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Document No 07

2004          Page last updated: 30 July, 2005

Understanding patients needs: a guide to cultural, spiritual and physical needs

Multi-Faith Care

Burton Hospitals NHS Trust

Index

Burton Hospitals NHS Trust

How to use this Guide

This resource is designed to be a quick and easy guide for Hospital Staff needing information about World Faiths in order to facilitate patient care.

Alphabetical:

The Faiths are arranged in alphabetical order.

Index:

At the front there is an index with a cross-reference for help where a Faith has more than one name.

Layout:

Each article on a faith contains a small amount of general information and a box containing details concerning patient care.

Baha'i

Belief in after-life rather than re-incarnation.

They believe there have been various 'manifestation' of God including their founder Bahaullah, Buddha, Jesus and Muhammad.

Seeks to be Universal Religion concerned with moral and social improvement.

Does not have a priesthood.

Bahai people meet together in a 'spiritual assembly'.

Patient Care

There are no unusual needs for a Baha'i patient in hospital. Normal routines and treatments will usually be accepted.

General

May need a translator - they come from very different culture and backgrounds.

Diet

• No special needs.
• Alcohol is not permitted.
• May want to fast - would appreciate food before dawn or after dusk - Special fast from 2 - 21 March.

Care of dying

Patient may ask for prayers to be said by the Spiritual Assembly of Baha'i. This might be arranged by the family.

A special ring may be placed on the patient's finger - please do not remove.

Otherwise routine last offices with the body wrapped in plain cotton or silk.

Cremation is not permitted.

Blood transfusions, Transplants, and post mortems

No religious objections.

Buddhism

No God as creator.

Belief in various gods - all less than Buddha (this depends on the area they come from).

Rebirth - What you do in this life affects the next stage - nirvana (perfection).

Four noble truths:

• Suffering is an integral part of human ,existence.
• Suffering is caused by craving.
• Freedom from sorrow comes from destroying 'unskillful states of mind'.
• The Eight fold Noble Path leads to an end of suffering.

Eight fold path:

• Right views - Complete understanding of the nature of life.
• Right outlook and motives.
• Right speech - no lying gossip or harsh speech. I
• Right conduct - being and doing good as well as not doing evil.
• Right livelihood - earn money in an appropriate way.
• Right effort - Self discipline.
• Right awareness.
• Right contemplation - meditation.

Nirvana - No more rebirth - a state of non-suffering - perfection.

Zen Buddhism - emphasis on meditation rather than study ­enlightenment comes from knowing our true nature.

Patient Care

General

Like peace for meditation. The use of a side room or day room would , be greatly appreciated.

Some will have strict rules of hygiene - wash before meditation and after using the toilet.

Might want to sleep on the floor.

The image of the Buddha, flowers, incense will all bring comfort ­please handle with respect.

Diet

Dietary rules and discipline vary a lot - the patient will usually explain what they want to eat.

Many are vegetarian.

Care of dying

This varies - but they will need time and s pace for meditation ( often considerable time).

Side room is essential - the state of mind at death influences the state of rebirth.

May appreciate a visit from a Buddhist monk or nun - the chaplain

should be able to organise this if the family do not.

May be unhappy with pain relieving drugs because of the need to maintain a clear mind.

They like to maintain a calm acceptance of death.

No special rituals after death.

Cremation is preferred.

Post Mortem and Transplants

Unlikely to be any objections.

Christian

Church of England (Anglican)

I The established Christian Church in England.

Belief in one God expressed as Father, Son, and Holy Spirit.

Christians see Jesus as the revelation of God and the means of reconciliation with Him (salvation).

The sacraments (Holy Communion, Baptism, Anointing) will be important to many Anglicans.

Patient Care

General

Anglicans often want to see and Anglican Priest to receive Holy Communion or Anointing or have prayers said, especially before an operation or when seriously ill.

Gideon Bibles should be available on the Ward.

Patients or relatives may want to pray in the chapel or ask the times of I services.

Diet

Some Christians may ask not to eat meat on Fridays.

Care of dying

Ask patient or relative if they would like the chaplain to visit to say prayers and/or to anoint the patient.

If a baby is in danger offer baptism.

Post Mortem and Transplants

No religious objections.

Some of the main free churches are:

Methodist United Reformed Church

Moravian Baptist

Church of Scotland Salvation Army

Pentecostal Assembly of God (Elim)

Free Church of England Quakers (Society of Friends)

Brethren (Plymouth) Lutheran

Independent Churches with their own unique style of government:

Belief in one God expressed as Father, Son and Holy Spirit.

