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Often times, people feel uncomfortable talking to and interacting with a person

who is dying. This is at least partly because we have no way to understand

their perspective and what they are experiencing mentally, emotionally, and

spiritually. Approaches to the dying process can help us become more

comfortable by increasing our understanding and adding insight into the

perspective of the dying person.

I think hope is an important aspect of all stages. A person?s hope can

help them through difficult times. Adults have more fears about death than do

children. They fear pain and suffering, dying alone, and invasion of privacy.

They also fear loneliness and being separated from family and loved ones. The

five stages of death have been identified as denial, anger, bargaining,

depression, and acceptance.

The first stage is denial. During denial, persons refuse to believe they

are dying. “No, not me” is a common response. The person believes a mistake

has been made. Information about the illness or injury is not heard. The person

cannot deal with any problem or decision related to the illness or injury. This

stage can last a few hours, days, or much longer. Some people are still in the

stage of denial at the time of death.

The second stage is anger. The person thinks “Why me?” People

behave with anger and rage. They envy and resent those who have life and

health. Family, friends, and the health care team usually are the targets of their

anger. They blame others. They find fault with those who are loved and needed

the most. Anger is a normal and healthy reaction. Do not take a person’s anger

personally.

The third stage is bargaining. The person now says, “Why me, but ….”

There is bargaining with God for more time. Promises are made in exchange

for more time. They may want to see a child marry, see a grandchild, have one

more Christmas, or live to see an important event. Usually more promises are

made as they make “just one more” request. This stage may not be obvious.

Bargaining usually is private and on a spiritual level.

The fourth stage is depression. The person thinks, “Why, me.” The

person is very sad. There is mourning over things that have been lost and the

loss of future life. The person may cry or say little. Sometimes, the person

talks about people and things that will be left behind.

The fifth and final stage of dying is acceptance of death. The person is

calm and at peace. The person has said what needs to be said. Unfinished

business is completed. The person is ready to accept death. A person may be

in this stage for many months or years. Reaching acceptance does not mean

death is near.

Dying people do not always go through all five stages. A person may

never get beyond a certain stage. Some move back and forth between stages.

Some people are in one stage until death. Dying may take a few minutes,

hours, days, or weeks. There is a general slowing of body processes,

weakness, and changes in the level of consciousness. The family is going to

go through a hard time. It may be very hard to find words to comfort them.

You can show your feelings to the family by being available, courteous, and

considerate.

I?ve always been scared of dying. With that brought a fascination. I am

always curious and intrigued when it comes to dying or thought of what lies

ahead. I believe that one of the reasons why I decided to go into the nursing

field, not because of death but the feeling of helping patients that are scared

and are going through the dying process. Just being able to comfort them and

help them can be very rewarding.


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