The first-ever meeting regarding the proposal for a meditative hospice was held in the UK on April 9th, 2011. Forty of us, almost all sannyasins, met in the Buckland-in-the-Moor Village Hall, in South Devon. It was a blast to see so many familiar faces again, and to kick off with dancing to some much-loved songs such as ‘I’m here to wake up to this day,’ and ‘Love is the fire’.
The meeting covered a lot of territory. For example, participants raised issues about ‘green burials’ V cremation; if we wanted NHS (National Health System) funding, would TLR need to be a Charity or a Trust; what sort of regulations we would need to comply with; whether we wanted advice from the Tibetan Buddhists; and the fact that Osho’s, And Now and Here, provides the most on the subject of death of any of his books. What follows is a resume of only the main areas of information discussed.
We started with an outline of the structure of the afternoon, viz:
- Me (Maneesha) reminding participants of the original idea for a hospice run according to Osho’s vision
- Simant explaining the practical considerations of such a venture that several of us had been discussing over the past 6 months via email
- Yatro providing a resume of findings from the pre-meeting questionnaire she created in order to collect participants’ input
- Participants’ time for offering comments, asking questions etc
- Wrapping up, and looking at the question: Where to from here?
The proposal has been slightly modified in that now I suggest that, as well as cooks, cleaners, grounds men, etc being local, so too can the palliative-care doctors and nurses if sannyasins are not available to fill these positions. (However, it still remains pivotal that those in the role of support person – offering psycho-spiritual support for guests preparing for and then passing through the transition – be sannyasins.)
In addition to the above I also explained that, “The Last Resort is designed for people in the last weeks of their life and also for those needing respite or whose their carers need respite: they could come to us for maybe or one or two weeks. (For symptom management they could go to a hospital or outpatient facility). Those coming for respite periods who are not meditators can utilise that time to be introduced to meditation as a resource that they can then take home for themselves and continue to practice.”
I described what I meant by our work around supporting guests in ‘dying consciously’. “Basically, teaching those who are non-meditators – and reminding/supporting those who already are – how to consciously relax the bodymind and move into silence and emptiness; and how to access the experience of oneself as other than the body-mind, as the watching consciousness. And, of course, we are proposing not only dying consciously but dying celebratively. So we will create a celebration around each person’s body-leaving so that they have a send off that is both meditative and joyful.” Finally, throughout, friends and relatives of our guests would be actively welcomed and supported.
Simant followed on from here. A sannyasin of 32-years, she was finance director at Medina the commune in Bury St Edmunds in Suffolk. She also helped to set up the Purnima meditation centre in London in the late 80’s. For the past twenty years she has been with the NHS in public health including commissioning palliative care and hospice services. Now retired from the NHS, she is happy to be involved in the project in a voluntary capacity.
Simant explained, “This section is basically to give you an idea of the nuts-and-bolts, practical discussions that have already taken place by email among some of us. The ideas put out have been so far-reaching, detailed and wide in their creativity, that we felt it might be helpful if you heard some of them, in the hope that they will provoke your questions and suggestions. We haven’t got any answers as of now; no decisions that have been made than other to follow the vision – Osho’s vision – for this type of project.
“The ideas so far seem to fall into five general topics: Leadership, finance, the scope of the project, communication, and interface with the NHS, local authorities and other providers of care.”
1) Leadership: “There are lots of types of leadership structures used in anarchist, collaborative and cooperative structures. But one way to bypass the whole hierarchy issue is to use detailed ‘Project Management’.
“What this means is that you start by agreeing on the aims and the resources that you have. Resources are not just participants’ skills but also include how much of their time participants are willing to give. In addition, maybe somebody has got a house or other building that would be suitable, or some equipment that is needed, or maybe knows somebody who has such a building or equipment
“As part of the project management, we’d need a ‘Feasibility Study’ – which examines the legal, financial and clinical do-ability of the proposal. We’d probably want that study to look at more than one model. For example, the proposal right now is for a stand-alone, bricks-and-mortar hospice. But the hospice could also be part of a commune, or exist alongside a nursing home, etc.”
