Post-Death Care and Cultural Sensitivity

The time of death is often heavily invested with cultural and religious ritual (Koeing 1997).
Such rituals frequently give rise to cross-cultural misunderstandings or frank conflict with standard hospital procedures. For example, in some cultures only same-sex workers should touch the body (Hallenbeck 1996; Hallenbeck 1999).
When dealing with a family from an unfamiliar ethnic group or religion, the clinician should inquire, ideally in advance, if any special accommodations need to be made for cultural or religious reasons (Hallenbeck 2002).
If not done previously, the clinician should ask if the family wishes to speak with a chaplain or other spiritual advisor.
When in doubt, seek assistance from someone familiar with that culture or religion (Pickett 1993; Lo 2002).
A tool developed by Pulchalski for addressing spirituality in patients or families is presented in the table below (Puchalski 2002).

Performing a Spiritual Assessment of Patient or Family
Faith	“Do you consider yourself a spiritual or religious person?” “What do you believe in that gives you meaning?”
Importance andInfluence	“How important is your faith (or religion/spirituality) to you?”
Community	“Are you part of a religious or spiritual community?”
Address or Application	“How can we help or be of assistance to you in the practice of your faith at this time?”
Adapted from Puchalski CM. Spirituality and end-of-life care: a time for listening and caring. J Palliat Med. 2002;5:289-294.

In Mr. Stanton’s situation, a history of religious disagreement among members of his family caused him and his daughter guilt, anxiety, and anger.

Palliative Care