Death and Dying: Before and After Stages Essay

for separately ace(a) smart day begins with a sunrise. It brings to earth a new igniter that has never been seen before. The new light starts small and gradually reaches its peak in the vast sky. It nourishes the land, yields warmth and comfort, and inspires epic tales. As the day ages the light easy sinks behind the horizon leaving behind brilliant splashes of color as if to reflect upon its accomplishment, save the pallet of colors testament quickly shrivel up to black as the light leaves the sky to go to enthr 1s unk forthwithn. Even though the day was bright and created wonder it moldiness weaken way to the tranquil, mysterious, and feeble night.Just as the dawn essential give to the night each birth must buffer to an eveningtual demolition. The night, want remainder, holds a soul mystery and tranquility for some(prenominal). To others it invokes all the horrors found in the scariest nightm atomic number 18s. While patch whitethorn find ways to prolong the inevitable, each must yield to the waning light and go into that which he may bring no knowledge of prior to the journey. It is a journey he will collide with al unmatched. He will be stripped of all his earthly bullheadedness including his body. Only his soul will be allowed to pass into the dusk the epoch of night. My friends, he must die and yet you must live on. As with e very(prenominal) story, stopping point too, has much than one perspective. The lone warrior who must apply the solitary journey and the spectators watching the eternal sunset both fall in their story well-nigh the equal event, tho each story is unique.The death and their family do non sire to face the uncertainty and oft trepid go alone all the same. Organizations such as RMH Hospice financial aid crumb assist both the destruction and their contend ones. Any psyche that has a end diagnosis, and is non expected to live for much than six months is eligible for Hospice assistance. Hospice C be befriends to alleviate the stress that is encountered during the last puzzle out by taking a holistic approach to treatment. It often severs as an educational tool to the soulfulness and their family. Hospice in like gentlemanner provides aw arness of the extracts that are available to the last someone. They likewise try to educate the community and health divvy up workers.The excogitate hospice jazzs from the root word for hospitality in Latin. In basicterms Hospice means to provide hospitality to the expiry soulfulness and their family. This means giving palliative or comfort care to the dying and cooperateing their go to bedd ones in galore(postnominal) ways. Hospice nurses provide medications to the thickenings that help to alleviate pain, ease breathing and treat start gear that accompanies the process of dying. The nurses also educated the family so that they rotter understand fracture what is happening with their loved ones. Hospice workers also p rovide some counseling to the family and patient. afterwardward the death they continue to keep in touch with the family.Historically nuns were pity for the dying mortals in monasteries prior to the construction of hospitals. The word hospital also comes for the Latin word for hospitality. In the late sixties a reanimate named Dame Saunders applied the term Hospice to the care of the dying (History of Hospice Care The field of study Hospice and Palliative Care Organization). She would also introduce the practice of caring for the dying to the United States. One of the purposes hospice serves is to help the dying somebody and their family to work through the stages and processes of dish appear awaying the fact death will occur and to provide help for the family after the death of their loved one. Hospice workers are aware of and educate around the stages that Elisabeth Kubler-Ross introduced to the realm of death and dying.The dying soulfulness envisions intimately the process of dying that Elisabeth Kubler-Ross identified, but their loved ones who are left behind after the death experience the grief associated with the departure of a loved one must complete the tasks of sorrow identified by William Worden in order to light upon an swallow upable quality of life without their loved one.Everyone reaches a point in their life when they understand that they will die. Sometimes this revelation comes as a part of a final disease diagnosis. Other times it is just now the realization that their age is greater than the time they father left. When the time of death is near those who are dying often begin working though a process that Elisabeth Kubler-Ross presented in the late sixties. She identified five travel that the dying person works through. These steps are now looked at as process beca social occasion a person may go mingled with the steps and in various orders (L.Bee &Bjorklund, 2005). Kubler-Ross identified denial, kindle, barraging, de pression, and acceptance as the processes that dying person experience.Denial is simply denying that one is keep out to death. The person may continue to present the illusion that there is nada wrong with them. A woman with breast crab louse was discoer by her friends as refusing to arouse surgery, and sought out some(prenominal) twinkling opinions. A man in hospice care because of prostate potbellycer may tell the nurse who is drag a floor cut back, I wear outt know wherefore you are here I am fine. One particular client who lives in a care for forwardness with several levels of care has belatedly been escaped to the special care unit because of his terminal condition and the new requirements of care. He is in deep denial patronage his diagnose of terminal lung cancer. He has made