1. Grieving/Death “It's only when we truly know and understand that we have a limited time on earth -- and that we have no way of knowing when our time is up, we will then begin to live each day to the fullest, as if it was the only one we had. “

2. Elizabeth Kubler Ross 1926-2004 1926-2004 A volunteer after WWII in concentration camps specifically Maijdanek where she discovered the “butterflies” A volunteer after WWII in concentration camps specifically Maijdanek where she discovered the “butterflies” Symbolized a transition between life and death Symbolized a transition between life and death Wrote Death and Dying published in 1969 Wrote Death and Dying published in 1969 May be required reading for many who work in medical, nursing or psychology programs. May be required reading for many who work in medical, nursing or psychology programs.

3. Dignity and Respect She challenged the medical profession to change their view towards death and treat the dying with dignity and respect. She challenged the medical profession to change their view towards death and treat the dying with dignity and respect. She helped introduce concepts such as living wills, hospice care and home health care. She helped introduce concepts such as living wills, hospice care and home health care.

4. Criticisms Everyone is a unique individual therefore Everyone is a unique individual therefore reactions will be different for every person. reactions will be different for every person. Stages or steps may in different order for some people. Stages or steps may in different order for some people. Feelings may be ignored with the assumption Feelings may be ignored with the assumption “it is just a stage”. “it is just a stage”.

5. The 5 stages of Death/Grief Denial Denial Temporary reaction to knowing that one faces death. Temporary reaction to knowing that one faces death. Anger Anger Resentment and/or envy over impending death. Resentment and/or envy over impending death. Bargaining Bargaining A defense mechanism for the purpose of postponing one’s imminent death. A defense mechanism for the purpose of postponing one’s imminent death. Depression Depression A sadness and gloom take over as the patient’s dying has to be reckoned with. A sadness and gloom take over as the patient’s dying has to be reckoned with. Acceptance Acceptance The patient reaches acceptance of his/her imminent death after going through the other stages. The patient reaches acceptance of his/her imminent death after going through the other stages.

6. Reactions to Death Physical Reactions Physical Reactions Numbness, unfeeling, pain, tightness in throat, disinterest in eating, can’t sleep Numbness, unfeeling, pain, tightness in throat, disinterest in eating, can’t sleep Emotional Reactions Emotional Reactions Stabbing pain, sudden anger, sense of unfairness, feeling of relief, guilt, gladness, anger, hostility, fear, anxiety Stabbing pain, sudden anger, sense of unfairness, feeling of relief, guilt, gladness, anger, hostility, fear, anxiety

7. Mourning Process 1.Shock One may deny that the death has occurred, collapse physically, violent emotional outbursts, or withdraw.One may deny that the death has occurred, collapse physically, violent emotional outbursts, or withdraw. 2.Intense Pain and Feelings of Loss Two or three months after the death the bereaved person may withdraw from the world.Two or three months after the death the bereaved person may withdraw from the world. 3.Resolution One starts living a regular life again. Memories of the deceased bring joy and pleasure rather than the pain of grief.One starts living a regular life again. Memories of the deceased bring joy and pleasure rather than the pain of grief.

8. Grief and Bereavement Grief is a natural process to death and dying. Grief is a natural process to death and dying. It is a necessary response to helping heal from the overwhelming sense of loss when a loved one dies. It is a necessary response to helping heal from the overwhelming sense of loss when a loved one dies. It is important to understand grief as part of the human experience. If you are grieving, some things you can do to help yourself include: It is important to understand grief as part of the human experience. If you are grieving, some things you can do to help yourself include:

9. Allow emotions Allow emotions Seek comforting rituals Seek comforting rituals For some, seeking solace in the faith community For some, seeking solace in the faith community Reading and learning about death-related grief responses Reading and learning about death-related grief responses Get enough rest Get enough rest Journaling Journaling Exercise and eat well Exercise and eat well Talking to someone Talking to someone

10. My Life 3 – FF to picture of camera. End when he says, “well this is me.” 3 – FF to picture of camera. End when he says, “well this is me.” 6 – Dr. explaining he won’t live long. End when Dr. says, “Don’t make it any more painful than it has to be.” 6 – Dr. explaining he won’t live long. End when Dr. says, “Don’t make it any more painful than it has to be.” 21 – End when Gale says, “Oh, Mom.” 21 – End when Gale says, “Oh, Mom.” 24 – End when scene is over, “We all are” said by Father. 24 – End when scene is over, “We all are” said by Father. 26 – End at end of roller coaster ride, seeing light. 26 – End at end of roller coaster ride, seeing light.

11. Step Mom 16 – Kids told of mother’s cancer. End when Anna runs upstairs. 16 – Kids told of mother’s cancer. End when Anna runs upstairs. 27 – How each child reacts differently to death. End after the second child’s gift and talking. 27 – How each child reacts differently to death. End after the second child’s gift and talking.