It is imperative that health care professionals understand and respect the cultural heritage of the family and their response to death and the dying process.
For in-depth information of end-of-life nursing care and death rituals for Hmong American elders refer to Gerdner, Cha, Yang, & Tripp-Reimer (2007).
End-of-Life Care: Post-Mortem Care
Helpful Phrases
Upon death, we recommend a few phrases that practitioners may be used to convey to the family that their loved one has died:
“Ib pas nqus tsis tuaj” (“One [more] breath doesn’t come”). Conceptually, this phrase means that the last breath was taken.
Alternative phrases that can be used are:
- “Nws puv ib puas nees nkaum xyoo” (“S/he has reached the 120th year
of life”); - “Tas sim neej lawm”= “S/he has reached the end of life”
- “Nws tsis nyob nrog peb lawm = “S/he is no longer with us”
- “Nws xiam lawm.” =“S/he is lost or gone”
Following the elder’s death, family members must be allowed the privacy and time to express their grief. Customarily both males and females express their grief by wailing loudly (nyiav) and caressing the deceased by stroking the hair, face, and arms (Gerdner, Cha, Yang, & Tripp-Reimer, 2007). In addition, they may continue to talk to the deceased, in the belief that the person’s soul remains present and is able to see and hear their words.
Reincarnation
It is often believed that cutting or dismembering the body will delay reincarnation and result in negative consequences to the soul and physical body in the next life. Consequently, autopsies and organ donations are generally not accepted. However, it is believed that the body should be free of metal pieces following death and prior to burial. This includes silver fillings, metal staples, and metal prosthetic devices. Traditional beliefs require that these items be surgically removed postmortem. Metal objects are believed to weigh down the soul, delaying or preventing reincarnation (Bliatout 1993; Culhane-Pera & Xiong, 2003; Vawter & Babbitt, 1997).
