James Brown has met his fate. On Christmas Day, December 25th 2006 the Godfather of Soul died. Gerald Ford has met his fate. On December 26th 2006 former president of the United States died. Saddam Hussein has met his fate. On December 30th 2006 former dictator of Iraq died. Elroy Holder has met his fate. On November 15th 2003 my father died. Today, my mother, Violet Holder is approaching her fate.
Do you know someone who has died? Was that person close to you? What was your reaction to the news of that person's death? Hopefully, you displayed compassion and acted appropriately. Hopefully you gave respect and showed remorse by at least saying, “I am sorry to hear such bad news.” In contrast, have you ever had someone close to you died? What was your reaction? I am certain it was quite different from the death of someone not close to you. Would you say the feelings were more intense? Were you in emotional turmoil or did you feel absolutely helpless?
Death might not affect you until it hits home. The effect may be merciless tears to requiring hospitalization to a dysfunctional void in your life. Choosing to cope with death can range from mild, unimportant and insignificant to very difficult and problematic. Choosing to cope with death in an unimportant, or insignificant mild manner may be considered cold-hearted. Choosing to cope with death as very difficult and problematic may be considered pathetic and weak In either case, the death of a loved one does affect you. Understanding death is the first step towards coping with a dying loved one.
To begin understanding death The Signet/Mosby Medical Encyclopedia defines death as the absence of life. Apparent death is the end of life as indicated by the absence of heart beat or breathing. Legal death is the total absence of activity in the brain, heart, and lungs, as observed by a physician. It further explains the patient, after having been diagnosed with a terminal illness, goes through five emotional and behavioral stages: denial, anger, bargaining, depression and finally acceptance. Family members and those close to the dying are predisposed to experience these stages also. This article is presented as a book report on On Death and Dying: What the dying have to teach doctors, nurses, clergy, and their own families by Elisabeth Kubler-Ross. “A profound lesson for the living.”-Life Magazine.
Because your dying relative or close loved one must and will live for a long time following a terminally ill diagnosis, it is imperative he/she not be consumed by death. You should not allow him/her to be consumed with the possibility of his/her death. However, do not concern yourself too much because he/she will eventually begin to deny his/her coming death. Be aware that this first stage serves as a cushion for the approaching death. It is very effective during the difficult times when death cannot be faced or talked about.
Maintaining the fantasy of a healthy body looses its edge and is eventually replaced with feelings of anger. Your dying relative or close loved one goes through a “why me and not him?” phase. Along with anger, your dying loved one would sometimes experience jealousy of the living; that can escalate into fury and/or hatred. These intense emotions are projected onto you and others, the world and maybe even towards God. Needless to say the second stage of anger is a very difficult and uneasy stage to deal with from the point of view of the family. You must be respectful, understanding and patient by giving your attention, consideration and at least a little of your time. A trusting friend of the dying could be of great help. His or her physician would be aware of this stage and can also give advice. The pastor of your church is also of welcoming service during this trying time. They or you should instill into the dying the value of his or her life as a precious and priceless human being. When this takes effect a sense of tranquility overtakes the dying.
Your dying loved one may begin to make bargains, mostly with God. During this third stage the dying may promise to live a godly life in exchange for an extension on his or her life. This stage is equally helpful to the dying. Their promises are usually stemming from guilt feelings of pass behaviors. You must not shrug off their promises as insignificant. You should be sensitive and aware that your loved one is in need of "confessing" pass indiscretions. You may want to encourage this until he or she "gets it all of his chest," or relieves him/herself of all irrational fears originating from guilt feelings. With this awareness, listen attentively with little interruption. Know, more bargaining may occur, most times privately.
As the illness prolongs, the dying eventually surrenders his futile efforts. He or she becomes depress. Frequent hospitalizations, financial burdens, the inability to keep house, the inability to send a child through college, more general, the inability for his or her wishes to come through are all reasons for the decline into depression. During this fourth stage of depression, your dying loved one experiences both reactive and preparatory depression.
It is important that you distinguish reactive depression from preparatory depression. The above examples are cause for reactive depression. They are self-reflections of losses that cannot be helped. For this depression you cheer up your dying loved one for immediate gratification with encouraging and reassuring words. Preparatory depression takes into account future losses, i.e., the people and things the dying loves. To facilitate the stage of acceptance reassuring words would be ineffective. You should allow the dying loved one to express his or her sorrow. He or she will find his or her approaching death much easier. At this final stage, there are very little words you can say to console the patient. Touching his or her hand or brushing his or her hair or just sitting in silence would be feasible.
Assuming the dying loved one has had enough time and help working through the previous four stages, the final stage of acceptance will be reached more peacefully. Your dying loved one is experiencing feelings of emptiness at this stage. This is a time when the family will need more support because the dying loved one usually wishes to be left alone. He or she wishes not to be disturbed by earthly matters. It is a quiet time. The presence of you or other members of the family is sufficient. A mere glance would be comforting for your dying loved one. He or she will be pleased to know that s/he's not forgotten. Furthermore, you and other family members would know that the approaching death is not such a terrifying, ghastly thing we all find we want to avoid.
