During the illness the main thing is to take care of the dying person's mind. Many others can take care of the body, but we can take care of the mind.
The most worthwhile thing to do is to inspire the person to think of others with loving kindness and compassion, to wish others to be happy and free from suffering. If a person dies with the thought of benefiting others, their mind is naturally happy and this makes their death meaningful.
You can teach the person taking-and-giving meditation (tong-len; taking upon oneself others' suffering and giving others one's happiness) or loving kindness meditation (metta), according to the capacity of their mind. If the person has a more strong nature of compassion, a "brave mind," they will be able to do tong-len, to take others' suffering and give out happiness. If the person can do tong-len, it's the best way to die, as it means dying with bodhicitta. His Holiness the Dalai Lama calls this a "self supporting death." For those who don't think others are more important than themselves, wishing others happiness and to be free of suffering is easier.
It's very important to know the person's mind. You can teach according to their capacity: check at the time, use your own wisdom and judge how profound a method to present to them. It would be best if you could give the dying person some idea of the death process according to tantra; the evolution of the dissolution of the elements, the senses, the consciousness, all the way to the subtle consciousness.
For the person who has lost their capacity to understand because of coma, dementia, etc., there is not much possibility for them to understand. We should aim to help them at least get a precious human rebirth. This should be our aim, not necessarily that the person believes in karma, for example, but that they die with a positive, happy mind, loving kindness, compassion; this is our precious gift. Our main aim is to take care of the physical body so that we can take care of the mind, to transform their mind to the positive so that at least the person can die without anger, desire, etc.
You should learn various methods to benefit the mind, calm down the mind, to benefit now and in the future. Get an idea of what level of method to offer.
If one visualizes Buddha, in the mind or outside, for example, or watches the conventional nature of mind, its clarity, other thoughts such as anger and attachment do not arise. If one can do this at the time of death, according to the person's mind you can talk about the "fully enlightened being" rather than the Sanskrit "Buddha." Talk about God if that's more skillful; compassionate God or loving God, or Omniscient One. Explain to the person that the nature of their mind, their heart, is completely pure; that the fully enlightened one, God, is compassionate to everyone, including them. Get them to think that their loving heart is oneness with God: the kingdom of God is within. This frees people from guilt, anger, their negative thoughts.
Initiations, vows don't protect from the lower realms; one just creates more negative karma after receiving or taking them and reaccumulates the karma for a lower rebirth. But mantra, for example, helps eventually attain a higher rebirth after their negative karma is used up. Even if the person doesn't want to hear mantra, it leaves a positive imprint on their mind, so that sooner or later they'll meet the path and have the ability to practice teachings, to clear obscurations and attain enlightenment. Even if they get angry hearing mantras and die with an angry mind, it's still better than not hearing mantras and staying peaceful. In this way, step by step, a person's karma brings them to the Mahayana path and to enlightenment. Arhats get stuck, while the Mahayanist gets enlightened, even if the arhat starts off with the higher rebirth.
When the person is dying
If you have studied the death process, you will be able to recognize the stages of a person's consciousness is going through, what elements are absorbing, and so forth, when the person is actually dying.
It is better if the family don't cry, as this creates clinging in the mind of the dying person. There are sounds to help the consciousness at the time of death, sounds that benefit, mantras, etc. Other than this, keep quiet and don't make any sounds. You should teach the family how to create this atmosphere.
It is okay to medicate pain in order to help the person to be able to think. But medicating for mental anguish is not okay. Sedation before death prevents working out bad karma. Anguish becomes fruitful if the person can experience it. It is hard to tell the difference. Often families want the patient medicated, but it is more for their own comfort than the patient's.
At death, invite the sangha to chant mantras nicely, in an uplifting way, as the Chinese do. When they chant like this, the person feels that nothing is more important than Amitabha Buddha. They feel protected and supported, guided.
Chanting the Thirty-five Buddhas' names* is extremely powerful, people can come there and chant together. Also, the five very powerful deities' mantras* normally used in Jangwa to liberate those dying and the dead, and to purify living ones and liberate those in the lower realms. Giving Breath to the Wretched* has powerful mantras, and is the text to use to help.
You can place a stupa on the person's chest or let them hold it. It purifies negative karma each time the stupa touches them. Even if the consciousness has already left the body it can still be beneficial to touch the body with the stupa. This is also good to do with babies or with people who don't understand. Even to a non-Buddhist you can say that the stupa is for peace or healing or purification. The person can visualize light rays coming from the stupa.
It is also good to have a few stupas on hand for healing or to dispel spirit harms. Also, a sheet of paper with the ten great mantras written on it can be put on the dying person's body while reciting the dedication prayer at the end of this.
When the breath has stopped
The very first thing you could do after the breath has stopped is Medicine Buddha practice* as a group or individually (for animals as well), chant the names and the mantra: Medicine Buddha made a promise that whoever chants his name and mantra, that all their prayers and wishes will succeed. The power of the prayer has been achieved by Medicine Buddha, so it's very powerful for their prayers to succeed. Of the ten powers, one is prayer, so pray as if you are the Medicine Buddha's agent, on behalf of the being who has died.
Then you can do Amitabha po-wa (transference of consciousness to a pure land), then other practices.
