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| Elisabeth Kubler-Ross |
Preparing for death often means finishing a life's work, setting things right with family and friends, and making peace with the inevitable. Spiritual and religious issues are important to many dying people and their families. Members of the clergy are part of the care team in some hospice and hospital facilities, and professional caregivers can help people and their families find appropriate spiritual assistance if they do not have a relationship with a minister or other spiritual leader.
Grieving is a normal process that usually begins before an anticipated death. According to Elisabeth Kubler-Ross, a pioneer in death and dying, the dying person typically experiences five emotional stages, often in the following order: denial, anger, bargaining, depression, and acceptance. A person in denial may act as if, talk as if, or think that he is not dying. Denial is caused by fears about loss of control, separation from loved ones, an uncertain future, and suffering. Talking to a doctor or other health care member can help the dying person understand that he can remain in control and that his pain and other symptoms will be controlled. Anger may be expressed as a sense of injustice: "Why me?". Bargaining can be a sign of reasoning with death, that is, seeking more time. When the person realizes that bargaining and other strategies are not working, depression may develop. Acceptance, sometimes described as facing the inevitable, may come after discussions with family, friends, and care providers.
Preparing for death is hard work, with many emotional ups and downs. However, for most people, it is a time of new understanding and growth. By dealing with past hurts and mending relationships, a dying person and family members can achieve a profound sense of peace.
Preparing for approaching death can be terrifying if you have no idea what to expect both physically and emotionally. As the dying process enters its final stages there are two different dynamics at work.
The physical aspect concerns the body as it begins its final process of shutting down; this ends the physical systems' functioning.
The other dynamic is the emotional/mental and spiritual area which is a different process. This is where the spirit of the dying individual begins to slip away from its immediate environment and attachments. This release tends to follow its own priorities when it comes to letting go; of family members, unfinished business of a personal nature and/or unreconciled problems. You have all heard people tell how someone on their death bed refused to let go until a certain member of the family was able to get there. Even when the body is trying to shut down the spirit hangs on until a resolution is reached. It is as though the dying person needs permission to go; needs to feel that he has achieved the support and acceptance of his fate by those he leaves behind. This way he can slip into the next dimension of life with grace and dignity.
Acceptance is coming to terms with reality. It is accepting that the world will still go on without you. Death is after all, just a part of life.
The EKR Foundation: Click Here
Elisabeth Kübler-Ross: Click Here
As a Social Service Designee, you may spend one on one time with dying residents. You may just want to read aloud or hold their hands. Some residents enjoy reading a passages from the Bible (or their preferred holy book) that are comforting (Psalm 23, in particular). Know your residents’ likes and dislikes. This will help you to know what residents would want you to do during this time. You can also get information from family members.
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