Stages%20of%20Dying

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Stages of Dying
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Test Review

• Cause of most fear
• How to face fear how related to Thanatology
• 4 Categories of Fear
• 3 of 4 things that dealing with death can teach
  us
• 3 of 5 reasons why North Americans can more
  easily deny death
• Euphemisms
• Cryonics movement
• Grief definition in own words
• 3 Steps to Grief Work Process
• 3 Ways to Prepare for Grief

• 3 of 5 Emotions associated with Grief
• Neurotic Guilt guilt feelings out of proportion
  to the cause
• Existential Guilt Sense of human inadequacy in
  face of death
• Abnormal Grief
• 5 Stages of Dying
• Where else the stages apply
• Rules of stages
• 3 Reasons why people NOT in denial may not talk
  with us personally
• Know 6 of 14 points for Dealing with the Dying

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Elisabeth Kübler-Ross

• The five stages, -- first introduced by Elisabeth
  Kübler-Ross
• In the late 1960s
• 5 Stages ? a process by which people deal with a
  terminal illness
• Bring death and dying into the mainstream.

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• 5 stages can also apply to
• Catastrophic loss. (job, income,
  freedom).
• Significant life events
• The death of a loved one
• Divorce
• Drug addiction
• Infertility diagnosis,
• As well as many tragedies disasters.

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Characteristics of the Stages

• Stages not necessarily in the order given
• All stages not experienced by all patients
  usually a person will always experience at least
  two.
• 3. Often, people will experience several stages
  in a "roller coaster" effect switching between
  two or more stages, returning to one or more
  several times before working through it.

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• Hint for the caregiver
• Dont try to rush the process to reach
  acceptance.
• Realize that Some people fight death until the
  end.
• The harder a person fights death, the more likely
  they are to stay in the denial stage.
• The ill person will have more difficulty dying in
  a dignified way.
• Some may adapt better with this approach.

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Stages of Dying

• Stage 1
• Denial 
• "I feel fine." "This can't be happening, not to
  me."
• Denial is usually only a temporary defense for
  the individual.
• Person may need this for a time to transition to
  later acceptance. (cushion)

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• Stage 2
• Anger 
• "Why me? It's not fair!" "How can this happen
  to me?" "Who is to blame?"
• a. The individual recognizes that denial cannot
  continue.
• b. The person is very difficult to care for due
  to misplaced feelings of rage and envy. Healthy
  people are resented!

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• Stage 3
• Bargaining 
• "Just let me live to see my children graduate."
  "I'll do anything for a few more years."
  "I will give my life savings if..."
• Person hopes that they can somehow postpone or
  delay death.
• Deal with God Ill live a better life if you
  just give me more life.

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• Stage 4
• DEPRESSION
• "I'm so sad, why bother with anything?" "I'm
  going to die... What's the point?
• a. The dying person begins to understand the
  certainty of death.
• b. The individual may become silent, refuse
  visitors and spend much of the time crying and
  grieving. (Allows person to disconnect).
• It is not recommended to attempt to cheer up an
  individual who is in this stage. It is an
  important time for grieving that must be
  processed.

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• Stage 5
• ACCEPTANCE
• "It's going to be okay." "I can't fight it, I
  may as
• well prepare for it."
• a. This final stage comes with peace
• and understanding of the death that is
  approaching.
• b. Person will want to be left alone.
• c. Feelings and physical pain may be
  non-existent.

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Dealing With the Dying

• We need to be willing to talk
• Dont be afraid of upsetting them they are
  already upset!
• Never say I know what youre going through.
  YOU DONT!
• Allow the dying to give you a clue
• (They may be afraid to upset YOU).
• Remember Not everyone wants to discuss it.
• (Some still in denial and you cant
  break through it.)
• Those not in denial may not talk because
• They are considering your feelings
• They are afraid they will have no visitors
• They may talk better with certain people.

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• 7. Dont be afraid to show your feelings.
  (doctors may be an exception).
• 8. Children may visit but use judgment
• Which will frighten them more?
• 9. Families often suffer from a misguided
  compassion
• They dont want to face it so they assume the
  patient doesnt want to face it!
• 10. Patients often know even if they havent
  been told.
• 11, Active Listening Respond to patients
  hints and dont be afraid to address their
  concerns.
• 12. Dying are often considered untouchables so
  dont be afraid of a hug, hold their hand, etc.
• 13. Regulate visits A visit is a medication,
  regulate the dose, dont become toxic!
• 14. REMEMBER They are still LIVING they are
  the same person, the difference is often in us!