Care of the Muslim Patient

Rebecca Minor, Aida Mansoor, Ann Minor

November 19, 2013

The Connecticut Charter Oak Chapter of HPNA

Hospice & Palliative Nurses Association

Rebecca Minor

• Special Education teacher in Farmington• Born in Bristol• UConn RA• Converted to Islam 5 years ago• MCCT• Berlin mosque

62% of Americans have never met a

Muslim

There are…

• 1.7 billion Muslims on earth – this is 1 out of every 4 people.

• Approximately 7 million Muslims in the U.S.

• 100,000 Muslims in the state of CT.

The chances of caring for a Muslim in the hospital are increasing.

Islamic Sources

The Holy Quran

The word of God revealed through the angel Gabriel to the prophet Muhamad (pbuh). It was revealed over a period of 23 years.

Today,1400 years later, it remains unchanged, still in its original Arabic language.

The Hadith

Words and traditions of the prophet Muhamad(pbuh) ~ peace and blessings be upon him

“The merciful bestows mercy to those who are merciful. Therefore show mercy to those on earth and the One in heaven will show mercy on you.”

Definitions & Terms

Allah

• Arabic word that means “the One God”.

• The term Allah cannot be pluralized or gendered.

Salaam

Assalaamu AlaikumPeace Be Unto You

Wa Alaikum AssalamAnd Upon You Be Peace

Islam

• Arabic word

• Means peace and submission to the will of God (Allah).

• Those who follow Islam are called Muslims.

The 3 major religions are followers of the prophet, Abraham. These religions are monotheistic – all believe in the same, one God.

Muslim• A Muslim is one who follows the way of Islam.

• A Muslim submits to the will of God so that they can live in peace.

Mosque / MasjidA place where Muslims worship God.

AdhanIslamic call to worship recited by the muezzin at prescribed times of the day.

EIDMuslims have 2 festivals:

•One at the end of the month of Ramadan.•The other at the time of the Hajj pilgrimage.

Seven Major Beliefs

1. God

The word for God in Arabic is Allah.

Christians and Jews living in Arabic speaking countries also use the word Allah when referring to God.

2. AngelsIn Islam, Gabriel is considered one of the four archangels whom God sent with his divine message to various prophets, including the last prophet Muhammad (pbuh).

3. Prophets

A prophet in Islam is a male human, from the sons of Adam; who received revelation from God in the form of Divine instructions.

• Adam• Noah• Abraham• Lot• Ishmael• Isaac• Jacob• Joseph• Job• Aaron

• Moses • David • Solomon• Elijah• Jonah• Zechariah• John the Baptist• Jesus• Muhamad

4. Holy Books Revealed to: In:

• Taurah Moses Hebrew• Zaboor David Hebrew• Injeel Jesus Aramaic• Qur’an Muhammad Arabic

5. Day of Judgment6. Good vs. Bad7. Life after Death

Paradise or Hell

Five Pillars of Faith

1. Declaration of Faith

• When someone becomes Muslim he or she states the Shahadah:

“La ilaha il Allah, Muhammad-ur-Rasool-Allah”

• As a person says the Shahadah they bear witness that there is one God and that the prophet Muhamad is the last Messenger of God.

2. Prayer - Salah

• Pray five times a day• Prayer rug• Ablution – washing before prayer• Jum’ah – Friday prayer

Prayer Positions

3. Charity - Zakat

• All things belong to God, therefore wealth is held by human beings in trust.

• “Purification” and “Growth”. Possessions are purified by setting aside a proportion for those in need. This cutting back balances and encourages new growth (wealth).

• 2.5% of ones income and wealth.

4. Fasting - Saum

Fasting helps to purify the soul, refocus attention on God, and practice self-sacrifice.

Ramadan •No food, drink or intimate relations from dawn until sunset for approximately 30 days.•The ninth month of the Islamic lunar calendar.•Ramadan 2014 ~ June 28-July 27

5. Pilgrimage - Hajj

• Mecca – Saudi Arabia• 5 days• Once in a lifetime• 4 million people perform the Hajj annually• Hajj 2014 ~ Oct. 1-6

Aida Mansoor

• Muslim Chaplain at HH and SFH• Born in England as a Muslim• Studied at Kings College in London• Graduate of the Hartford Seminary• President of MCCT• Berlin Mosque

Muslim View of Illness

Take the time to know your patient

The Muslim population in the U.S. is very diverse. Cultural background may influence the way they respond to illness and other life crises.

Illness

During illness, Muslims are expected to:

•Seek God’s help with patience and prayer;•Increase remembrance of God to obtain peace;•Ask for forgiveness;•Give more in charity and;•Read or listen to more of the Qur’an.

