Death and Dying

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The Stages of Dying and of Losing a Loved One
Usually, a person (or their loved ones) will go through all or some of the following stages of feelings and emotions. The dying person’s stages can often be more predictable than the stages experienced by a loved one who has just suffered a loss. 1.Denial

The dying person being able to drop denial gradually, and being able to use less radical defences, depends on: -how he/she is told about his/her status;
-how much time he/she has to acknowledge what is happening; -how he/she has been prepared throughout life to cope with stressful situations, particularly those that are out of their own control. 2.Anger

Rage, anger, envy, and resentment may replace denial.
“Why me?” It is a phase that is difficult to deal with because no one has the answers to this question. Anger is usually projected at random to persons, situations, and events, which most often include the loved ones. •Loved ones may react by feelings of guilt. What did I do to cause my loved one this pain? Why not me instead? Is God punishing us? Did I do enough? 3.Bargaining

The terminally ill person or their loved ones may entertain thoughts like “if I behave well and do good things from now on maybe I will be cured.” •Sometimes a mental agreement is made with God to postpone inevitable death, or cancel it, if certain actions are carried out. The patient will sometimes fall into a strict regime trying to “earn” healing or delay death. •Bargaining can take many forms – eating ‘correctly’, making friends of foes, performing unfinished business, consulting other doctors, taking special kinds of medicines, taking trips, etc. 4.Depression

Reactive Depression = depression as a result of past issues or matters that are deemed to be unresolved in the life of the terminally ill person. •When there can no longer be denial, and bargaining seems to be of no avail, depression can set in with a terminally ill person or their loved ones. •Often the caregiver can assist in alleviating reactive depression by helping the terminally ill person deal with guilt and shame feelings. Once these are dealt with, often depression will be lessened. Preparatory depression = depression that is usually related to anticipated or impending loss. Here encouragement and reassurance might not be as helpful as the loved ones just “being there” for this person. •The ‘preparatory’ depressive state of a terminally ill person prepares for acceptance of death, so it must not be blocked or interfered with. •If permitted to express sorrow, the terminally ill person will reach acceptance more quickly and easily. •Only persons who have been able to work through their anguish will finally reach acceptance and peace in the situation of death and dying. Family members and loved ones need to do the same. 5.Acceptance

Given sufficient time, the dying person will, with help, work through the previous stages, and having mourned his/her loss, can reach quiet acceptance. •The person who has reached the ‘acceptance’ stage is neither resigned nor hopeless, nor is he unhappy; rather, this is a time devoid of feelings – or almost so, a time of separating himself/herself from the world •Loved ones need to be unafraid to sit with the dying person. Much reassurance is given thereby. 6.Resignation

It is very difficult to leave this life when there is still so much to do and to live for. •Resignation is acknowledgment of the dying state yet a reluctance to ‘let go’. Resignation does not allow for the most peaceful acceptance of dying. This is also very painful for the remaining loved ones. •This stage often results in repeated battling with all the stages above mentioned, sometimes by the remaining loved ones for years

Important Note for Caregivers and Loved Ones of Terminally Ill Persons The above stages that a dying person can go through are not necessarily the case with everyone and may not be as...
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