NURS 750 Week 5 Group PowerPoint Presentation Preparation on Hindu Traditions at the End of Life Example

A Good Death Is a Conscious One: Preparation Paper, Outline and Annotated Bibliography for a Nursing Presentation on Hindu Traditions in Death and Dying

Topic Selection

Last winter, on the oncology unit of our regional medical center, a family asked the nurses not to give their father any more of the medication that was making him drowsy. He was dying of pancreatic cancer, in pain and restless. The nurses believed the family was prolonging his suffering; the family believed the nurses were taking away his last chance to die well. A Hindu chaplain from the community explained to the team that for many Hindus, being awake and aware at the moment of death, able to hear prayers and think of God, matters for the soul's future. With that understanding, the team and family agreed on smaller, more frequent doses that eased his pain while letting him respond to the family's chanting. He died two days later with his sons beside him.

None of the three of us, a neonatal nurse practitioner, an oncology nurse and a hospice nurse in a DNP cohort, had learned about Hindu end-of-life practice in our nursing education. That is common. In a national study of 414 undergraduate nursing students in Ireland, knowledge of Christian, Islamic and Hindu death rituals was low, and most students had learned what they knew outside formal nursing education (Thamanam et al., 2025). Our group therefore chose Hindu traditions in death and dying as the topic of our presentation for professional nurses.

Learning Outcomes

After the presentation, nurses will be able to:

• 1. Explain how the Hindu beliefs of karma, rebirth and liberation shape preferences about awareness, place of death and treatment at the end of life.
• 2. Identify at least five practices Hindu families may wish to perform before and after death and the nursing actions that make room for them.
• 3. Plan a family-centered conversation about goals of care that identifies the family's spokesperson and preferences for disclosure.
• 4. Describe how to balance symptom relief with a patient's or family's wish for awareness at the moment of death.

Hindu Beliefs About Death

Hinduism is not a single creed but a family of traditions sharing core ideas. The soul, the atman, is eternal and passes through a cycle of births and deaths, samsara, shaped by karma, the moral consequences of one's actions. The ultimate goal is moksha, liberation from the cycle. Death is therefore a transition rather than an end, and the state in which a person dies matters. Many Hindus hope to die at home, surrounded by family, with the mind fixed on God, hearing sacred names or verses from the Bhagavad Gita; nursing guidance written for Hindu families describes these hopes and the rituals that serve them (Singh & Freeman, 2011). This explains why a family may resist sedation or prefer that a relative be taken home to die.

The family's role is central. Duty to family, dharma, runs deep, and adult children, particularly sons, are often expected to care for parents and to lead the rites after death. In focus groups with first- and second-generation Asian Indians in the United States, nearly all of them Hindu, participants described traditional expectations of family duty and family decision-making that persisted across generations, along with tension between those expectations and the realities of American life and health care (Sharma et al., 2012). Disclosure varies: some families prefer to receive serious news first and share it with the patient themselves. Clinicians in one Midwestern city named identifying a family spokesperson and ensuring effective interpretation as two of the main communication challenges with seriously ill South Asian patients, and recommended asking about preferences early (Khosla et al., 2017).

Rituals Before and After Death

Before death, families may wish to gather at the bedside, chant prayers or mantras, read from scripture, place a few drops of water from the Ganges River and a leaf of the sacred tulsi plant in the dying person's mouth, and tie a sacred thread or place religious images nearby. Nurses can provide privacy, allow larger family groups and avoid removing threads, beads or marks on the body.

After death, many families wish to wash and dress the body themselves, often with family members of the same sex. Autopsy is usually unwelcome unless required by law, and cremation is preferred, ideally soon after death, so prompt release of the body matters. A period of mourning, commonly about thirteen days, follows. These customs vary by region, community and family, and the nurse's first step is always to ask.

Hindu Patients and Hospital Care in the United States

Research on Hindu patients in American hospitals is limited but growing. At one cancer hospital, adults of Dharmic religions, most of them Hindu, used chaplaincy less often than other patients, and ritual care was the most frequently documented spiritual need; interviews revealed unfamiliarity with chaplains and concern about faith-discordant care (Patel et al., 2025). The same group found that adults of Dharmic religions with cancer had more intensive care at the end of life, including more inpatient deaths and more ICU care in the last month, and that palliative care tended to begin only after heavy acute care use (Patel et al., 2026). Attitudes toward hospice may also be a barrier: in focus groups with 36 South Asian American university students, many opposed hospice once it was explained, citing cultural incompatibility, a desire for normal life and a preference for death at home (Khosla, 2024). On sedation, a scoping study found that Indian religions lack authoritative statements but commonly value consciousness at death for spiritual reasons, while generally accepting palliative sedation as an option (De Weyer et al., 2026). Awareness at death is a spiritual value, not a refusal of comfort, and the nurse's task is to honor both.

