Smudging Ceremony at Funerals and in Canadian Hospitals

Smudging is not optional at many First Nations funerals — it is the primary mechanism for purifying the body, the space, and the people present. The smoke from sacred medicines carries away heavy energies and protects the departing spirit. When a death occurs in a hospital, the Truth and Reconciliation Commission's Call to Action #22 calls on health-care decision-makers to recognize and use Indigenous healing practices with Indigenous healers and Elders where requested; whether and how smudging is accommodated depends on facility policy and safety rules.

What Smudging Involves

Smudging uses one or more of the four sacred medicines:

• Tobacco — the first medicine given by the Creator, used to carry prayers.
• Sage — for purification and clearing negative energies. The smoke is directed over the head, eyes, mouth, and heart.
• Sweetgrass — braided to represent the unity of mind, body, and spirit. Its sweet aroma invites positive energies.
• Cedar — for protection and grounding. Cedar branches create a protective boundary around the grieving family.

An Elder, Knowledge Keeper, or designated family member lights the medicine in a non-combustible container — an abalone shell, stone bowl, or cast-iron pan — and uses a feather or their hand to direct the smoke. A wooden match is preferred over a lighter.

Smudging at the Funeral

During the wake and funeral period, smudging may happen during body preparation, at the wake, or at another point chosen by the Elder and family. The Elder determines the timing and the specific medicines used.

Attendees may be invited to smudge themselves — drawing the smoke toward their body — but non-Indigenous guests should only participate when explicitly invited. Watching respectfully from your seat is always appropriate.

How to Request Smudging in a Canadian Hospital

The Truth and Reconciliation Commission's Call to Action #22 calls on those who can effect change within the Canadian health-care system to recognize the value of Indigenous healing practices and use them in treatment in collaboration with Indigenous healers and Elders where requested by patients. It does not create one uniform hospital procedure; whether and how smudging is accommodated depends on the facility's policy and safety rules. The practical steps are:

Step 1: Identify the staff liaison. The inpatient's social worker, spiritual care practitioner, or the charge nurse is your contact. Tell them you want to ask about arranging a smudging ceremony at the bedside.

Step 2: Safety assessment. The hospital must confirm the room is safe for smoke. Smudging cannot happen in:

• Positive pressure rooms
• Rooms where oxygen is being administered
• Areas near highly flammable medical equipment
• Rooms without proper ventilation

Step 3: Ventilation and space. Ask whether the hospital has a designated healing space with ventilation that exhausts smoke directly outdoors, not into the general HVAC system. If no suitable indoor space is available, ask whether an outdoor area or another permitted location can be arranged.

Step 4: Fire alarm procedure. Before lighting the smudge, ask the staff liaison to confirm the facility's fire-alarm procedure with hospital security. If the local zone is temporarily bypassed, security must be notified again after the ceremony so the alarm system is restored.

Step 5: Ash disposal. The ashes from smudging are sacred — they represent the return of medicines to the earth. They must not be thrown in the garbage. Follow the facility and family or Elder protocol for cooling them completely in a suitable container and returning them to bare soil or placing them under a tree.

When the Hospital Says No

Hospitals can restrict the location and timing of smudging for legitimate safety reasons (active oxygen therapy, fire risk). If you encounter resistance, ask to speak with the hospital's Indigenous Patient Navigator or Indigenous Health team, if available. These staff members can help mediate between clinical safety requirements and cultural accommodation.

If the specific room cannot safely accommodate smoke, alternatives include:

• A different room — a family room, chapel, or outdoor courtyard
• Smoke-free alternatives — liquid smudge sprays, dry-rub medicines, or placing unburned medicines around the patient without lighting them

These alternatives are not considered equivalent to a traditional smudge by many Elders, but they may be the permitted option in a high-acuity ward. The family and Elder make the decision together with the facility.

After Hospital Death: Smudging Before Transfer

When a First Nations person dies in hospital, the family can ask the Indigenous Patient Navigator or clinical team whether smudging can be arranged in the room before the body is transferred to a funeral home. The same safety and ventilation rules apply, and the timing must be coordinated with the facility.

This bedside smudging is often the first ceremonial act after death — it sets the spiritual context for what follows over the next several days or the period prescribed by the family and community.

The First Nations Canadian Funeral Guide includes a hospital smudging request checklist, a script for communicating with clinical staff, and a guide to the four sacred medicines and their roles throughout the funeral period.