1. Human Growth and Development
Death and Dying

2. Basic Definitions
____________________________________=final stage of growth
____________________________________________=disease that cannot be cured and will result in death
____________________________________=program designed to provide care for the terminally ill while allowing them to die with dignity. It provides palliative care
_______________________________________=measures taken to treat symptoms and/or pain even though it will not cure a disease; _________________________________ measures

3. Stages of Death and Dying
Dr. Elizabeth Kubler-Ross identified ______ stages of grieving that dying patients & their families/friends may experience in preparation of death: denial, anger, bargaining, depression, & acceptance
The stages may _________________t occur in order, & they may ____________________________ or be __________________________ several times
Patients may __________________ progress through all of the stages before death occur
Patients may be in ______________________ stages at the same time

4. Denial “_____________________________________________________!” stage
Usually happens when first told of terminal illness
Occurs when the person __________________ accept the ________________________ of death or when the person feels loved ones cannot accept the truth
Pts may say “The doctor doesn’t know what he is talking about” or “_______________________________________
_________________________________________________________________”

5. Denial Pts may get 2nd opinion, request more tests
Pts may _______________________ or avoid discussion about their situation
It is important that pts _______________________________ these feelings & HCW listen to pt & try to provide support without confirming or denying: “It must be hard for you.” “You feel additional tests will help?”

6. Anger Occurs when pt is no longer able to ___________________ death
Pts may say “________________________________?” or “It’s your fault.”
Pts may __________________________________________ at others, become hostile & bitter
Pts may ______________________________ themselves, their loved ones, or health care workers

7. Anger
HCW must understand that this anger is not a personal attack, the anger is caused by the _________________________________________
HCW should provide understanding & support, respond to pt’s demands _________________________________ & with ________________________________________

8. Bargaining
Occurs when pts ____________________________ death but want more ____________________________ to live
Pts may turn to ______________________________ and spiritual beliefs
At this point, the will to live is strong, & pts fight hard to achieve goals
Pts may make ________________________________________ to God to obtain more time
HCW must be supportive & good listeners & help pts meet their goals when possible

9. Depression
Occurs when pts realize that death will come soon & they will no longer be with their families or be able to complete their goals
Pts may express ______________________, __________________________________, become _______________________
Pts may experience great _______________________________ & overwhelming despair
HCW should let pts know that it is Ok to be depressed, provide quiet understanding, support, a simple touch, & __________________________ pts to cry or express grief

10. Acceptance
____________________________ stage when pts accept fact they are going to die
Pts may complete unfinished business & try to help those around them deal with the oncoming death
Pts gradually ________________________________ themselves from the world & others
At the end, they are at peace & can die with __________________________________
Pts still need ________________________________ support, even just the touch of a hand