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Living with dying.

We will all die someday. We know that, and intellectually we accept it. Yet few of us have lived so long and so fully that we are ready to die soon. When persons are told they have a terminal illness, the news can be crushing -- to them and their loved ones.

Reactions of a Dying Person

People are individuals, and how they respond to a terminal illness depends on a number of factors, such as their age, sex-role conditioning, personality, ethnic background, previous grief experiences and religious philosophy. The specific illness, relationship with family and the need or ability to provide for them after death will also affect how one feels about dying. There is no single pattern of emotions that a dying person will follow.

However, there are common reactions to a terminal illness. Persons who are dying will usually experience some of them.

They may deny at first that they are dying. "Those stupid doctors made a mistake" they'll say. They may go to several other doctors, hoping that one will say they're not dying. They may try all kinds of "magic" cures.

They may try to negotiate their way out of death. "I'll go to church every day, "They promise silently, or "I'll devote the rest of my life to helping others if I live." This denial acts as a buffer that allows the dying person to accept his or her death slowly -- although some people never do.

Dying patients may become very angry. They may say to themselves, "Why me? I've been a good person; I don't deserve to die." They may blame the doctors for not diagnosing the disease sooner and curing it. They may curse God for letting them die. They may be angry throughout the course of the illness, expressing hostility toward everyone around them.

They will almost certainly be afraid, for a number of reasons. They may fear death, but even more, they may also fear the process of dying. They may fear losing family, appearance, self-control and the ability to work or be useful.

The dying patient may feel guilty or ashamed. If a woman has always taken care of her family, she may feel guilty that she must now be cared for. She may imagine that she is being punished for a past transgression, such as an extramarital affair. She may feel guilty for being angry with those around her. If she is losing control of her bodily functions, she may feel ashamed.

She will likely become very depressed. After all, she must give up all her plans for the future, and that's depressing. In her grief, she may withdraw from her family for a time, preferring to be alone and think.

Finally, but not always, your loved one may accept her fate. This doesn't mean she won't grieve anymore; it means that she knows she will die and is willing to prepare for it.

Reactions of the Family

Of course, the dying person isn't the only one who will grieve. The family will too. If someone you love is dying, you will probably begin working through your sorrow as you prepare for your loss, although this may not diminish the acute grief you experience when the death actually occurs.

You may also deny at first that your loved one is dying. You may feel angry at the doctors who didn't prevent this disease. If you think your husband caused himself to become sick -- if he was a heavy smoker and is dying of cancer, for example - you may even feel angry with him for not taking care of himself.

You may also bargain with God, offering to be a better person if He will spare your loved one. You may even offer to die instead.

You will probably also feel guilty. You may blame yourself for not insisting that your loved one see a doctor sooner. You may feel guilty for any past disagreements you've had with the dying person. You may feel guilty because you can't come up with comforting words. You may feel guilty simply for being healthy when your loved one is dying.

You may also feel panicky, wondering how you will survive without your loved one. You may slip into depression. You may lose your appetite or eat voraciously. You may be unable to sleep, or sleep constantly. You may experience your grief as genuine physical pain. And if your loved one keeps getting better then suffering relapses, you may feel as if you're on an emotional rollercoaster ride.

Telling the Children

If you have children, you face the difficult task of telling them that their father, mother or grandparent is dying. Depending on their ages, children may ask all kinds of questions. Keep your answers as simple and honest as possible. Do not tell a child that Grandma is going to get better if she's not. And do not hide Grandma's condition from your child. If the child wants to see Grandma, that's all right, -- but with the warning that his grandmother will look very sick if her appearance has deteriorated.

Remember, your children need to resolve their own grief. They will take their cues from you, so give them permission to grieve by letting them see your own grief. Don't try to "protect" them from the grieving process.

Coping

How can you cope with knowing your loved one is dying? How can you help the dying person to cope?

While nothing will make this situation easy, open communication will at least make it less difficult. We don't like to talk about death in our culture, and too often a dying person and the family ignore the subject. But you both need to express the strong emotions you are feeling. Ignoring them won't make them go away. So talk about your fears, and let your loved one talk too. Talk about what you must do to prepare for your loved one's death. Cry if you want to. Talk about your anger, your guilt, your depression.

Rabbi Earl Grollman, who has written extensively on death and grief, says one of the most common mistakes families make is to treat dying persons as though they're already dead, excluding them from family activities and discussions. This makes the dying person feel lonely and rejected. If your father is dying and you normally sought his advice, continue to seek it. If you shared stories about your children with your mother, continue to do so. In short, treat your loved ones like the living persons they are.

Meanwhile, you need to work through your own grief. Lean on your family and friends. Share your feelings with them. Try to lighten your schedule if it's heavy. Grief is stressful, and you don't need the added strain of too much to do. Find time to sit by yourself and put things in perspective.

Take care of yourself physically as well. Try to eat well, get enough sleep and exercise. Physical activity can help offset depression and provide you with an outlet for your emotional energy.

Now and then your grief may become so intense that you'll wonder if you need professional help. While there is no "normal" way to grieve, if you think you aren't coping well, you might consider asking your clergyman, doctor or funeral director to suggest a counselor. If nothing else, you may be relieved to discover that you are coping normally.

Alternatives to Hospitals

In years past, most people died at home. That is still a possibility. Many people prefer the idea of dying in familiar, comfortable surroundings instead of a hospital. At home, dying persons can still maintain some control over their lives; in a hospital, they may feel that their schedule is determined by others.

If your loved one prefers to remain at home, ask your doctor to recommend in-home medical services. You and other members of your family may need training on how to care for your loved one. Although caring for a dying person can be strenuous, you may later treasure this time you could spend together.

If home care isn't feasible, there is another alternative: a hospice. This can be a large home -- which may or may not be affiliated with a hospital, a section of a hospital or a home care program - where patients can rest and receive care. Although hospices differ from one another, most allow patients to have their personal belongings, choose their own schedules and activities and have visitors when they like. Hospices stress comfort and a sense of community instead of strictly medical treatment.

A Final Note

When your loved one dies, you may find to your surprise that you don't cry anymore. You may even experience a sense of relief, then feel guilty. You've been through a trying experience, and you're probably "grieved out" for a while. You may not need to prove your love by crying anymore.

In time, your grief will diminish. You haven't forgotten your loved one, but your relationship has changed. You can't enjoy their physical presence anymore, but they will continue to be a part of your life. Your memories and your feelings will live on.

Pamphlets from the National Funeral Directors Association Learning Resource Center
Anatomical Gifts
Cremation
Children and Death
Death Away From Home
Easing The Burden
Embalming
Funerals Are For The Living
Funeral Costs
Funeral Etiquette
Grief After S.I.D.S.
Grief
Helping Groups
In Service Of Others
Living When Your Spouse Has Died
Living With Dying
Suicide
The Traditional Funeral
A Way To Remember
What Are My Options?
What Can I Do To Help?
When A Baby Has Died
When A Co-worker Dies
When A Death Occurs
When Your Parent Dies
Will I Ever Stop Hurting?


We would be pleased to send you a copy of any of the pamphlets listed above. Request them from:

NFDA Learning Resource Center

11121 West Oklahoma Avenue

Milwaukee, Wisconsin 53227
COPYRIGHT 1991 National Funeral Directors Association
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1991 Gale, Cengage Learning. All rights reserved.

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Publication:Pamphlet by: National Funeral Directors Association
Article Type:pamphlet
Date:Jun 20, 1991
Words:1650
Previous Article:Grief - a time to heal.
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