Cultural and religious considerations in end-of-life planning

This article is for informational purposes only and does not constitute medical, legal, or financial advice. Always consult with qualified professionals regarding your specific situation.

Your mother wants her children around her. Not for comfort, though that too, but because in her culture, family presence at death is essential. Your father has asked that certain prayers be said. Your sister wants the body washed and wrapped in a particular way. Your brother is worried that the hospital won't understand what your family needs.

End-of-life planning is not just medical or legal. It's cultural and spiritual. It's about who your loved one is, where they came from, what their community means to them, and what dying well looks like in their tradition. When you understand this, you can advocate for their wishes more effectively. You can make sure that whoever is caring for them in their final days understands what matters.

What Matters Most

The first step is understanding, deeply, what your loved one's culture and faith mean to them. For some people, religion is central to everything, including how they die. For others, it's cultural identity more than active practice. Some people want religious rituals; others want their family and nothing more.

What matters is asking. You might say, "I want to make sure we honor what's important to you if you get very sick. What does that look like?" This is an open question. It doesn't assume they want something religious. It just asks what matters to them.

For some, the answer is family. "I want my kids around me. I want to know they're going to be okay." For others, it's very specific. "I want my rabbi here. I want the prayers said in Hebrew. I want to die at home if possible." Some people want community—their mosque, their church, their temple. Others want privacy and quiet.

Some people care about practical things. They want to know their grandchildren will stay close to their spouse. They want their wife to remarry if she wants to. They want their funeral to cost less so there's more money for the family. These can be cultural or religious values, or they can just be their values.

Some cultures have specific beliefs about death and dying. In some traditions, the timing of death is guided by God or destiny, and medical intervention that prolongs dying is against their beliefs. In others, every possible intervention is expected because life is sacred and must be extended. In some cultures, the person should die at home; in others, dying in a hospital is appropriate because it removes the contamination of death from the home. There's no universal right answer. What matters is what your family believes.

Honoring Non-Medical Wishes

Once you understand what matters, you need to figure out how to honor it within the medical system. This is where advocacy comes in.

If your father wants his imam to visit, you ask the hospital or hospice about their chaplaincy policies. Can your imam visit? Can he lead prayers? Can he be present when your father dies? Most healthcare facilities will accommodate this. If yours won't, you escalate. You talk to the patient advocate or the administration. You explain why this is important. You might decide to pursue home care or home hospice partly so these visits are easier.

If your mother wants her children present, you start planning now. Where will everyone stay? How will they coordinate time off? How will you manage it if the dying process is long? Hospice and hospitals can usually accommodate family, but having a plan means fewer surprises.

If your family has specific rituals—certain foods to eat, certain prayers to say, certain ways of being present—you tell the medical team. "My mother wants us to read the Quran to her. Is that okay?" "My family wants to wash his body before the funeral. Can that happen here, or do we need to do it elsewhere?" Most healthcare workers are accommodating. They've cared for many different traditions. But they won't know your family's needs if you don't tell them.

If your loved one wants to be buried quickly, as many Muslim families do, you start planning with a funeral home before the end. If your faith requires certain things to be done with the body, you talk to the funeral home about whether your hospital will help this. If your family has traditional funeral practices that the modern hospital hasn't encountered, you explain them and ask for cooperation.

Conflict Between Cultures

Sometimes there's conflict. Maybe your father, who immigrated, wants care that aligns with his culture. But his adult children, raised in America, think he should do something different. Maybe your mother wants a certain kind of funeral, but your siblings want something else. Maybe your partner's culture has different death practices than your family's.

These conflicts are real and hard. What helps is remembering whose death it is. If your loved one has capacity to make decisions, their wishes take priority. You might not agree with them. You might think they're making a mistake. But if it's their death and they're clear about what they want, that's what happens.

If there's conflict between your loved one and the medical system, you help bridge it. You translate not just language but culture. You help the doctors understand why your father wants to know all his diagnosis and prognosis immediately,it's not anxiety, it's how his culture believes you should face illness. You help your mother understand that the hospital's way of managing pain might look different than her traditional healer's way, but they're both trying to help.

If there's conflict between family members about what your loved one would want, you go back to the person themselves if they can communicate. "Mom, your kids have different ideas about what you'd want if you were very sick. Can you tell us?" If they can't communicate, you try to find documents where they've expressed wishes. You talk to their doctor about what they would recommend based on their values. You might bring in a hospital chaplain or social worker to help the family talk.

If your loved one is choosing something medically risky because of their cultural or religious beliefs, doctors might push back. "You're refusing antibiotics because you believe in natural healing, but your infection is life-threatening." What happens then depends on your loved one's capacity and wishes. If they're able to make decisions and they've clearly chosen their cultural practice over medical treatment, that's their right. The medical team has to support that, though they might express their concerns. But they can't override it.

Involving Religious Leaders

For many people, having their religious leader present at the end of life is deeply important. This might be a priest, rabbi, imam, monk, pastor, or spiritual teacher. It might be a formal religious leader or someone who serves that role in the community.

If your loved one wants this, contact that person as soon as possible. Don't wait until the end is near. Let them know the situation, let them know what your loved one would want, and establish a relationship with them. If your loved one is in a hospital or facility, give the facility contact information for this person. Ask that they be called if death seems imminent.

Some religious traditions have last rites or final prayers that should be said. Some traditions have specific things that should happen after death. A priest might need to give last rites. A rabbi might need to say certain prayers. The body might need to be handled in a specific way, washed by certain people, buried quickly. These can all be coordinated if you establish the relationship early.

Some people have conflicts between what they want religiously and what the medical system offers. A Jehovah's Witness might refuse blood transfusions even when they're medically critical. A Christian Scientist might refuse medications. An Orthodox Jew might not want certain kinds of medical intervention on the Sabbath. These aren't conflicts to fight about. These are wishes to respect. The medical team can support the patient's values even if they don't share them.

Creating a Culturally Informed Plan

The best end-of-life plans include cultural and religious dimensions. They include things like, "My mother wants her daughter to be present when she dies." Or, "My father wants the imam from our mosque to visit and lead prayers." Or, "My grandmother's tradition requires that she be buried within 24 hours."

You can write this down. It becomes part of the medical record. It tells every person who cares for your loved one what matters. And when that knowledge is written down and in the record, it's more likely to be honored.

You can also assign someone to be the cultural liaison in the medical system. "My son will coordinate with our religious community." "I'll explain what our family needs." Having one person in that role makes it easier for the medical team to understand and honor your family's values.

At the End

Culture and religion are part of how we die, just as they're part of how we live. When you honor your loved one's cultural and religious wishes, you're honoring them fully,not just as a patient, but as a person rooted in tradition and faith.

This doesn't require the medical system to agree with your beliefs. It requires them to respect your autonomy, to help what you need, and to understand that how you die matters because of who you are and what you believe. That's what good end-of-life care looks like.

How To Help Your Elders is an informational resource for families working through aging and elder care. We are not medical professionals, attorneys, or financial advisors. The information provided here is for educational purposes and should not replace professional consultation. Every family's situation is unique, and rules, costs, and availability vary by location and circumstance.