Human Growth and Development Death and Dying Basic

Human Growth and Development Death and Dying

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

Stages of Death and Dying • Dr. Elizabeth Kubler-Ross identified 5 stages of grieving that dying patients & their families/friends may experience in preparation of death: denial, anger, bargaining, depression, & acceptance • The stages may not occur in order, & they may overlap or be repeated several times • Patients may not progress through all of the stages before death occur • Patients may be in several stages at the same time

Denial • “No, not me!” stage • Usually happens when first told of terminal illness • Occurs when the person cannot accept the reality 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 “The tests must be wrong”

Denial • Pts may get 2 nd opinion, request more tests • Pts may refuse or avoid discussion about their situation • It is important that pts discuss 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? ”

Anger • Occurs when pt is no longer able to deny death • Pts may say “Why me? ” or “It’s your fault. ” • Pts may strike out at others, become hostile & bitter • Pts may blame themselves, their loved ones, or health care workers

Anger • HCW must understand that this anger is not a personal attack, the anger is caused by the situation • HCW should provide understanding & support, respond to pt’s demands quickly & with kindness

Bargaining • Occurs when pts accept death but want more time to live • Pts may turn to religion and spiritual beliegs • At this point, the will to live is strong, & pts fight hard to achieve goals • Pts may make promises to God to obtain more time • HCW must be supportive & good listeners & help pts meet their goals when possible

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 regrets, withdraw, become quiet • Pts may experience great sadness & overwhelming despair • HCW should let pts know that it is Ok to be depressed, provide quiet understanding, support, a simple touch, & allow pts to cry or express grief

Acceptance • Final 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 separate themselves from the world & others • At the end, they are at peace & can die with dignity • Pts still need emotional support, even just the touch of a hand