Death is inevitable. Death is something everyone must deal with at some point in their life. However, there are cultural differences when it comes to death and dying. Although death is universal, it is important for nurses to understand the cultural differences when it comes to death and dying because people have different ways of coping with death according to their cultural customs and traditions. Culture plays an important role in healthcare.
According to Potter & Perry (2014), culture is described as “shared patterns of learned values and behaviors that are transmitted over time and that distinguish the members of one group from another” (p. 110). There are many similarities when it comes to death, such as the color black being viewed as a symbol of mourning and often worn at funerals. However, it is important to understand the differences in some cultures, such as having white as the color that symbolizes mourning and worn at funerals. It is important for nurses to understand culture sensitivity when caring for patients.
As nurses strive to provide culturally sensitive care, they must recognize how the clients’ and their perceptions are similar as well as different” (College of Nurses of Ontario, 2009, p. 3). There are also different ways cultures cope with death, such as mourning and celebrating. For instance, in some cultures death is often mourned at funerals, while some may celebrate the life of the deceased. The Chinese culture has a unique way of coping with death and dying. They have different beliefs when it comes to death, such as having strong connections with their ancestors and conserving life.
Their beliefs on death are influenced by their ancestor worship, traditions, and spirituality. I will discuss the Chinese cultures customs and traditions on death and dying. The three religions the Chinese culture follow are Taoism, Confucianism, and Buddhism. Taoism is based on philosophy and Buddhism follows spirituality. (Hsu, O’Connor, & Lee, 2009, p. 154). I will be focusing mainly on the Taoism religion and their beliefs on death and dying as well as the Buddhism rituals. The Chinese culture have a very strong connection with their ancestors.
In fact, many of their beliefs and traditions regarding death are linked to ancestor worship. Ancestor worship affects both the living and deceased because a strong bond with their ancestors is believed to bring connections from generation to generation. They believe that once a family member passes away they continue to exist, and thus, ancestor worship is important to ensure the deceased continues to take care of the family and bring good fortune. Festivals are often held every year to offer the deceased. Death is considered a taboo in the Chinese culture because it is believed to be bad luck.
The Chinese believe in conserving life and thus, talking about death is restricted, even when someone is dying. The Chinese culture fears death and certain symbols and gifts that represent death are avoided. For instance, the color white symbolize death and a handkerchief or clock as a gift symbolizes death and bad luck. Death is only considered good if a person dies of natural causes and lived a long life (Xu, 2007, p. 412) Because of their strong belief in conserving life, the Chinese often resort to the practice of Traditional Chinese Medicine. TCM is still one of the most popular complementary and alternative for Chinese people” (Hsu, O’Connor, & Lee, 2009, p. 154).
They believe that this practice will help them live longer. Traditional Chinese Medicine is based off the philosophy of Taoism that the mind and spirit are also related to health (Hsu, O’Connor, & Lee, 2009, p. 164). Respect and treatment for the dead must be the same as the living. The Chinese believe once a person dies they still live in another world, and thus must be taken care of on their journey there. Happiness, wealth, and health are important aspects of life in the Chinese culture.
Food, money, and other possessions the deceased liked are often found in their tomb to ensure they are kept happy. They believe if the dead is not kept happy, the entire family will have bad luck and suffer. Status is considered highly important for the Chinese culture because it reflects social status of the deceased and their family. The more people that attends the funeral is often considered better because it represents that the deceased had a good face in society. Death is considered a family matter. Therefore, when a person dies the immediate, extended, and other relationships in life the person had are all involved.
The Chinese do not share their grief and decisions with strangers because they feel their duties will not be fulfilled for the deceased. They focus more on paying respect for the deceased rather than showing grief. It is important for the family members to make decisions for the dying person, specifically the oldest son or husband. Dying in the home is traditionally considered the most holy place to die because the Chinese believe it is the best place for bonding with the deceased and ancestors in order for the deceased to rest peacefully (Hsu, O’Connor, & Lee, 2009, p. 168).
