The 5 Stages of Grief among Terminally Ill Patients

terminally ill woman

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Many people mistakenly believe that grief occurs only when they have completely lost a loved one. In reality, it can happen anytime, even before a family member or a friend breathes their last. Experts call this premature grief.

Also, grief affects not only caregivers but also healthcare providers and the patients themselves. For this reason, a hospice service, including a home care agency, provides auxiliary support besides round-the-clock medical care for both patients and their carers. These include:

  • Chaplaincy – spiritual support
  • Counseling – psychological support
  • Social work – practical, emotional, and financial support
  • Volunteer program – companionship for caregivers, including help with household chores in times of urgent need

However, anyone who meets grief face-to-face needs to understand even the basics of what they’re going through.

The Stages of Grief

People describe grief in different ways. Others compare it to the ocean: it comes in waves. Sometimes they feel everything is going to be all right. On other days, their lives seem to be falling apart. Many also feel that the pain will never go away, and they’ll always be sad.

But the most popular way to explain grief is through its many stages, as described by Dr. Elisabeth Kubler-Ross:

1. Denial

When someone experiences a traumatic event such as a terminal diagnosis, their mind instinctively protects them from strong emotions. This is called denial.

People in this state might avoid speaking about their loved ones or being near pictures of them. Some people even begin to question the doctor’s prognosis, while others remain detached from their feelings that they move on as if their life isn’t ending soon.

Sometimes dying patients believe they still have more options left. They might then resort to complementary therapies or alternative medicine.

2. Anger

When denial fades and the reality of the situation sets in, people become angry with themselves and others. They might be mad at the doctor for not doing enough or misdiagnosing them or even God for taking them sooner.

Patients at this stage might be prone to outbursts and lashing out. They might even blame a loved one or a caregiver for causing their illness. They might also withdraw from others and feel the need to be alone with their grief.

sad senior man

3. Bargaining

Patients at this stage are vulnerable and are likely to spend their days with a lot of what-ifs: “What if I could have done this or that?” “What if I had listened to the doctor?” “What if medical technology progressed faster?”

They might also be racked with guilt. They might say, “I should have eaten healthy or took my supplements,” “I should have been paying attention more to my body,” or “I shouldn’t have been so stubborn.”

Some even make unreasonable requests so that they can try to change their fate. They might begin to devise a trade with God: “I’ll be a better person if you bring my health back” or “I’ll do anything just to live.”

4. Depression and Sadness

When bargaining fails, the next stage is depression and sadness. There’s no longer hope that things will get better. People feel they lost everything: their health, their loved ones, and even their faith in God. They withdraw even more and feel weighed down by life.

They will also likely have high levels of anxiety at this stage. They might not be able to sleep or eat well due to the stress they’re feeling. There might even be thoughts of suicide at this point, especially among those who live alone.

5. Acceptance

Acceptance is the last stage of the grieving process but the most critical one, according to experts. At this point, the patient enters back into reality. But this time, they do so more positively. They’ve learned to accept the changes in their lives and begin living again.

They often look back at how they felt during earlier stages and feel grateful for what was given to them rather than resentful of what was taken away. They might even develop a sense of compassion for themselves.

In some cases, some patients declare a new lease of life. They focus on what is important to them and learn lessons from their struggle that they pass along to others.

When a person has undergone this process, they can truly say that grief has led them on a path to inner peace. Sometimes it seems as though it takes forever, but the process is meant to be endured and has a healing effect that cannot be achieved any other way.

Grieving doesn’t follow a timeline. It is also not linear. Sometimes a patient reaches the acceptance stage but feels they’re bargaining on other days.

Regardless of what stage the patient is in, all their feelings are valid, no matter how negative. Instead of criticizing or downplaying these, carers should strive to provide support to ensure the ill individual continues to have the best quality of life possible.

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