The Nurse's Role and a Christian Perspective

The nursing role that runs through these practices is simple to state and hard to do: ask, make room and protect. Ask the dying person and those at the bedside what they hope for in the last days, who speaks for the family and how much they want to know. Make room for family presence, chanting, sacred items and family care of the body, even when unit routines must bend. Protect the patient's comfort and the family's wish for awareness together, by titrating medications in conversation with the family rather than choosing between pain and consciousness. Each of these actions is ordinary nursing care adapted to a family's faith.

For our group, all three of us Christians, this topic raised the question of how to care faithfully for families whose beliefs about death differ from our own. We found an answer in Paul's words that love is patient and kind and does not insist on its own way (English Standard Version Bible, 2001/2016, 1 Corinthians 13:4-5). Respecting a Hindu family's rituals does not require sharing their beliefs about rebirth. It requires the kind of love that serves a neighbor in the way the neighbor needs, which the final slide before the review questions will address.

Presentation Outline

• Slide 1: Title, group members and the opening case
• Slide 2: Learning outcomes
• Slide 3: Why this matters: Hindu patients in American hospitals and gaps in nursing knowledge
• Slide 4: Hinduism as a family of traditions; avoiding stereotypes
• Slide 5: Atman, karma, samsara and moksha (Outcome 1)
• Slide 6: A good death: awareness, place and the presence of family (Outcome 1)
• Slide 7: Family duty, spokespersons and disclosure (Outcome 3)
• Slide 8: Goals of care conversation: a model dialogue (Outcome 3)
• Slide 9: Pain, sedation and the wish for awareness (Outcome 4)
• Slide 10: Practices before death: prayer, chanting, Ganges water, tulsi, threads (Outcome 2)
• Slide 11: Nursing interventions at the bedside (Outcome 2)
• Slide 12: At the moment of death and immediately after (Outcome 2)
• Slide 13: Care of the body, autopsy and cremation timing (Outcome 2)
• Slide 14: Chaplaincy, community priests and faith-concordant support
• Slide 15: Hospice and palliative care: barriers and bridges
• Slide 16: A Christian nurse caring across faiths
• Slide 17: Review questions with answers
• Reference slides

Annotated Bibliography

De Weyer, N., Lambaerts, J., & Broeckaert, B. (2026). Christian and Indian religions on palliative sedation: A scoping study. Annals of Palliative Medicine, 15(3), Article 47. https://doi.org/10.21037/apm-2025-aw-129

De Weyer et al. (2026) mapped the normative views of Christian denominations and of Hinduism, Buddhism and Sikhism on palliative sedation through database and gray literature searches, expert consultation and a comparative grounded theory analysis. Christian traditions generally accept sedation to relieve suffering when intent is clear and it is distinct from euthanasia. Indian religions lack authoritative statements but commonly value consciousness at the moment of death and emphasize prayer and meditation for suffering, while generally accepting sedation as an option. The study's strength is its careful comparison; its limit is that normative texts may not reflect what individual families want. It supports Slide 9 and Outcome 4, giving nurses a reason to discuss sedation openly rather than assume refusal.

Khosla, N. (2024). "It seems like a bad thing": US South Asian youths' perspectives about the use of hospice care. American Journal of Hospice and Palliative Medicine, 41(4), 383-390. https://doi.org/10.1177/10499091231180819

Khosla (2024) held ten focus groups with 36 university students of South Asian heritage to explore knowledge of and attitudes toward hospice. Participants agreed that comfort mattered for incurable illness, but several did not know the terms hospice or palliative care, and once these were explained most opposed hospice, citing a desire for normal life, cultural incompatibility, the hospice environment and a preference for dying at home; some objected even to home hospice and to a stranger in the house. The study is small and limited to students, but it matters because young adults are often decision-makers for older relatives. It will support Slide 15 on hospice barriers and suggest how nurses can frame comfort care in culturally acceptable terms.

Khosla, N., Washington, K. T., Shaunfield, S., & Aslakson, R. (2017). Communication challenges and strategies of U.S. health professionals caring for seriously ill South Asian patients and their families. Journal of Palliative Medicine, 20(6), 611-617. https://doi.org/10.1089/jpm.2016.0167

Khosla et al. (2017) analyzed focus groups and interviews with 57 health professionals, including nurses, physicians, social workers and chaplains, in one Midwestern city. Participants described three challenges with seriously ill South Asian patients: ensuring effective interpretation, identifying a family spokesperson and working across different cultural norms. Their strategies included asking early about patient and family preferences and encouraging early appointment of a spokesperson. The data are from one city and from clinicians rather than families, and the authors caution against stereotyping. The study supplies practical strategies for Slides 7 and 8 and Outcome 3, where nurses practice identifying a spokesperson and asking about disclosure.

