry?”

A case of motor nervous disease (a disease Stephen Hawkins has), who could not move any of her muscles except the eye lids was brought by her family to Prashanti. Her perception was normal but could not respond as all her muscles were paralyzed. She was explained in clear loving words the concept of five aspects our personality. The real core personality the Anandamaya (bliss) and Vijnanamaya Kosa (knowledge) of our body are imperishable. Disease and death is only for the physical body which is made of the chemical materials that will merge into the dust after death. But the other four bodies i.e., the mind with all our wishes, with all its shakti; Vijnana with all true knowledge and ananda full of bliss survives death (Sukshma sharira) and waits to enter into another physical body to carry on its journey (rebirth). She was also made to practice lot of simple breath awareness and mentally chant Maha Mrityunjaya Mantra by listening to an audio tape with a head phone. Her daughter and husband are even grateful to yoga even today for this knowledge that brought peace and fearless smile on her face before dying. Our sages said that it is very important to die like a warrior, die fearlessly, die with positive thought of devotion and total surrender, and die with a request to him to give a good life for the next birth. The last thought that we have at the time of switching off is the one that fructifies for the next birth. Let us remember a statement made by a Vedanta student to the relative just before the death “why are you all tensed? I am coming back to continue my wish to see HIM. I shell come back in a healthy new young body to achieve my goal  through a better Guru, do not grieve, I am going fearlessly.

Thank you all for everything you have done to me in this life. Sorry if I have hurt you knowingly or unknowingly. I am the imperishable atman, the bright blissful source of this creation. Disease is only for the body which is dying in a few hours from now, and then the breathing becomes difficult, had to go on to a ventilator in the ICU. Which could not help and the end came in the next 24 hours when the heart also stopped.

Thus yoga when practiced by terminal cases can help either to survive or accept death fearlessly and cheerfully. Yoga has an important role in pain management and freedom from distress.

HASTA UTTHANASANA – crossing the arms above the head

Position: Standing

Benefits: This Asana relaxes the shoulders, stretches the muscles of the chest and strengthens the back. It calms and balance the mind.