no effort to commission a will. He has established no life history will or a person to act as his power of attorney should he be unable(p) to make decisions concerning his medical des ires or finances. He has even refused to rival with the social worker. His daughter is currently freeing through legal process to obtain power of attorney.She requested Hospice care for him. A hospice nurse met with him, and he agreed to sign consent and keep his current DNR status active, but he stated, I am just now doing this so Sally will leave me alone. He keep mum refuses to fill out the wish throw given to him by hospice. The wish book allows for the dying persons to write eat wishes they would liked honored as they are dying and after they are dead. It is assumable that he feels there is no need to express this information because he is fine.Denial from family members can also be seen. Aides and nurses who go to the homes of the hospice clients wrap up denial from family members as a part of their observations.At a home visit one hospice nurse has met opposition from the daughters of a 59 division old man in the Hospice weapons platform. She is reluctant to sign of import cover because daddy is gonna live a long time still, despite his need for luxuriously amounts of oxygen and advancing congestive fancy failure. Another man, observed at an assistant living set in Harrisonburg by a nurses aid working on the special care unit, response to his 69 married womans terminal cancer diagnosis and recent move to the new unit by saying those dn doctors they dont know any(prenominal)thing anyway. Shell pull through this. Shes been through worse. He is reflecting upon the scratch line time she was diagnosed with cancer 6 geezerhood ago. This time howevershe has chosen to not go through the aggressive treatments for her cancer. petulance is other process identified by Kubler-Ross. Anger refers to the feelings felt once the person realizes they are dying. It is only natural for a person feel fantastic at the loss of their or so precious asset. Anger is sometimes seen in sudden outburst. An olden woman at an assistant living facility who is norma lly peaceful and quite was observed by a student throwing her miniscule glass birds in her room and cursing God a a couple of(prenominal) days after receiving bad news from her doctor. In the same facility the student was confronted with a materialization man who has AIDS. He was nigh unapproachable because of his hatred of persons with much life ahead of them.Anger is not restricted to the dying person only. Family members experience this emotion as well. A nub age man whose wife is visit frequently by a hospice nurse due to the effects of the end stages of terminal cancer curses God for taking his wife kind of of someone who had through with(p) ugly deeds. He clenches his fist and looks to the sky as if to challenge God himself. Anger is reflected in family members of an elderly woman who has suffered a fall as the contribute of neglect. The fall caused much trauma for the woman, and it became evident she would not recover from the damage. Her family vocalizes their an ger and feelings of unfairness to the adjutants who care for their pay off in the special care unit.Bargaining is the offer of a sacrifice in commit for more life. The dying cancer patient may ask God to succumb him life until the end of the holiday season, and he will ask for nothing else. A little woman in a hospice care program asked God to grant her enough time to see her gardens bloom one last time. This too was a last request. Another gentleman promised estimable behavior and greater religious commitment in pass on for a longer life.Bargaining is also seen among family members. They are willing to give up a lot in order to preserve a loved ones life. For example the shopping centre age man losing his wife to terminal cancer reported asking God to save his wife, and amaze his instead. He also promised to be a better person and give more money to the church. To show that he was serious he donated several thousand fromthe sale of property to the church. His sincerity and h urt made the beholder indirect request to cry. He was clearly trying to save his wifes life.Depression affects the mental health of the dying. Depression in the dying is a reaction to the disorder of their life created by the disease and because of the realization that they must prepare to meet death (Strickland, 2005). Depression in the dying person is often observed by caregivers in the form of the refusal to eat, not going out, refusing to see other people, and showing no interests in hobbies they one enjoyed. The man with congestive flavour failure often enjoyed building small wooden toys. When asked if he had been in his workshop lately he said, No, just soak up not felt like it. Not really much point. The young man suffering from AIDS has not turned on his playstation in a month. He used to play several hours a day. His mother has offered him several new games.Acceptance of ones death is not the same as giving up. It is actually the act of pass judgment death in a manner that allows for the need reflection of the life lived. The middle develop woman with terminal cancer put her affairs in order, made all her own funeral arrangements so her family would not have to, and dictate her living will and estate will to her attorney. She has accepted her own mortality. An elderly woman has sold property she does not use, started giving away her possessions to family members, and is write her memories in a diary.She also decided to give up her bank visor and split the money between her five grand children. With a evil little smiled she said, Now the greedy lawyers wont get a dime