2) Finance: Simant explained some of our options regarding how finance might be handled, and also the financial status of The Last Resort. That is, it could be a charity- based structure that’s independent of individual investors. Or a market- based set-up or based on a form of insurance: people who wanted to die in The Last Resort could start paying insurance from the very start. She also listed some of the costs: that of renting or buying a facility, of employing staff, and so on.
3) Scope: The range of ideas stretched from the original bricks-mortar structure to community outreach service, and, as already mentioned, to a hospice occupying just a section of a commune, etc. Simant commented, “All of these could happen, though some of them would be very complicated to set up – not only financially but logistically, legally and in other ways. The original vision – of a stand-alone building – is something that could be up and running relatively quickly because it’s a fairly circumspect service.”
4) Communication. Simant pointed out that Yatro had been handling the sharing of communication up this point and it has been a big job, especially given that Yatro has got her own living to earn as well. As an alternative to one person continuing to shoulder the whole responsibility, we could create a website that incorporated a forum. This would allow those interested to stay updated on progress and also enable us to contribute.
She continued: “We also need to create a communication strategy because we need to know, ‘In planning, setting up and then maintaining the hospice, what do we want to communicate, with whom, about what?’ For example, we will have the press to deal with. We will also need to consider how early and in what way we want to communicate with future partners like the NHS, local authorities or any other local charities who are involved, and so on.”
5) Interface with the NHS. According to Simant the NHS provides free palliative care and pain relief to patients in charitable UK hospices. It has also funded hospices in areas with none, but Devon [where the meeting was held] has four and public finance is now very limited. ‘Private’ clinical facilities receive very limited NHS support so TLR needs to be not-for-profit to qualify for NHS clinical support. Early liaison and physical proximity to relevant hospital services would promote close working with NHS and other care providers.
Response to the Questionnaire
Conscious that we were nearing the end of the meeting, Yatro briefly outlined the kind of responses she’d received from the questionnaire. Its purpose, she said, “Was really to give us an idea pre-meeting as to where people were at, and also to give participants an idea of certain issues that were already being discussed.
“There was an overwhelming ‘yes’ to a hospice project. People saw dying as the last adventure and one in which they’d want to have people around who are in tune them and what they want.
“Some people listed, among features that they would want when dying, the availability of Osho’s words; silence, being in nature; music; someone holding their hand…. As to ideas about the form of the hospice, as Simant has already mentioned, there was a large scope. Most people said they’d like to work in the hospice in one kind of capacity or another; some would like to contribute ideas; some had modest amounts of money they could contribute; lots want to leave their body there.. So there was an enormous amount of interest.
“This brought home to me how talented we are and what a range of skills we have to offer. For example, among the respondents were a social worker, counsellor, computer person, planning person, a doctor, someone who worked with NHS, a medical lab technician, handyman, construction…and those who have worked as carers and been around the dying, along with many all-rounders.”
Where to from here?
I asked for a show of hands as to whether we wanted to take the next step. With the majority indicating affirmation, I suggested that the Feasibility Study and the website were probably the two items we needed first.
The question of what exactly a Feasibility Study is was raised, and addressed by Guptadhana. In essence, he explained, “Risks are in there. My experience of some years of being involved in various sannyas projects is that they almost always either flop or fly on the basis of what resources are available to them. And they almost always – the ones that flop – do so because nobody’s actually sat down in advance and thought, ‘Is this feasible? Will it ever work?’ A feasibility study is an essential tool in taking a vision and then making it manifest.” Some donations were collected towards the costs of the Feasibility Study, and thanks to those people and to others who promised to contribute.
Footnote: Since the meeting, the Feasibility Study has been started. The projected date of its release is the end of May 2011. In it, the costs and benefits of various components of different models will be compared, including The Last Resort scope, size and location; property and overhead costs; population served; co-location with a sannyas community (whether a commune or an area where sannyasins live); funding base; legal and financial structures; ethical and legal constraints; voluntary or paid staff; resources; access (to NHS services and for patients and carers) and optional appraisal methods.
The second meeting about The Last Resort, this one initiated by Dutch sannyasins, is scheduled for Friday May 6th, at Osho Wajid MC in The Hague.