A patient’s family, friends and medical staff (caregiver, CNA, hospice nurse, chaplain) become the patient’s support system and eventually the patient’s world (especially during a terminal illness). Because the patient and their world are so intertwined, the five stages of grief are transferable to the members of the terminally sick person’s world. For instance, one can expect a terminally ill person to experience denial, anger, bargaining, or depression before accepting “this cancer is not responding to nothing and it is running its course.” The patient’s relatives and friends, bound to the patient by love, duty or both will experience the stages of grief as well as the patient. Their timing may not be the same, but years of recorded observation has shown that often the patient’s close network grieve with the patient and of course, after the patient dies. (Greater detail about this in another article)
The stages of grief that Dr. Kubler-Ross identified are specifically related to the trauma/experience of dying. Since dying, perceived as extremely traumatic, and the stages of grief of a dying person have been observed, recorded and accepted “as tried and true” for the dying, the 5 stages of grief have been transferred to the general population. What is known and documented as true for the dying person has been labeled as ‘true’ for anyone experiencing trauma-especially one experiencing such for their first time.
So…we have five stages of grief of the terminally ill, established in 1969 and have been observed and documented for 40+ years. “On Death and Dying” gives those who love, care for or work with extremely sick people a guideline or warning of what is to come.
It is debatable if the same guideline can be used for healthy people facing serious challenges. For the sake of this blog, I will accept the five stages of grieve for all humans experiencing trauma or a dramatic event in their life.
Let’s look briefly at each stage but keep in mind they don’t come in a particular order or don’t last for a specific time.
Denial Always the first stage; one does not initially accept. This is the stage where one refuses medicine or treatment because they do not accept their diagnosis. Denial often presents itself immediately following the declaration of deceased.
Anger A patient may become angry with their self, angry with God, angry with a situation. Family may become angry with the choices their relative made, angry about a system or systemic issues, angry they did not do this, angry that they did that.
Bargaining Most often bargaining is with God: If you save my husband from this I will stop smoking. And will go to church. And…
Depression Self explained. Depressed about dying, depressed about an impending surgery, depressed about loss of health, loss of mobility, loss of…
Acceptance The person resolves to the situation
Keep in mind that there is no order to these stages. One can enter acceptance right away or begin with bargaining.
Always remember that there is no time frame or time limit for none of the stages. One can be angry for years or for one day, another person may spend months in denial. One may be depressed for a month and another for the remainder of their life.
Keep in mind that everyone grieves differently. Have you ever met a person that is always angry? Know someone with a short fuse and are subject to loud outbursts? Maybe you met the smolder; they are on a slow simmer all the time and no one ever understands why they are always disagreeable or always angry. Quietly angry or loud and demonstrative; anger is anger and anger can be grief.
This is just a general outline of the types of emotions that are experienced during grief. Please do not attempt to analyze someone or predict what stage they are in, and please do not talk about it or allow someone hear your words. The purpose of this article is to enlighten one about the emotions associated with grief and how they affect the personality.
Had I known what I just typed I would not have been so devastated over my mother’s anger. I would have shrugged off her hurtful words and accusations as the words of a grieving old sick lady. Had I sought some type of counseling or support I would have been advised to let her have her say and take nothing personally. On that statement I leave you with
Next Article: The value of the support group
I hope this was helpful. It helped me when I learned it, or afterwards. Here are a bunch of flowers to cheer you up. Please come back and visit again 🙂