End of Life Care - End of Life Care for Muslims Patients

Who should read this leaflet?

The purpose of this document is to provide an aid to Muslim patients and their families about personal needs and preferences at this difficult time.

Key Messages:

•    To provide a brief overview of Muslim practices and requirements around end of life care and death
•    To be a simple reference at this most difficult time of death

Emotional support and religious care

It can be challenging receiving difficult news, facing times of uncertainty as your loved one is approaching their end of life.

The Chaplaincy and Spiritual Care Team provide support, advice and resources to patients, relatives, and staff members during this difficult time. If appropriate or requested, the Muslim Chaplain can take du’a (prayers) or read chapters of the Qur’an.

Chaplains and volunteers visit the wards regularly. Between general visits, when urgent please ask a health care professional to contact the Chaplaincy and Spiritual Care Team. As well as supporting people, the Chaplaincy and Spiritual Care Centre has other resources available, such as:

• A prayer room, ablution facilities, copies of the Qur’an, Qur’an cubes, prayer mats, tasbih, hijab and other items are usually available if required
• Volunteer Imams lead Jumu’ah
• The Muslim chaplain, Imam and/or volunteers can read scripture and or say prayers if appropriate and requested.

Please refer to helpful contacts to find the location of prayer rooms across the Northern Care Alliance.

When death is imminent

As a Trust we understand within the culture of Islam, death is seen as a natural event and a transition from the worldly life into an eternal life, “every soul shall taste death” (Qur’an). It may be important for patients and their loved ones to:

• Speak with staff about care, treatment, and support needs
• Discuss their needs and preferences post-death to prepare for a swift burial if possible
• You may find the support of the Muslim Chaplain is important in saying End of Life Prayers, having needs acknowledged and working with staff to help meet these where reasonable, legal, and practical to do so
• To ensure efficient communication during this difficult time, it is important to have the contact details of next of kin and, if necessary, one other key person

The role of the family and loved ones

As a Trust we appreciate that should death occur in the company of family and loved ones, it is recognised that this is centered on your involvement to complete rituals of dying and the remembrance of God.

Families might want to consider the following:

• Gathering around your loved one to help them turn their thoughts to Allah/God
• Recite the Shahada or play a recording of it to the patient. Qur'an Cubes are normally available to all wards
• Remind your loved one of the good things that they have done in their life, reinforcing hope in the Mercy of Allah/God, and seeking his forgiveness
• Prompt your loved one to repeat the words of faith as their last words. Sura 36 (Yasin) is often recited to ease the pain of death
• If this support is what the patient wants, then the staff should enable this as fully as possible

There may be difficulties of space and privacy, for example, staff will seek to sensitively support the patient and their loved ones through any difficulties. Staff and relatives should work together with relevant departments such as Chaplaincy and Spiritual Care Team, Palliative Care Team and Bereavement Service to enable the best care possible.

At the time of death

As death approaches, the Chaplaincy and Spiritual Care team will contact the Muslim chaplain, they will be given facilities to assess and perform the usual Islamic rites. These include assisting the person to recite a declaration of faith (Shahadah), reciting chapters from the Qur'an and praying for the peaceful departure of the soul.

As you are aware, your loved one should be turned onto the right side facing the direction which Muslims turn while offering daily prayers and is considered by them to be the holiest place on Earth. Alternatively, the patient may be laid straight with their feet pointing towards Qibla.

Health care professionals are required to remove all needles and catheters unless the death is being referred to the coroner in which case these must be left in place. At the time of death, to maintain patient dignity, a relative may wish to request a member of staff to do the following:

• Give the families (if available) the choice to undertake or be involved with washing the body
• Handle the body gently and prepared for burial in a specific manner
• If the family wish to bind the jaw, then advice should be sought from the Chaplaincy and Spiritual Care team who will contact the one of the Muslim Chaplains
• Remove jewellery if possible (after being discussed with a member of staff)
• Turn the patient’s head to the right
• Cover the deceased body with a sheet. We would encourage family members to cover the hair with a headscarf as appropriate
• Contact the Chaplaincy and Spiritual Care team so the Muslim Chaplain can make arrangements for the ritual practices if family aren’t able to attend the above
• Facilitation of burial is to take place as soon as possible – if this is not possible the reasons will be explained to you by a member of staff.

Following death

The Trust are aware of the requirement to bury the deceased the same day if possible. To initiate swift processing, it is necessary to know who is responsible for helping to facilitate this.

People to be contacted

A doctor (attending practitioner) will be needed to certify death.

In hospital this will be the patient’s doctor or Registrar. At home this will be the patient’s GP, if the GP was the last doctor to treat the patient. The doctor will provide a Medical Certificate of the Cause of Death (MCCD). If the patient died at home, it will be the patient's GP who must sign this certificate. Before a death certificate can be issued a review of all deceased patients care is required by the Medical Examiner Office or Coroner.

Please ask staff on guidance and information around the Medical Examiner Team.

Medical Examiner Office is open between 8am and 4pm Monday - Friday Saturday and Sunday 9.30am to 11.30am.

The MCCD will be emailed to the registrar. The deceased's passport and either their NHS medical card or their birth and marriage certificates are usually required for the Registrar of Deaths at the Register Office in the area that the patient died.

Please refer to the Important information for Bereaved relatives' NCA leaflet (PI_C_1352) for further information regarding Registrar/Coroner/Medical Examiner details.