You can recite Sang Chö, The Prayer of Good Deeds (commonly known as The King of Prayers)*. At funerals it is also good for everyone attending to read it together.
You can recite the Namgyelma (Ushnisha Vijaya) mantra twenty-one times, then blow on water, sesame seeds or perfume or talcum powder, blessing it with the mantra, and then sprinkle that over the dead body. The Namgyelma mantra is very powerful for purifying; it is best to recite the long mantra if possible, but the short mantra can also be recited.
If it is written on a cloth or paper and placed on a mountain top or roof and if it is written on cloth or where the wind can blow it, whoever is touched by the wind receives blessings and their karma is purified. Circumambulating a stupa that contains the mantra purifies all the karma to be reborn in the hot hells.
When the breath stops, in Tibet you would not touch the body until a lama in the village did po-wa; this is important. Look for signs that the consciousness has left the body (after po-wa), for example: the white drop, like pus or water from the nostril or, for a woman, blood and water from the lower part. First pull the hair in the center of the crown towards the back, so that the consciousness comes out through there. Also, hair falls out from the back of the head.
Preparing for death during life
His Holiness the Dalai Lama says that is it difficult at the time of death to really meditate as you did in life. If during your life you couldn't meditate well, then you can't at death, you can't hold the concentration.
The essence is to have accumulated merit and done purification in every day life in your relationship with sentient beings; to have served others with a sincere heart, loving kindness and compassion, to have done the hard work to benefit them. And to have made offerings to the Guru Triple Gem.
Practicing the good heart during your life, that is, bodhicitta, purifies so much negative karma, even very heavy karma, and it stops creating more negative karma. It is this negative karma that makes the mind experience fear of death. Especially, bodhicitta stops the immeasurable suffering, the suffering rebirths, that arise later from these negative actions. And you should live in morality, the precepts, taking the precepts from a spiritual master or in the front of holy objects.
It is very important to integrate into your life the Five Powers and to learn the Five Powers to be practiced at death. These are very special practices to achieve enlightenment quickly. They involve po-wa, transference of consciousness at the time of death into a pure land. In the pure land one receives teachings on the Vajrayana, which enables one to achieve enlightenment in one lifetime. How effective the po-wa is depends on how well one practices the Five Powers at death. And this depends on how well one does the general practices in the life.
The Lam-rim explains the four ways to accumulate powerful, extensive merit. One should attempt this in every day life, while doing all the normal activities, eating, sleeping and walking, etc., rather than the actions being done out of worldly desire, samsaric attachment.
Creating a conducive environment for the dying
(advice to Tara Home, a hospice to be established at Land of Medicine Buddha in Soquel, CA)
Make the place as beautiful as possible: a calm, peaceful, serene, holy environment is so important. There should be beautiful views, beautiful art, flowers, Tara images. Flowers give a very special spiritual feeling. The point is to create a positive imprint on the person's mind. By being there, the person is not afraid of dying, their mind is elevated. When families come, they see it's a nice place and want to come, a place that makes them feel there's no need to be afraid of death.
Because of His Holiness the Dalai Lama's wisdom and compassion, more and more people are feeling comfortable with Buddhism these days. We need to help people have an open mind to different methods. You can make it clear to people that Tara Home is Buddhist, then if they're okay with that, they can come.
The religious tradition of the residents depends on their prior practice in daily life. Advice you give them depends on what you have been doing yourself—lam-rim, thought transformation—how one has been practicing in daily life, and not just sitting meditation. In general, Mahayana has much to offer to the dying, or to anyone with problems. And Highest Yoga Tantra is the only system that offers a real explanation of death. The precise instructions only exist in the Highest Tantra, not in other traditions. Only general instructions are given in other traditions, not explanations in terms of the subtle consciousness, winds, chakras, etc.
The robed sangha can live in Tara Home for several months at a time, to distinguish the level of practice that each patient can relate to, and to create a holding environment.
The new people just joining, who haven't done this service before, need to learn from the people who have been doing service for a long time. Those who are experienced in how peoples' minds are should study different books, different teachings from different sources, and from their experience come to know what states of mind people die with.
Meet together once or twice a month; everyone should read what has been compiled. People with more skill and wisdom can then edit this and it can become a book. No need to rush. This book will become a guide for the long run, for the organization, and to benefit other organizations.
You should practice po-wa. Each year you should take po-wa teachings and retreat on po-wa so that you can practice. It is very important to do po-wa retreat every year.
If one becomes accomplished at po-wa and receives the signs of accomplishment, then this can be the best public service—liberating others and helping them at the time of death. It is okay to ask other lamas to do po-wa, any Tibetan lama who is a good practitioner. Bring in high lamas to do po-wa and to do Jangwa purification. If it is difficult to invite the lamas to the hospice, then the lamas can do po-wa wherever they are, from a distance. You need to inform the lama which direction the head is facing.
In general, it would be good to do the elaborate Medicine Buddha once a week, very good for success for dying. Also, you can do The Medicine Buddha Sutra once a month. The special text with 100,000 Buddha's names by Pabongka Rinpoche can be recited at death. Ribur Rinpoche got the text recently from Lhasa; it is at Tushita Meditation Centre in Delhi and Tibetan monks can read it.
- Contact the Education Office at FPMT International Office for copies of these practices and prayers.