A Quaker Approach to Living with Dying

Photo © Martin Kelley.

I’ve been present with hundreds of people as they’ve died, hundreds more who were already dead by the time I was paged, and hundreds more who were in their dying process. I’ve accompanied spouses, parents, children, friends and family members as they’ve experienced the horror and sorrow of grief. For the past 20 years, I’ve been a chaplain, mostly in hospitals, a few with hospice. In doing this work, I’ve crossed death’s path more often than I can count as I’ve zigzagged my way through the hospital corridors and in the homes of folks experiencing the last days, weeks, months of life. Those of us on the interdisciplinary healthcare team struggle, as best we can, to provide our dying patients with a “good death,” however they and their families define such. There’s a saying in healthcare, “People die as they have lived.” Sometimes that is not the case, but, more often than not, that’s the way it goes.

Often, Quakerism is defined as a way of life. Some questions that I have carried for years in the ministry of chaplaincy include the following:

  • What does our Quaker faith and spirituality offer us as we face decline, diminishment, and death?
  • What can we say, as Quakers, with regard to dying and death as a personal and spiritual experience?
  • Is there a Quaker way of dying? How do we, as Quakers, do this?

My formative experience with regard to the Quaker way of dying was by accompanying a Friend through her decline and death. Her final illness, dying process, and death were Quaker community and meeting experiences. Her experience wasn’t a private or family‐only affair. When she couldn’t come to meeting, small groups of Friends were dispatched to her home, hospital, or nursing facility to have meeting for worship with her. Friends from meeting stayed with her overnight in the hospital when she had to be on the breathing machine and was so uncomfortable and scared. She had a committee of trusted Friends who arranged for her practical needs when she was still able to live independently, including staying with her 24/7 when just home from the hospital and at times of extreme debility. These Friends helped with discernment regarding transition from independent living to a skilled nursing facility. In what turned out to be her final hospitalization, these Friends helped her discern her choice to decline heroic life‐sustaining treatment and allow herself a natural death. Friends reflected with her about her desire for integrity and living in alignment with the testimonies, her beliefs about an afterlife. She was afforded the opportunity, though her Quaker way of living, to proceed to a Quaker way of dying. One First Day, as we knew death was approaching, our meeting of about 80 Friends decided to meet in a hospital conference room for worship. About halfway into the worship hour, a Friend came downstairs to announce our Friend’s death. It was a gathered meeting. Our Friend died the way she had lived.

Last year, desiring conversation on these questions, I facilitated an interest group I called “The Quaker Art of Dying” at the Pacific Northwest Quaker Women’s Theology Conference. The conference brings women together from the divergent Friends traditions in the Pacific Northwest, primarily from Canadian, North Pacific, and Northwest Yearly Meetings, as well as other independent meetings and churches, to articulate our faith and to learn from each other. The group was well attended and diverse. I presented three queries to the group for discussion. We broke into small groups each taking one of the queries, then reconvened into the large group to get the bigger picture.

What is a Quaker approach to declining health, dying, and death?

Friends reported their understanding that all life is sacred and Spirit informs all life. A Quaker approach would be a mindful, conscious, and prepared approach, with an excitement—or at least a willingness—to enter the mystery of death. It was agreed that a Quaker approach would involve less denial that someone is dying or that death is imminent. There is a value for listening, hearing one another’s experiences, and entering new situations with curiosity, not offering answers. Especially for Liberal Friends, but for some Evangelical Friends as well, there was less focus on an afterlife. A Quaker approach would be a well‐ordered approach, with orderly records, legal documents, and final letters and lists of wishes. Friends agreed that cremation was customary and in alignment with Quaker values. The writing of a memorial minute was another Quaker tradition to document the passing of a Quaker life. As one Friend stated, “The Quaker approach is portable; you can take the heart of the Quaker way wherever it needs to go.”

How do our beliefs, testimonies, and values inform our approach to the end of life?

Friends agreed in their understandings that we have a direct connection with the Divine. Some Friends voiced a lack of fear about death. Others voiced fears about the decline of physical and cognitive abilities and the actual process of dying, such as the possibility of pain, loss of competence, being a curmudgeon, or depleting family resources. One Friend likened the burdens of dying to birthing: “Both are hard work.” Friends agreed that upholding the dying person in community benefits the community as well as dying person. Friends voiced an intention to allow support and presence of others as we approach the end of life, as well as taking all the alone time we need.

How can we prepare for death? Our own and that of our loved ones? A list emerged.

We need to:

  • Pray.
  • Think about what we want.
  • Talk about what we want, even though it is difficult, especially with our children.
  • Talk about what others want.
  • Talk with our families about our wishes.
  • Pray some more.
  • Deal with unfinished business—either finishing it or leaving it unfinished, but dealing with it intentionally.
  • Educate ourselves about health decline and the dying process by reading books like Atul Gawande’s Being Mortal.
  • Talk with our spouses or significant others, about things we’ll need to know if they can’t tell us themselves for whatever reason.
  • Prepare for the process:
    • Who do we want involved? Who do we not want involved? Do we want a care committee or not?
    • How do we want our remains disposed? Do we prefer cremation or burial? If we want to be cremated, do we want our remains to be scattered, interred, or buried?
    • What do we want for a memorial or funeral?
    • Do we want an obituary; a eulogy? What would we want said in our memorial minute?
  • We need to help meetings and churches be prepared for the decline, debility and deaths of their members and attenders.
  • Keep praying.