Funeral costs

You may be aware some Muslims pay regularly into a 'burial/ death committee'. This enables the funeral to be arranged and paid for by the Mosque or privately within a group of people. If there is no such arrangement the cost must be met by the deceased’s estate or their family.

If it is evident that there is insufficient money in either the estate or the family’s capacity to pay, this may be covered by the Muslim community as an act of charity.

If the deceased or their family is on Income Support there may be help available, this would only apply for burials within the UK. The Department for Works and Pensions can be contacted for further information. Any claims must be made within 3 months of the burial.

Get help with funeral costs (Funeral Expenses Payment): https://www.gov.uk/funeral-payments/how-to-claim

Living Wills

The Next of Kin is most likely to know the wishes of the deceased and will legally be the person who makes the decisions.

A living will and/or a statutory declaration can be made by the patient. This is where 'advanced decisions on medical treatment and burial' are made, and allows a person to inform medical staff, carers, and the family how they wanted to be treated both medically and when they die.

This can be difficult to discuss but it avoids conflicts regarding treatment and the funeral.

Organ donations

There are different schools of thought in Islam regarding this sensitive issue. There is a significant opinion amongst Muslim Jurists that organ donation is allowed as it is done to preserve life. The Chaplaincy and Spiritual Care Team can support through this process if required.

Anyone wishing to be an organ donor would be well advised to obtain a donor card and inform their family. Should you require any further information please request to speak to the organ or tissue donation specialist nurses within the hospital.

Stillbirths and miscarriages

If baby of any gestation is born alive and dies shortly after birth, within 28 days, this is known as neonatal death. The baby should be washed, shrouded, and covered with a clean cloth to be given a funeral and buried.

With a miscarriage under 24 weeks the baby should be shrouded and buried. The NCA hospitals currently only cremate neonatal babies. Should parents wish to arrange a private burial they should explain their wish to do so to the medical staff providing care. (Please contact the Chaplaincy and Spiritual Care Team).

If the baby is born with no signs of life (stillbirth), the baby should be shrouded and buried.

Babies delivered over 24 weeks with no sign of life must be registered at the local register office.

For all babies born with any signs of life who then die shortly after birth, their birth and death must be registered.

Helpful Contacts

Chaplaincy and Spiritual Care Departments
https://www.northerncarealliance.nhs.uk/patient-information/  chaplaincy

BRO (Bury, Rochdale & Oldham)

Bury and Rochdale - 0161 778 3568

Oldham - 0161 627 8796
spiritualcareteam.referrals@nca.nhs.uk

Salford - 0161 206 5167
chaplaincy.salford@nca.nhs.uk

Urgent or out of hours
When urgent please contact the hospital Switchboard and ask for the on-call Chaplain to be contacted.
Salford - 0161 789 7373
Oldham, Bury or Rochdale - 0161 624 0420

Register offices

Bury Register Office
Town Hall, Knowsley Street, Bury, BL9 0SW Tel: 0161 253 6026
https://www.bury.gov.uk/births-deaths-and-ceremonies/register- office

Oldham Register Office
Chadderton Town Hall, Middleton Road, Chadderton, Oldham, OL9 6PP.
Tel: 0161 770 8960
https://www.oldham.gov.uk/info/200129/deaths/1887/ register_a_death registrars@oldham.gov.uk

Rochdale Register Office
Number One Riverside, Smith Street, Rochdale, OL16 1XU Tel: 01706 924 784
https://www.rochdale.gov.uk/deaths-funerals-cemeteries/ registering-death

Salford Register Office
Salford Civic Centre, Chorley Road, Swinton, Salford, M27 5DA Tel: 0161 793 2500
https://www.salford.gov.uk/births-marriages-and-deaths/ dealingwith-a-death/registering-a-death/ registeroffice@salford.gov.uk

Medical Examiner (ME):

Office hours are 8:00am - 4:00pm Monday to Friday
Salford Care Organisation - 0161 206 8168
Oldham Care Organisation - 0161 778 5701
Bury and Rochdale - 0161 778 2122.

Out of Hours Service operates Saturday and Sunday and Bank Holidays (excluding Christmas Day and Easter Sunday) 09:30am – 11:30am. ME’s will contact relatives directly at a weekend within the working hours.
 
Prayer rooms are situated in:
For Jumu’ah prayers the Trust will endeavour to provide extra space beyond this Prayer Room.

Salford Care Organisation
Level 3, Hope Building

The Royal Oldham Hospital
D Block Building (Between the Garden entrance and Lucy Pugh)

Fairfield General Hospital
Next to the Peace Garden (from the main entrance follow the signs for Pharmacy).
For Friday (Jumu’ah) Prayers there is extra space available to colleagues on the Ground Floor of Fairfield House. The second Jumu’ah takes place in the smaller room next to the Peace Garden and is accessible to all.

Rochdale Infirmary
Level D (from the main entrance follow the signs for the prayer room)

For Jumu’ah prayers the room adjacent may also be used for extra space.

Bereavement Services Contacts

Bereavement Services - Contact hospital switchboard

Children of Jannah - Child Bereavement support for families
0161 4805156

Child bereavement UK
www.childbereavementuk.org

SANDS - Still birth and Neonatal Death Society 0808 164 3332
helpline@sands.org.uk
www.uk-sands.org

Cruse Bereavement Care
0808 808 1677
www.cruise.org.uk

Samaritans
116 123

Muslim Bereavement Support Service (MBSS)
020 3468 7333
info@mbss.org.uk
www.mbss.org.uk