Thursday, May 1, 2008

The First Stage of The Death and Dying Process

If your child looks healthy, if your pet seems fine, or if your relationship seemed ok, then when all of that falls apart, the first thing you do is deny the diagnosis. Denial is the first stage of the process a patient and family go through when a terminal diagnosis is made. Denial can also occur when a relationship begins to crumble, a traumatic injury has occurred, and when sudden death occurs unexpectedly.

Denial is the process of not acknowledging that the diagnosis has been made. Denial is acting as if everything is fine, when in reality, the patient is very ill. In the case of relationships, denial comes in the form of ignoring the present circumstances and acting as if there is not a problem.

During denial, family members usually have difficulty expressing the truth or often don't want to discuss things at all. It is important for others, especially the health care team to recognize this stage. In the initial stage of denial, it is not the best time to make health care and treatment decisions. Often, your doctor will give out the facts and let you mull them over for a week or two. It gives you an opportunity to get second opinions, further conclusive tests, and to get used to the ideas and terminology first discussed.

After a few days or weeks, and after treatment begins, the reality of the situation starts settling in. The patient and family pass through to the second stage of the process. Be patient with all involved. Each person goes through the stages at a different pace. An example, in the case of a child, a mom might move through the denial phase quicker than dad. Grandparents may not want to believe the facts at all. Or grandparents understand the terminal diagnosis while parents remain in denial longer.

As a health care team, we try to assist with families as they progress through the stages so that a healthy acceptance can be achieved long before the death takes place. This gives the family better quality time in the end. It doesn't lessen the sadness or pain, but gives them the time to say and do the things needed so they feel less guilty and have less regret if and when death occurs.
Things to do to help:
1. Always be honest without dampening hope...but try to remain realistic.
2 LISTEN , listen, listen....most often the family or patient needs to verbalize, they don't want or expect you to fix it.
3. Be available for errands, for phone calls, or to be the shoulder to cry on.
4. A prepared meal or doing household chores, lawn mowing, or any unexpected kindness shows the patient and family that you care.
5. Be patient.... remember everyone goes through the stages at their own pace.
Next.... the second stage .....Anger.

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