bag of it.During the last week of his wifes life the middle aged man came to accept his wifes very near death. He quit asking for her life to be extended. When he asked for the nurse and aide to join him in prayer he now prayed for comfort and a peaceful passing for his wife. He asked for guidance in the days after her death. He also asked her what she wanted to be buried in. H e knew she was a particular woman when it came to dressing.A person or family member can experience these stages in any order. They may also experience more than one stage at once. For example the man with congestive heart failure had accepted the fact that he would soon be dying,but he still bargained for more time. He wanted to live though his daughters wedding. He felt he could die in peace if he could attend his youngest daughters wedding. Anger was the first reaction to one womans terminal diagnosis, but instead of bargaining she went into depression. Her depression was often mixed with hot actions. If she bargained it was in her individualised space and time. On the eve of her death she became afraid to be alone, and she explicit for the first time her acceptance of death. I do not want to die alone. Please stay with me, she asked several aids in the nursing home she lived in. The young man with AIDS knows he is dying and he is quick to state I am going to die soon, and he has signed a DNR form, made request for his funeral, and signed his property over to his mother.He show acceptance by the above mentioned acts, he is still very angry and considers himself unjustly persecuted by the Gods, he can be heard often barraging for more time, and is severely depressed. The only stage he seems not to be in is denial. It is possible in the depths of his mind he may still try to convince himself that he normal, well, and has many years to live. Denial was once an issue for him however, for nearly six years he refused treatment for HIV because he did not want to admit he was carrying the virus in his blood. He pursued numerous second opinions.Family members give away the same fluidity in the stages indentified by Kubler-Ross.The daughter who refused to sign important papers for her bewilder because she felt he was not in the dying process eventually agreed to sign them. However she stated, I do not think he is dying, but I need the help so I will sign them. T he family angry because of the neglect that wizard to the terminal condition of their mother never let go of the angry feelings even though they moved through the four other processes. The middle aged man was depressed during the time his wife was dying. He also bargained with God despite being angry with him. In a few nationals the family members simply accepted the fact their loved one was dying. If there were any of the other stages present they hid their feelings very well. In these cases the dying person was very old, had lived a full life, and there was not the presence of terminal illness. one time the loved one has passed away the tasks of mourning and recuperating from the loss is placed on the survivors. William Worden has establishedfour tasks of mourning. These tasks must be met in order for the survivors to return to the quality of life that they experienced before the death of their loved one (Worden, 2001). These tasks, unlike Kubler-Rosss stages, are worked through in order.Wordens first task requires that the mourners accept the reality of the loss, (Worden, 2001). Worden cognises the reality of death is tough to accept even if the death was anticipated. In post-death visits done by Hospice this is most common land seen in a verbal form. The daughter of the man who died from congestive heart failure remarked upon a scuttlebutt made by an observer about the toy train her father had made, Daddy is- I mean was eer good with his hands.She had a hard time accepting the fact her father was dying, but is working into accepting his death. The middle aged hubby who incapacitated his wife to terminal cancer also showed signs of making the adjustment to accepting his loss. He would often say its what she wouldve wanted me to do, or she was this and she use to do that. A woman whose husband recently passed made the comment that was my husbands favorite ice skitter, at an ice cream social event at her assistant living facility.Sometimes this slip of speech is noted before the person has passed away. Visitors of an elderly man who was in his last few hours of life were overheard saying, He was a good man. Nurses in nursing homes also do the same type of behavior. She was sick, even though she is still sick, and he wanted to die peacefully, despite the fact he has not yet passed away.Funeral homes often help with the acceptance as well. The monument cards are written in past tense. Funeral directors give the option for an open casket funeral or popular opinioning. The practice of being able to view the body of their loved one often helps people to accept their loss as reality. The ideas that are associated with a funeral and funeral parlors also help the surviving members to come to terms with the fact a loved one has died.Wordens second task involves the project of working through the grief, (Worden, 2001). Grief can intromit both physical, emotional and behavior aspects. It is often referred to as the pain of loss, the empty space in myheart, and nothingness. Family members can compel depressed after the loss. A newly leave behinded woman refuses to eat, and stays in her room. Prior to her husbands death she was active within the assist living facilitys community As the weeks turned to months she began eating at all meal, and once again participating in the activities. Occasionally she will even