Christians see Jesus as the revelation of God and the means reconciliation with Him (salvation).

Patient Care

General

Free Church patients will welcome prayers and depending on their tradition may expect sacramental' ministry, in particular Holy Communion.

Patients or relatives may want to pray in Chapel or ask the times of

Services.

They want their own Minister or may be content with the ministry of the Hospital Chaplain.

Diet

Some Christians may ask not to eat meat on Fridays.

Care of dying

Depending on their tradition a special ministry may be expected - ask the patient relative.

If a baby is in danger of death offer baptism or a blessing - many will choose blessing rather than baptism.

Post Mortem and Transplants

No religious objections.

Worldwide Christian Church under the leadership of the Pope

Belief in one God expressed as Father, Son and Holy Spirit.

Christians see Jesus as the revelation of God and the means of reconciliation with Him (salvation).

The sacraments (Holy Communion, Baptism, Anointing) will be important to Roman Catholics.

Patient Care

General:

Confession, Anointing of the Sick, Holy Communion and Last Rites are very important.

The patient will want to see a Roman Catholic Priest in the event of serious illness or death.

Patients or relatives may want to pray in the Chapel or ask the times of Mass.

Diet

Some Catholics may ask not to eat meat on Fridays.

Care of dying

Very important to ask patient or relative if they would like the Roman

Catholic Chaplain to visit and administer Last Rites.

If a baby is in danger offer baptism.

Post Mortem and Transplants . No religious objections.

Christian Science

Aims to commemorate the word and works of Jesus, and reinstate primitive Christianity and its lost element of healing.

Reliance on prayer for the healing of sickness and disease. . However they can choose to rely on conventional medical treatment.

Patient Care

General

May ask that drugs/therapy are kept to a minimum.

If in hospital voluntarily the will probably accept normal treatment. If in because of an accident they may wish t6 have no medical treatment. . The patient may ask to see a Christian Science Practitioner - contact the Chaplain's Office.

Would appreciate privacy to study the Bible, the Christian Science textbook and Christian Science literature.

Diet

No particular requirements.

They refrain from drinking and smoking.

Post Mortems and Transplants

Will only agree to a Post Mortem if required by Law. . Would not normally donate nor accept an organ.

Hinduism

Hindu believe there is one Supreme Being - Bhagban. There are many named families of gods each seen as representing a particular aspect of the Supreme Being. Three sub-supreme gods: Brahma, the creator, Vishnu the preserver and Shiva the destroyer and regenerator. They have families who appear in different forms and times.

Every Hindu should pray, revere the old and 0ffer generous hospitality to any visitor

Belief in reincarnation in which the status, condition and caste of each life is determined by the behaviour in the last life, making each person responsible for who he is and what they do.

The caste system is illegal in India but the system does have a very strong hold.

A copy of the Bhagavad Gita, if not on the ward, can be obtained from the Chaplain's Office.

The priest may tie a thread around the neck or wrist of the dying person, to bless him or her.

The priest may also sprinkle blessed water from the Ganges over the dying person or place a sacred tulsi leaf in his or her mouth.

Naming System

First name

+lal (male) Oevi (female)

+

Subcaste Name (or family name)

The first name and lal/Oevi are used together and might be written as one word e.g. Arima Oevi or Arimadevi.

Patient Care

General

Hindu women are often reluctant to undress for examination. Total privacy is essential.

Most Hindus require time for meditation and prayer. ,

Idols or pictures of gods may be kept under the pillow or by the bed.

Washing is an important part of Hindu life.

Avoid using the left hand where possible.

Patient might want to lie on the floor - close the Mother Earth.

Diet

Hindus will not eat beef.

Many Hindus are strict vegetarians.

Some Hindus avoid tea and coffee and alcohol. . Some Hindus may fast regularly each week.

Care of dying

May receive comfort from the hymns and reading from the Bhagavad Gita, which family/relatives read.

Consult family before touching the body.

Do not remove sacred threads or jewellery.

Post Mortem and Transplants

Post Mortem only allowed if legal necessity. . I No religious objections to transplants.

Humanism

A way of living life to the full without belief in God or an after life.

Humanists are 'cautiously optimistic' and believe people can understand each other, and that problems can be solved by people working together.

Freedom of choice is very important which may have a bearing on those who discuss their case with the patient.

All people deserve equal treatment whatever sex, race, age, sexuality.

Patient Care

General

No special needs.

Diet

I Nothing special.

Care of dying

No particular last rites.

An officiant from the humanist association can carry out a non-religious funeral - contact the chaplains office for details.

