2 Test Review Cause of most fear How to face fear – how related to Thanatology4 Categories of Fear3 of 4 things that dealing with death can teach us3 of 5 reasons why North American’s can more easily deny deathEuphemismsCryonics movementGrief – definition in own words3 Steps to “Grief Work” Process3 Ways to Prepare for Grief3 of 5 Emotions associated with GriefNeurotic Guilt = guilt feelings out of proportion to the causeExistential Guilt = Sense of human inadequacy in face of deathAbnormal Grief5 Stages of DyingWhere else the stages applyRules of stages3 Reasons why people NOT in denial may not talk with us personallyKnow 6 of 14 points for “Dealing with the Dying”
3 Elisabeth Kübler-Ross The five stages, -- first introduced by Elisabeth Kübler-RossIn the late 1960’s5 Stages a process by which people deal with a terminal illnessBring death and dying into the mainstream.
4 5 stages can also apply to: Catastrophic loss. (job, income, freedom). Significant life eventsThe death of a loved oneDivorceDrug addictionInfertility diagnosis,As well as many tragedies & disasters.
5 Characteristics of the “Stages” Stages not necessarily in the order givenAll 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.
6 Don’t try to “rush the process” to reach acceptance. Hint for the caregiverDon’t 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.
7 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)
8 Stage 2Anger "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!
9 Person hopes that they can somehow postpone or delay death. Stage 3Bargaining "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: “I’ll live a better life if you just give me more life.”
10 Stage 4DEPRESSION"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.
11 Stage 5ACCEPTANCE"It's going to be okay."; "I can't fight it, I may aswell prepare for it."a. This final stage comes with peaceand understanding of the death that is approaching.b. Person will want to be left alone.c. Feelings and physical pain may be non-existent.
12 Dealing With the Dying We need to be willing to talk Don’t be afraid of upsetting them – they are already upset!Never say: “I know what you’re going through.” YOU DON’T!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 can’t “break through it.”)Those not in denial may not talk because:They are considering your feelingsThey are afraid they will have no visitorsThey may talk better with certain people.
13 8. Children may visit – but use judgment 7. Don’t be afraid to show your feelings. (doctors may be an exception).8. Children may visit – but use judgmentWhich will “frighten” them more?9. Families often suffer from a misguided compassion:They don’t want to face it so they assume the patient doesn’t want to face it!10. Patients often “know” even if they haven’t been told.11, “Active Listening” – Respond to patients hints and don’t be afraid to address their concerns.12. Dying are often considered “untouchables” so don’t be afraid of a hug, hold their hand, etc.13. Regulate visits: “A visit is a ‘medication’, regulate the dose, don’t become ‘toxic!’”14. REMEMBER: They are still LIVING – they are the same person, the difference is often in us!