make small humorous remarks about all the time she has now that she does not have to worry about her husband.Adjusting to the win overd environs is the third tasks in Wordens four tasks to mourning the loss of a loved one. The changed environment is the places where the loved one is missing from. The home, or apartment, and place of work are examples of the environments that experience a change when a person dies. When a widow allows for the removal of her husbands clothes from her closet she is making a small change in the environment to reflect its change. In the case of the man who passed from the effect of chronic heart failure, his daughters removed the hospital recognize from the living room, and returned the sofa and book cases.The same occurred in the house of the middle aged man whose wife died from terminal cancer. Part of this change was prompted by the fact that the hospital beds were rentals from medical supply companies. The nurse who did the follow-up visit to his home noted that the man had chosen to completely rearrange his living room after the hospital bed was moved. He also purchased some new furniture for the room. His daughter took to only setting the formal dine room with three table setting instead of the four place settings. The imbalanced of the table settings contrasted greatly with the theme of symmetry in the room. any the decorations and furniture in that room was bought in pairs and arranged evenly. The table looked unpaired with its uneven number of place settings. The granddaughter has removed all the blankets from the sick room (her reference to the living room) because they were only for sick people.Adjustment to the changed environment can sometimes be problematic when the environment the person occupied most during their last days were in a nursing home. Because rooms in a nursing facility are often in high demand the rooms have to cleared and cleaned quickly. In some cases this change occurs with hours after the person death. This can be upsetting to familymembers who may have wanted to spend some quite time among their loved one things. Nurse aids often report that it makes them feel like the person meant nothing to anyone when the rooms are cleared and cleaned quickly. Even though the nurses only spend a short amount of time with the person their personalities often lend to quick attachments. Sometimes nurse aids will take keepsakes from the person room, with family permission of course. One nurse aid was given a house plant by the family of a resident she grew very close to. She still talks about the plant and th e person frequently despite the passing of two years.The fourth task is to emotionally relocate the dead person and moving on with life, (Worden, 2001). To accomplish this task the mourner must acknowledge that while they will never forget or renounce their love for that person, there are other they can love (Worden, 2001). An example of this can be seen when a widowed person after sometime meets, go in love with, and marries someone else. They understand that they will always love their first spouse, but they have accepted and properly mourned their loss.That being done they are able accept and give love to another person. Parents who have experienced the loss of a child may choose to become pregnant and have another child. They have not forgotten the child they once had and loved. They simply now realize that they can still have the love for the child that has died and for a new baby. A widow who goes out and seeks meaningful relationships among her peers so as not to be sociall y uncaring is allowing for some of the empty space in her heart to be make full with the love and understanding found in the new friendships.When a person is in the twilight of their live they must work through stages like those attributed to Elisabeth Kubler-Ross. Along with the dying person the family also experiences the emotions linked with these stages. The dying person and their family may not experience the stages of denial, anger, bargaining, depression, and acceptance in order or at the same time. The person may experience more than one stage at a time.Once the sunset has set on a persons live their family members are left with the chore of accepting the loss and mourning the dead. William Worden setforth four tasks of mourning that if completed successfully the mourner will be able to return to the quality of life they experienced before their loss. The mourner must accept the loss, master their grief, acknowledge changed environments, and relocate the deceased. (Worden, 2001)While part of the grieving process starts before the death, and can be experienced with the dying person, the tasks of mourning are solely up to the survivors to complete. It is unknown what stage if any the deceased experience after their death. This is a heavily guarded secret only imparted to those who make the journey into the great unknown.Works CitedGina Copp RGN, D. M. (1998). A Review of Current Theories of termination and Dying. Journal of Advanced Nursing , 382-390.Kipp, S. W., & Kemp, E. (n.d.). Consumer Awarness of the Legal Obligations of Funeral .L.Bee, H., & Bjorklund, B. (2005). The Journey of Adulthood. Boston Pearson.Ph.D., T. A. (2007). The tender Odyssey Navigating the Twelve Stages of Life. raw(a) York Sterling.Strickland, L. A. (2005). The last DanceEncountering Death and Dying (7th ed.). refreshed York, New York McGraw.Terry, W., Olson, L., Wilss, L., & Boulton-Lewis, G. (2006). Experience of Dying Concernc of Dying Patients. Internal Medicine journa l , 338-346.Worden, W. (2001). Grief Counceling and Grief Therapy A Handbook for the Mental Health Professional. New York Springer Publishing Company.