A non-religious funeral is available to anybody who wants one.

Post Mortem and Transplants

No objections to either.

May be keen to provide transplant.

Jehovah' s Witness

Christ is created - the perfect man, god in a 'secondary sense' - (their words).

Meet together in a 'Kingdom Hall'.

Each has to work out their own salvation. '

No paid ministry but their ministers carry a card of identification.

The Hospital Liaison Officer is very willing to help with information and advice.

Patient Care

General

Strongly held belief that taking blood into their body is wrong ­ especially blood transfusion.

If there are problems with medical treatment, whether adult or child, in the first instance contact

Diet

Reject food containing blood e.g. black pudding.

Care of dying

No special rituals.

Post Mortems and Transplants

Individual choice. Many will prefer not to have a Post Mortem.

Jewish

Believe in one spiritual God who cannot be represented in any shape form.

The land of Israel is considered a Jewish homeland.

Orthodox Jews - follow a traditional interpretation.

Progressive - seek a modern Jewish interpretation of the ancient laws Judaism has always believed in life after death.

Patient Care

General

The Sabbath begins at sunset on Friday and lasts until sunset (Saturday. Work is prohibited. The patient or relative should be consulted as to what that person can or cannot do.

Diet

Many Jews will ask for 'Kosher' food. If not available a vegetarian diet is often acceptable.

Care of dying

A dying person should not be left alone.

Families may wish to sit with their relatives during the last days hours.

If a patient or his/her relatives wish to see Rabbi, then the patient's own Rabbi should be the first to be called.

Once death is established the son or nearest relative (if present) me wish to close the eyes and mouth.

Post Mortem and Transplants

Post Mortem only permitted if legally required. . No religious objection to transplant.

Mormon

or more correctly: The Church of Jesus Christ of Latter-day Saints

A 'sect' - they are not part of mainstream Christian Faith Groups

They see God the Father and Jesus as physical persons and also that all human beings can reach the status of godhead.

Celestial marriage - binds together husband. and wife, parents and children for all eternity.

Baptism of or the dead - the living may be baptised on behalf of their dead relatives, in order in order to gain their salvation.

Don't have 'clergy' as such. Religious services are conducted by male member of the 'ward'. A ward is a mormon church and will have a Bishop to lead it.

Patient Care

General

Very health conscious.

They may ay be wearing sacred undergarment - which must be treated with respect. '

Diet

Do not take stimulants including tea and coffee. . Would appreciate milk and fruit juice.

Care of dying

No particular ceremonies.

Would appreciate contact with members of the church.

A Bishop may attend to minister to the person.

At death the sacred undergarment must be replaced after the washing is complete.

Post Mortem and Transplants

No religious objections to transplants.

Muslim

Allegiance to God (Allah) and to his prophet Mohammed.

Times of prayer - dawn, noon, mid-afternoon, after sunset, before retiring.

Friday is holy day of prayer for Muslim. ­

Muslims pray facing Mecca which is South East.

During the time of Ramadan it is incumbent that all Muslims fast, but ill patients are exempt from this. Food should be available for any patient before dawn and after sunset. .

Naming system

A wife is likely to be named like this:

- First name + Mrs (Begum)

. Or daughter as:

- First name + Miss/Mrs (Bibi)

Or it might be written First Name + Husband or Father's Name

Important: Begum or Bibi are not Surnames.

Patient Care

General

Great importance is attached to cleanliness.

Privacy is appreciated but not essential.

Both male and female Muslims are very modest.

May need a washbasin. Jug of water appreciated.

An offer of the Koran would be appreciated. This must be handled with the greatest respect.

Diet

Muslims choose to eat Halal meat.

Muslims do not eat pork, ham or bacon.

Care of dying ,

The presence of a religious leader is not generally necessary.

At this time relatives may give holy water (lam lam) and verses from the Koran (Qu'ran) maybe requested.

The patient may wish to sit or lie facing' Mecca.

. After death the family should be allowed privacy to express emotion.

The body should not be touched by non-Muslims, however, if this is unavoidable disposable gloves must be worn. The eyes should be closed, limbs straightened and the head tuned towards the right shoulder (this is so the body can be buried with the face towards I Mecca).

Post Mortem and Transplants

Pagan

Not the same as someone who doesn't believe (like 'happy pagan'). A variety of witchcraft/ other movements to revive and spread the 'pagan way' and to protect pagan sacred places and Mother Earth.

Patient Care

General

Might ask for some privacy if friends visit - to worship together.

