When you hear the word yoga, do you picture people standing on their heads or balancing on one leg while crossing their arms and legs in a mind-boggling maneuver of balance and flexibility? I’ve seen those pictures too. Eye catching, right? But the tradition of yoga is far more diverse than what we see on Instagram.
In fact, if you can breathe then you can do yoga. Breath work, or pranayama, is at the root of yoga. Simple breathing practices can be a balm for people nearing the end of life. Add in a few gentle, accessible movements with some guided imagery, and yoga can bring about a profound sense of well-being.
Yoga in Hospice
Common symptoms for those nearing death—pain, breathlessness, sleeplessness, fatigue, digestive upset, depression and anxiety—can all be soothed by a yoga practice adapted to each person’s needs and abilities. Caregivers can also get some respite with a restorative yoga practice.
This is why hospices in Canada are beginning to offer yoga to patients and caregivers.
In India, where yoga has been practiced for thousands of years, you can find hospitals based entirely on therapeutic yogic treatments. For yoga to persist through the centuries, from one end of the globe to the other, you know it’s got to be good.
Evidence-Based Yoga
We’re beginning to see clinical evidence of the therapeutic benefits of yoga in western medicine. In clinical trials, researchers at the University of Texas MD Anderson Cancer Center saw better stamina among lung cancer patients and family caregivers who practiced yoga for just seven weeks, compared to those who didn’t do any yoga.
At Memorial Sloan Kettering Cancer Center in New York, a training program is available for yoga instructors so they can learn the best ways to support cancer patients with their practice.
Yoga vs. Hockey
Yoga was first introduced to North America in 1893 by Swami Vivekananda at the Chicago Parliament of World Religions. While yoga is sometimes seen as exotic, it’s actually more commonplace than you think. After 130 years of international exchange, yoga is now practiced by one in five Canadians. Compare that to the number of Canadians who play hockey, which falls in at less than one in twenty.
Shavasana
Shavasana, which translates into “corpse pose,” is one example of a yoga posture to practice with someone in palliative care.
Most yoga practices finish with shavasana because it benefits everyone, but at the end of life this might be the only posture needed. To guide someone through shavasana, have them lie down on their back with legs relaxed, about one foot apart, and arms resting at a relaxed distance from their sides. You can use a pillow or bolster under the knees if that helps to release tension in the low back.
Eyes are closed.
Start here with a slow, deep breath in and a long sigh outward, then let the breath settle into a natural rhythm, without trying to control it.
Lie still for five minutes or more. The idea is to let go completely of all the tension in the body, and let go of all thoughts. If the mind wanders, bring it back to the breath. Ask what are the qualities of the breath, without judgment or any attempt to control it. Is the breath warm, cool, long, slow, rapid, shallow, or deep? What is the feeling on the tip of the nose? How does the chest move as the breath goes in and out? Do other parts of the body move passively as well? Does the breath sound like a gentle tide or a breeze? How does it sound in the pauses between breaths?
Progressive Relaxation
If someone finds it difficult to relax the body in stillness, shavasana can be practiced by actively tensing up the toes, then as the breath is released, let the toes relax; tense up the legs, then as they breathe out let the legs relax; tense up the hips, then let them relax; suck in the belly and the muscles around the ribcage, breathe out and relax; tense the shoulders up, breathe out and relax; tighten the arms, breathe out and relax; and finally scrunch all the muscles around the face, eyes, nose, and mouth, then breathe out and relax.
Spend a few minutes in total relaxation, allowing the thoughts to drift through the mind as if they are white clouds drifting across the sky.
People often find it challenging to release tension and stop the thoughts that circle around the mind. With guided practice comes a sense of total relaxation and a release from pain. The corpse pose is about leaving behind old habits and tensions of the mind and body, and awakening with a rejuvenated sense of being. In the context of working with patients at the end of life, practicing shavasana might also support a more peaceful transition in death.
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Erika McDougall is a death doula candidate with Home Hospice Association and a yoga teacher trainee with Yoga Therapy in Toronto. You can reach her at ewes2410@homehospiceassociation.org
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