These practices, beliefs, and ancestor worship all influence the Chinese cultures traditions on death and dying. Ethnocentrism and stereotyping can negatively impact the nurse-client relationship, and this can create a barrier. According to Potter & Perry (2014), ethnocentrism is defined as “members of ethnic groups that display a tendency to view their own way of life as more valuable than others” (p. 111). Ethnocentrism can become a cultural conflict if a nurse does not understand the cultural differences and resorts to using their own values and beliefs when caring for a patient.
It is important for nurses to be aware of cultural sensitivity and accommodations towards other cultures because there can be a cultural conflict between the nurse and client. For instance, a Chinese client may have their own way of taking medicine, such as Traditional Chinese Medication practice, but the nurse may follow their own way of giving that patient a specific medication because they are unaware of the cultural differences. The nurse may follow his/her own belief and give western medicine because of what they were taught, and thus, ignore the fact that it may be a traditional practice for that client.
According to Potter & Perry (2014), Stereotyping is defined as “generalizations about any particular group that prevent further assessment of unique characteristics” (p. 111). Stereotyping can happen if a nurse fails to view each patient as an individual and judges them based on their ethnicity. As a result, the nurse ends up using discrimination and racism with clients. An example of stereotyping would be the nurse categorizing Chinese clients as always having too many visitors. For instance, a nurse may have a Chinese client to care for and automatically assume they will have many visitors coming in to care for the client.
The nurse may not be aware of the importance of family role in the Chinese culture when it comes to a dying person. The family also makes decisions for the dying person in the Chinese culture, so it would be important to avoid ethnocentrism and stereotyping when it comes to this. I would address these challenges of ethnocentrism and stereotyping by being culturally competent. It would be important for me to be culturally competent to avoid ethnocentrism and stereotyping for my clients. I would use self-reflection to identify values and beliefs of clients.
I would also use cultural assessment to understand different cultures and gain knowledge about their values and beliefs. If I was caring for a Chinese patient, I could use these techniques to understand their cultural beliefs and values. For instance, if a Chinese client refuses to take a medicine I would be aware of their cultural beliefs on Traditional Chinese Medication and understand that they think it works better than Western medicine. I would understand that the client will either not take the medicine or cut the dose in half because of their belief.
I would teach the client about the medication and explain in details, such as the doses and why it is important for them to take it. In addition, I would allow family to visit the client with extended hours, but also ensure they know the visiting policies and limitations. I would involve family when it comes to making decisions about their loved one to respect their family customs when it comes to decisions about the dying or deceased. I would ask if they have a decision maker in the family. These skills would help me in caring for a Chinese patient and other diverse cultures to avoid ethnocentrism and stereotyping.
My own perceptions would influence how | support my client because I have my own values and beliefs in my culture. My culture has its own beliefs in regards to death and dying so it would influence how I would support my clients on death and dying. The Hindu culture has many differences compared to the Chinese culture, so I would have to be aware of the cultural differences. For instance, in my culture spirituality is very important when it comes to a dying person. We believe in praying in the hospital for the person because it would help them.
In addition, we also believe in reincarnation and karma when it comes to death. If a person does not die of natural causes and has a tragic death it is usually believed to be because of something in their past life. Supporting a client from a Chinese culture who has many visitors would be influenced by my own beliefs on family because we also have many visitors coming in when a family member is in the hospital. My perceptions would change when I become a nurse because I would understand other cultures values and beliefs.
I would be more aware and culturally competent. I would view each patient as an individual and take the time to assess their cultural differences and beliefs. The Chinese cultures beliefs and values are influenced by ancestors, traditions, and spirituality. Their bond with their ancestors, Traditional Chinese Medicine practice, and values about family all influence their cultures view on death and dying. Understanding the bond with ancestors and strong family affair when it comes to a Chinese client would be important when caring for a dying client.
Being aware of the cultural differences on death and dying is important in the healthcare setting because nurses need to understand their clients’ cultural beliefs to have a therapeutic nurse-client relationship. Being culturally competent is also important when it comes to dealing with a dying client because it would help us understand the families’ beliefs as well. Knowledge about Being culturally competent and culturally sensitive would help me as a nurse to better understand Chinese clients and improve care for them. I understand their values and beliefs on death and dying, so in the future I am prepared to care for Chinese clients.