There isn't one set Pagan faith so the patient will need to be asked how they will be affected in hospital.

The patient may ask that a small candle or figure of their goddess be on their locker.

Their family may not know of their beliefs.

Diet

Vegetarian/ Vegan/ Raw foods.

Care of dying

Patient may ask for prayers to be said by their Spiritual Adviser - they should have the phone number with them.

Like to know they are dying - to prepare for it.

Prefer to die at home.

Post Mortem and Transplants

Up to the individual.

Most Pagans would probably donate for transplant.

Rastafarian

Growing movement which began in the West Indies, mainly in Jamaica and Dominica in the 1930s.

Rastafarians try to follow the Nazarite Vow of Separation, which forbids the cutting of hair, forbids certain foods and also requires the shunning of the dead, emphasising life, not death.

Legal marriage is unnecessary and thus extended families many be complex.

Patient care

General

No part of body hair can be cut, the operation site may be shaved if absolutely necessary.

Rastafarians may be unwilling to wear hospital garments which have been worn by others, therefore, disposable theatre gowns may be preferred.

Blood transfusions may be refused.

Diet

Will not eat pig meat, shellfish or some fish.

Care of dying

Family members may pray at the bedside of the dying person but there are no special rites or rituals.

Post Mortem and Transplants

Both are intensely disliked.

Unlikely to donate for transplant.

Seventh Day Adventist

Like other Christians but:

Use Saturday as the Sabbath day for rest and worship.

Believe in the actual and imminent return of Jesus.

Patient care

General

Their 'Sunday' is from Friday sunset to Saturday sunset.

Diet

Might be vegetarian. They will not want to eat 'unclean food' like pork or shellfish.

They abstain from alcohol and smoking.

Do not drink tea or coffee.

Care of dying

No specific rituals.

The patient or relatives may want their Pastor to call

Burial is usually preferred.

Post Mortem and Transplants

Left to the individual to decide.

Sikh

The founder of the religion was Guru Nanak who was born in 1469.

The "five K's" : worn on the body by 'initiated' Sikhs

1. Kesh - long uncut hair
2. Kanga - small comb
3. Kirpan - sword (usually a miniature)
4. Kara - steel bracelet
5. Kach - shorts

Sikhism teaches that the human body is only a temporary abode for the soul. W hen one dies the soul transfers from one body into another (reincarnation).

There is a tendency for patients to ask for food from home. This is simply to satisfy their taste.

Sikh men will be very offended if required to remove their turban.

Naming system

. First name + Singh (male) + Family Name Kaur (female)

Patient care

General

Female doctors and nurses for female patients when possible.

A patient should not be asked to remove the Kara (steel bracelet) unless vital (eg MRI scan). ­

The shorts/underwear (the Kachhera) 'are kept on while bathing and then removed and replaced in a particular way.

Diet

Most Sikhs are vegetarians but t here a re some that eat meat, but it must be kept separate from vegetables.

They do not eat beef. The cow is treated as sacred, it is given the status of mother, the provider of milk.

Will not eat Halal meat. Chicken, Iamb or pork is preferred.

Care of dying

Family and friend may read from the Psalm of Peace (may say or sing).

No loud lamentation is encouraged. ­

At death do not remove the 5 K's - long hair, comb, bracelet, short, sword.

The deceased is washed and dressed, complete with the five K's and the body taken home so the friends and relatives can view it before the funeral which will be a cremation.

Post Mortem and Transplants

No religious objections.

Zoroastrianism

Belief that the world is a constant battle between the Good God (Ahura Mazda) and the Evil Spirit (Angra Mainyu).

They follow the teachings of Zoroaster.

Aim to live the good life every day.

They believe at death judgment will bring out whether they have lived their ideals - of good outweigh bad they will ascend to heaven, otherwise the soul falls to hell.

Patient care

General

Patient will be wearing a sacred shirt (Sudreh) tied with a sacred cord (Kushti). - These are always worn and treated with respect.

They will prefer running water to wash.

Unlikely to accept blood transfusions.

Diet

They don't fast as this goes against the Food Life and will weaken the body in the fight against evil.

Care of dying

The family will probably supply a special sacred shirt and cord to be worn under a white shroud.

They may want the head covered by hat/scarf.

Accept cremation and burial.

Post Mortem and Transplants

Post Mortem only by Coroner's legal requirement.

The pollution of the body is against the will of God and therefore they will probably neither accept nor donate an organ.

National Contacts

The following addresses may be used to make contact on behalf of a patient. However, in the first instance, ask the patient what their needs are or what they would prefer. If, for any reasons, the patient is unable to answer for themselves, the next contact should be with the next of kin or a close member of family.