Patel, R. V., Bowden, J. M., Boselli, D., Strahley, A. E., Gibbs, S. L., Murali, K. P., Patel, V. R., Kotecha, R. R., & Nelson, J. E. (2025). Utilization and perceptions of chaplaincy among hospitalized adults of Dharmic religions with cancer. Cancer, 131(7), Article e35797. https://doi.org/10.1002/cncr.35797

Patel et al. (2025) reviewed records of 54,828 adults hospitalized at a cancer hospital and interviewed patients and chaplains. Adults of Dharmic religions, 58.4% of them Hindu, had more advanced illness yet lower chaplaincy use than others (31.6% vs. 36.7%), with similar unmet spiritual needs on admission; ritual care was the most frequently documented need, at 72%. Interviews described unfamiliarity with chaplaincy and concern about faith-discordant care. The mixed methods design is a strength, though a single specialty hospital limits generalization. This source anchors Slides 3 and 14 and shows that nurses may need to connect Hindu families with community priests or explain what chaplains offer.

Patel, R. V., Bowden, J. M., Boselli, D., Strahley, A. E., Gibbs, S. L., Murali, K. P., Patel, V. R., Patel, A., Kotecha, R. R., & Nelson, J. E. (2026). Palliative care and EOL care utilization in hospitalized adults of Dharmic religions with cancer. Journal of Pain and Symptom Management, 72(5), 581-592. https://doi.org/10.1016/j.jpainsymman.2026.07.028

Using the same hospital population, Patel et al. (2026) compared palliative care use and end-of-life quality measures. Adults of Dharmic religions used palliative care somewhat more (14.6% vs. 11.8%), but had more inpatient deaths (27% vs. 12%), more late hospice enrollment, more chemotherapy in the last two weeks and more ICU care in the last month. Interviews highlighted Ayurveda and dietary practices, the role of belief in coping and inconsistent communication of preferences. Its large sample is a strength; it cannot separate religion from other factors such as recent immigration. It will support Slide 3 and the argument that goals-of-care conversations should start earlier for these families.

Sharma, R. K., Khosla, N., Tulsky, J. A., & Carrese, J. A. (2012). Traditional expectations versus US realities: First- and second-generation Asian Indian perspectives on end-of-life care. Journal of General Internal Medicine, 27(3), 311-317. https://doi.org/10.1007/s11606-011-1890-7

Sharma et al. (2012) conducted focus groups with 12 first-generation and 11 second-generation Asian Indians in the mid-Atlantic region, almost all Hindu. Themes included attitudes toward death and suffering, family duty and preferences for disclosure and decision-making. Participants described tension between traditional expectations, such as caring for parents at home, and the demands of American work and family life, and noted that families rarely discussed preferences explicitly. The participants were highly educated, many in health care, which limits generalization, and the study is older than most of our sources. It remains one of the few to compare generations and will support Slide 7 on family duty and disclosure.

Singh, A., & Freeman, M. (2011). The important role for nurses in supporting the Asian Hindu patient and family at end of life: Providing culturally sensitive end-of-life care. Canadian Oncology Nursing Journal, 21(1), 46-49.

Singh and Freeman (2011) wrote a practice article for oncology nurses that summarizes Hindu beliefs about death and rebirth, gives an overview of the rituals surrounding dying and death, and guides nurses in supporting patients and families through them. As a descriptive article rather than research, its claims rest on the authors' knowledge of the tradition, and it describes Canadian practice. Its value is its practical detail, which no recent study provides. The group will use it for Slides 10 to 13, cross-checked with the Hindu chaplain who advised in our opening case.

Thamanam, N., Lehwaldt, D., Sweeney, M. R., & Corbally, M. (2025). Measuring undergraduate nursing students' knowledge of Christian, Islamic, and Hindu death rituals: A national study. Nurse Education Today, 151, Article 106691. https://doi.org/10.1016/j.nedt.2025.106691

Thamanam et al. (2025) surveyed 414 undergraduate nursing and midwifery students from eight institutions in Ireland with a validated 23-item knowledge questionnaire (Cronbach's alpha 0.873). Knowledge of death rituals across Christianity, Islam and Hinduism was low, and most students had learned what they knew outside formal education. The authors call for required cultural education on end-of-life practice. The study measures students rather than practicing nurses and was conducted outside the United States, but its finding of a knowledge gap justifies the presentation. It will appear on Slide 3 and will shape the review questions on Slide 17.