This conversation continues. In a recent meeting of our Quaker women’s discussion group, I facilitated a robust discussion about a Quaker approach to end‐of‐life issues and posed similar queries to the group. Evangelical Friends spoke of the “continuum of life” that transcends death, the need for “being right with God,” and the peace that “being with Jesus” will bring. Liberal Friends spoke of “entering the mystery” and “going into the Light.” There seemed to be agreement and assurance that “all will be well” at the end of physical life. Some women focused on the need to enter this time of life with their “affairs in order.” Other women spoke of their experiences accompanying a dying person in their meeting or church or in their own families. All seemed to enjoy the discussion of “things we don’t usually get to talk about” and voiced an intention to encourage further discussion in our churches and meetings. Later this month, I will attend my own meeting’s retreat where the topic will be “Spirituality As We Age.” No doubt, we will be continuing the discussion of how we Quakers intend to die as we have lived.

Katherine Jaramillo is a staff chaplain at Legacy Good Samaritan Medical Center in Portland, Ore. She has worked in healthcare chaplaincy for 20 years. She is a member of Bridge City Meeting in Portland.

Posted in: Online Features, The Art of Dying

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9 thoughts on “A Quaker Approach to Living with Dying

  1. Karen Modell says:

    Nicely put Friend Kate. Complaining each other on the final journey is one of the most important actions we take together as Friends.

  2. Gwendolyn Giffen says:

    City & State
    Bellaire, Ohio
    I also have seen many, many people die, but from the other side of the bed. For the past 20 years, I have worked as a registered nurse. I grew up a Quaker, and my mother was a recorded Quaker minister. This past autumn, she slowly declined after breast cancer cells that were resistant to chemotherapy, took off through her body like a drug resistant organism, and took over her liver and bones. In December, she died with with her husband and I at her side. For 20 years, I have worked with the other nurses and aids who turn, reposition, clean, medicate, and attend to the bodily needs of the dying. Those caregivers suffer spiritually, and immensely. They usually do not have the freedom or energy to attend church, and they become very disillusioned with many forms of religion. As I helped my own mother go through the dying process, I felt frustrated with the lack of integration between those attending to her spiritual needs, and those attending to her physical needs. She was a very involved person. So there was a bit of overkill from the spiritual community, while my niece and I, and sometimes my brother and two aunts for short periods of time, attended to her physical needs, in an intense and demanding sharing of shift‐work between just a few people. Hospice gave us a couple of hours a week of reprieve, but they were not by far the backbone of her direct care. I truly became quietly sick and disgusted with all of the ministers and friends coming to pray with her by the end. I smiled at everyone, hugged people, but inside, the frustration with it was building.This feeling may have been misplaced and misguided, but I’ve had months now to think about it. We all have different roles in caregiving. We really do. I’ve only brought myself to go to my Friends meeting twice since she died, and it has been fulfilling when I went. But I can’t deal with the belly‐fuzz picking, and I probably will not be able to for a very long time, if ever. I suppose that it is important for the people going through it, to dwelll and discuss personal issues. Direct caregivers only really have each other, and on‐the‐fly, in reality. I truly wish I could pick my own belly fuzz, but there isn’t time, and I don’t have the patience. There is just too much to do, and not enough people doing it. I’d like for everyone to receive the care my mother received, at home, as she died. But I know that most Quakers will not be able to do that. I know that my own family will not. I know that a minister might give me a little comfort, but when I am dying, please, plenty of pillows, and keep me clean and dry. And buy me frozen mocha latte’s at McDonalds every day.

    1. monanne says:

      City & State
      Wheatridge, CO
      Gwendolyn, what a beautiful and truthful response. Condolences on the death of your mother. I am not a Quaker, though through the death of my husband (along with some other serious subsequent family struggles), I, too, have felt both disillusioned and forgotten by many in the faith community. Caregiving is immensely hard work, and while we all know it’s wise to take care of ourselves in the midst of it, it’s not often realistic, especially if the workload is shared between so few people or borne by only one person. The same can be said when caring for a loved one in non‐death‐related crisis; many wish to step in for spiritual needs but not the very real physical needs (for both the patient and the caregiver). It seems to me to be like saying “Be warm and be filled” but not actually warming or filling someone who needs it. Perhaps this is something to be discussed and planned for ahead of time, along with other issues of death preparation. It’s an important topic. Thank for starting the conversation.

    2. Louise says:

      City & State
      Fairfield, Ia
      GG, thanks for sharing your experiences!

    3. Sharon Mitchell RN says:

      City & State
      Ontario Canada
      I do not see this as a strictly Quaker way of life/death. Everyone should be treated with the kind of care and dignity you provide here .As an evangelical Christian ‚and an “old” RN, I would hope I could provide that for those I know.
      Not everyone is receptive to what they see as an invasion of their privacy.….
      and great nursing care is not always the norm.…..God bless Ms Giffen and those like her.

    4. Aaron Freeman says:

      City & State
      New Haven
      Remember the Sabbath, to keep it holy.
      “Belly Fuzz Picking,” is to companion others, as they recover the strength they have spent, for this goes a long way in recovering our own.
      That your mother has brought you through this experience, is a ministry gto benefit her strengths.

  3. Barbs says:

    City & State
    Wellington, Nrew Zealand
    Hope you get what you want and need, Gwendolyn. Same for all of us. Good post. Thank you.

  4. City & State
    Shelby Twp.
    The greatest gift:another human being allowing you to administer to them in their dying. Feels like one foot in heaven and your heart is full.

  5. Penn says:

    City & State
    How do Quakers feel about green burial instead of cremation?

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