Agnostic, Atheist and People of no religion

Chinese
possibly influenced by Buddhism, Taoism or Confucianism

Christian Scientist
It should not be assumed that they have no beliefs. They may be glad of human support and friendship but should be approached with sensitivity.
The Church of Christ Science
108 Palace Gardeos Terrace, London, W8 4RY
Tel: 0207 221 5650

Baha'is
National Spiritual Assembly of the Baha'is of the UK
27 Rutland Gate, London, SW7 1 PO
Tel: 0207 584 2566

The Buddhist Society
53 Eccleston Square, London SW1 Tel: 0207 834 5858
Please refer to the individual patient or the Local Community Unit.

Christadelphians
404 Shaftmaor Lane, Hall Green Birmingham, B28 6328
Tel: 0121 7776328 .

Greek Orthodox
Greek Orthodox Archdiocese and Great Britain and Thyateira
Thyateira House, 5 Craven Hill London W2 3EN
Tel: 02077234787

Hindu
Bharitiya Vidya Bhaven
4a Castledown Road, London W14 9HQ .

or

National Council of Hindu Temples (UK)
26 Hillingdon Avenue, Great Barr Birmingham B43 7HS

or

Ramakrishna Vednanta Centre
Unit House, Blind Lane
Bourne End Bucks SL8 5LG

Humanist
British Humanist Association 14 Lamb's Place, Conduit Pass London WC1 R 4RH
Tel: 0207 430 0908

Jehovah's Witness
Watch Tower House, The Ridgeway London NW7 1 RN
Tel: 0208 906 2211

Jews (Orthodox)
The Office of the Chief Rabbi
Alder House, Tavistock Square London WC1
Tel: 0207 387 5772

Jews (Reformed)
Reform Synagogues of Great Britain 80 East End Road London N3 2SY
Tel: 0208 3494731

Jews (Liberal and Progressive)
Union of, Liberal and Progressive Synagogues
109 Whitfield Street London W1

Mormons
Church of Jesus Christ of Latter-Day Saints Public Affairs Department, Church Offices 751 Warwick Road, Solihull West Midlands 891 3DQ
Tel: 0121 711 2244

Muslim (Ahmadiyya)
London Mosque 16 Gressenhall Road, Putney London SW 18
Tel: 0208 870 8517

Muslim (Shi'ite)
Iranian Embassy, London

Muslim (Sunni)
London Central Mosque 146 Park Road London NW8 7RG

or

Islamic Foundation Marketfield Dawah Centre, Ratby Lane Marketfield, Leicester LE6 ORN
Tel: 01530 244 944

Pagan
Please refer to the individual patient for their own Spiritual Adviser

Rastafarian
Not organised on a national basis. Please refer to the individual patient, your local Race Quality Council or Community Unit.

Russian Orthodox
Russian Orthodox Church
All Saints Ennismore Gardens London SW7 1 N H
Tel: 0207 584 0096

Sikh
Contact the Sikh Temple or Gurdwana in your local telephone directory

or

Sikh Council for Inter-Faith Relations
43 Dorset Road Merton Park London SW19 3EZ

Spiritualist
The Spiritualist Association of Great Britain
33 Belgrave Square London SW1 X 80B
Tel: 02072353351

Vietnamese
possibly influenced by Buddhism, Taoism or Confucianism
Vietnam Refugee National Council 25 Station Road London SE25 5AH
Tel: 0208 771 8960

Zoroastrian
Zoroastrian Association of Europe
88 Compayne Gardens London NW6 3RU
Tel: 0207 328 6018

Health Care Needs of a Multi-Racial Society
Perminder and Gurdev Bal

The World's Religions: Understanding the Living Faiths
Consultant Editor: Or Peter Clarke

The Ethnic Health Handbook - a factfile for Health Care Professionals
Ghada Karmi - Blackwell Science Ltd

The Hutchinson Encyclopaedia - 10th Edition

Dealing with Death, Practices and Procedures
J Green and M Green, Published by Chapman & Hall (1992)

Caring for Dying People of Different Faiths
Julia Neuberger, Published by Usa Sainsbury Foundation (1987)

Death with Dignity - Meeting the Spiritual Needs of Patients in a Multicultural Society
Available from the Nursing Times Book Service, York House, 26 Bourne Road, Colsterworth

Access to Health Care for People form Black and Ethnic Minorities
Edited by Anthony Hopkins and Veena Bahl, published by the Royal College of Physicians of London

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