Patients, especially those who are terminally ill, are encouraged by family members to recite the Shahadah as it reaffirms ones connection with God.

Death

The Qur’an emphasizes that death is only a transition from this existence to a future life.

•“Every living creature will die one day”.

•“They (true believers) say: To God we belong and to Him is our return.”

Healthy Body

The prophet Muhammad taught that maintaining a healthy body is an individual’s duty. “Taking proper care of one’s health is the right of the body.”

Seeking Treatment

The sayings of the Prophet encourage patients to seek proper treatments in the time of illness:

•“There is no disease that Allah has created, except that He also created its remedy.”

•The prophet not only instructed sick people to take medicine, but he himself invited expert physicians for this purpose.”

Clothing & Modesty

“Modesty and faith are joined closely together and if one is lost, the other goes as well.”

Women

• Hajib• Loose, non-revealing clothes.• Some women may be clothed from head to

toe with the exception of the face.

Men

Men should be covered from the waist to the knees.

Touching

• Shaking hands• Same gender nurse and doctor

Food & Nutrition

Dietary Restrictions

• Halal• Pork• Gelatin• Alcohol• Shellfish

Fasting

• The month of Ramadan

• Allowed exceptions:• The sick, the old, the young• Menstruating women• Pregnant women, nursing women• Travelers

Medical Procedures

• Blood Transfusions• Organ Donation• Abortions & Stillborn• Assisted Suicide and Euthanasia• Autopsy• Cremation

Advance Directives

• The Imam should work closely in discussion with medical staff.

• DNR order is acceptable but it should be carefully explained.

• Prolongation of life by supportive machines is strongly discouraged for those who are terminally ill – when the quality of life is poor.

Ventilators

• If the patient is on a ventilator and there is total organ failure the ventilator can be withdrawn.• If the patient then breathes alone or stops

breathing that is considered to be the will of God. • The ventilator cannot be withdrawn to end

the patient’s life.

Death

Death is defined as the departure of the soul from the body – however neither the Qur’an nor hadith give clear signs of the soul’s departure.

•“Brain death’ may not be accepted as death by some Muslims.

•Most Muslims consider death as a cessation of all bodily functions.

• Face toward Mecca.• Mouth and eyes closed.• Arms and legs straight -

toes tied together.

• Clothes removed by person of same gender.• Ritual body wash.• Wrapped in white cloth.

Preparation of the Body

• Body buried quickly – usually within 24 hours.

Burial

Ann Minor

• Hospice & Palliative Care Nurse ~ Holistic Nurse• Born in Norwich • Converted to Islam 3 years ago• Berlin mosque• So much to learn!

Muslim Greeting

Assalaamu Alaikum

Wa alaykumu-s-salam

Family & Islam

• Strong support system• Parents & elderly• Visitations from family and friends

"If a Muslim visits his/her fellow Muslim who is ill in the morning, then 70,000 Angels pray for that person until the night and if that person visits at night then they pray for him/her till the morning, and due to his/her good intentions he/she gains a garden in Paradise."

Patient Advocate

The Medical team should call a Muslim chaplain or the Islamic center if they are not familiar with the Islamic traditions.

Muslim Coalition of Connecticut

Food

Although the sick do not need to fast they may want to. A Muslim physician may be useful in advising and counseling the patient.

Halal foods ~ Jewish Kosher or VegetarianHaram foods:• Jello• Pork• Broth, Chowder, Soups, Gravy• Animal shortening - breads, puddings, etc.• Lard• Alcohol – vanilla extract, Dijon mustard

Prayers

• Let patient know the direction toward Mecca.• Position bed towards Mecca.• Get prayer schedule from the internet.

• Play a recording of the Adhan.• Help them perform wudu.• Provide privacy.

Nov. 2013 Prayer Schedule

Nov. FajrDawn Sunrise

ZuhrNoon

AsrAfternoon

MaghribSunset

IshaNight

3 29 Sun 4:51 6:26 11:35 2:19 4:43 6:17

4 30 Mon 4:52 6:27 11:35 2:18 4:42 6:16

5 1 Tue 4:53 6:28 11:35 2:18 4:41 6:15

6 2 Wed 4:54 6:29 11:35 2:17 4:39 6:14

7 3 Thu 4:56 6:30 11:35 2:16 4:38 6:13

8 4 Fri 4:57 6:32 11:35 2:15 4:37 6:12

9 5 Sat 4:58 6:33 11:35 2:14 4:36 6:11

Dying Process

At the last moments before death, Allah sends the angels of death to get the soul from the human body.

Allah says, “He is the irresistible, supreme over His slaves, and He sends guardians over you, until when death approaches one of you, Our messengers (angel of death and his assistants) take his soul, and they never neglect their duty.”

Surat Al-An’am, (verse 61)