Dealing with major grief, death a challenge

Elisabeth Kubler-Ross, M.D. was a Swiss-born psychiatrist, a noted pioneer in near-death studies, and the author of the ground-breaking book, “On Death and Dying”. She was born in Switzerland on July 8, 1926, and passed away at age 78 at her home in Arizona on Aug. 24, 2004. It is generally recognized that Dr. Kubler-Ross had a very profound impact on the care of terminally ill patients. Her pioneering work with terminally ill patients truly helped to revolutionize the attitudes of health care providers toward grief issues and care of the dying and their families.

Elisabeth Kubler-Ross published her classic book, “On Death and Dying” in 1969. At that time she presented what she referred to as the five stages that most humans go through when faced with very significant personal life and death issues. In her book, she was the first to describe these five mental stages that people nearly always go through when they learn that they, or a loved one, are dying. She describes these five stages as “DABDA”, and these five letters stand for: Denial, Anger, Bargaining, Depression, and Acceptance. These five stages are also sometimes referred to as the five stages of grief.

≤ Stage 1 — Denial: We all want to believe that nothing bad can happen to us. When a person is given the diagnosis of a terminal illness, it’s natural to enter a stage of denial and isolation. They may choose to seek out second or third medical opinions, and this is totally appropriate. During this stage, one might also isolate themselves from family and friends to avoid discussions about the illness. This stage of denial is usually short-lived. Soon after entering it, most people begin to accept their diagnosis as reality, and choose their plan to move forward.

≤ Stage 2 — Anger: As a person accepts the reality of a terminal diagnosis, they may start to ask, “Why me?” The realization that their hopes, dreams, and well-laid plans may not now happen, and this will often bring on some anger and frustration. A person’s anger may be directed to those offering care, and even to family and friends. Fortunately, for most people, this second stage of anger is also short-lived.

≤ Stage 3 — Bargaining: When their denial and anger don’t bring the intended outcome, many people will move on to bargaining. Most people who enter the bargaining stage do so with the intent to change their past way of living. They may agree to help the needy, to be completely honest, be respectful of others, and to generally live a better life. People who enter this bargaining stage often find that this does not change the terminal illness situation in their life, and they then move on to stage 4 – depression.

≤ Stage 4 — Depression: As it becomes clear that their terminal illness is here to stay, many people experience depression. They may be faced with multiple medical procedures, ongoing treatments, and the physical symptoms of their illness. As a result, mental depression may now occur. This stage of depression is an important one for these people to go through. It is a period of grieving that is essential for the dying person to cope with their death. If they are able to grieve fully and move through depression, the fifth stage of acceptance will follow.

≤ Stage 5 — Acceptance: This fifth stage of acceptance is very important and allows the individual to now peacefully deal with their personal impending death situation. Acceptance is the stage of peaceful resolution that death will occur and offers the individual quiet expectation of its arrival. When a person is fortunate enough to reach this stage, their death is often very peaceful. They have had permission to express fear, anger, and sadness. They have had time to make amends and say goodbye to loved ones. The person has also had time to personally grieve and to reflect upon so many important people and things that have meant so much to them during their life.

EDITOR’S NOTE: Dr. Jim Surrell is the author of “The ABC’s For Success In All We Do” and the “SOS (Stop Only Sugar) Diet” books. Requests for health topics for this column are encouraged. Contact Dr. Surrell by email at sosdietdoc@gmail.com.