Death can occur suddenly and without warning, or it can be expected. Older people, or people with terminal illnesses, may have time to prepare for death. A terminal illness is a disease or condition that will eventually cause death. Preparing for death is a process that affects the dying person’s emotions and behavior.
Dr. Elisabeth Kubler-Ross researched and wrote about the process of dying. Her book, On Death and Dying, describes five stages that dying people and their families or friends may experience before death. Not all clients go through all the stages. Some may stay in one stage until death occurs. Clients may move back and forth between stages during the process. These five stages are described below.
- Denial. People in the denial stage may refuse to believe they are dying. They often believe a mistake has been made. They may talk about the future and avoid any discussion about their illnesses. This is the “No, not me” stage.
- Anger. Once they start to face the possibility of their death, people become angry that they are dying. Anger is a normal and healthy reaction. The caregiver must learn not to take anger personally. This is the “Why me?” stage.
- Bargaining. Once people have begun to believe that they really are dying, they may make promises to God or somehow try to bargain for their recovery. This is the “Yes me, but…” stage.
- Depression. As dying people become physically weaker and symptoms of the illness get worse, they may become deeply sad or depressed. They may cry or withdraw or be unable to perform even simple activities. They need physical and emotional support. Listen to and be understanding of clients.
- Acceptance. Most people who are dying are eventually able to accept death and prepare for it. They may make plans for their last days or for the ceremonies that may follow. At this stage, people who are dying may seem emotionally detached.