0.4 4.4 death and dying

Research has indicated that hospice care is beneficial for the patient (Brumley, Enquidanos,&Cherin, 2003; Brumley et al., 2007; Godkin, Krant,&Doster, 1984) and for the patient’s family (Rhodes, Mitchell, Miller, Connor,&Teno, 2008; Godkin et al., 1984). Hospice patients report high levels of satisfaction with hospice care because they are able to remain at home and are not completely dependent on strangers for care (Brumley et al., 2007). In addition, hospice patients tend to live longer than non-hospice patients (Connor, Pyenson, Fitch, Spence,&Iwasaki, 2007; Temel et al., 2010). Family members receive emotional support and are regularly informed of their loved one’s treatment and condition. The family member’s burden of care is also reduced (McMillan et al., 2006). Both the patient and the patient’s family members report increased family support, increased social support, and improved coping while receiving hospice services (Godkin et al., 1984).

How do you think you might react if you were diagnosed with a terminal illness like cancer? Elizabeth Kübler-Ross (1969), who worked with the founders of hospice care, described the process of an individual accepting his own death. She proposed five stages of grief: denial, anger, bargaining, depression, and acceptance. Most individuals experience these stages, but the stages may occur in different orders, depending on the individual. In addition, not all people experience all of the stages. It is also important to note that some psychologists believe that the more a dying person fights death, the more likely he is to remain stuck in the denial phase. This could make it difficult for the dying person to face death with dignity. However, other psychologists believe that not facing death until the very end is an adaptive coping mechanism for some people.

Whether due to illness or old age, not everyone facing death or the loss of a loved one experiences the negative emotions outlined in the Kübler-Ross model (Nolen-Hoeksema&Larson, 1999). For example, research suggests that people with religious or spiritual beliefs are better able to cope with death because of their hope in an afterlife and because of social support from religious or spiritual associations (Hood, Spilka, Hunsberger,&Corsuch, 1996; McIntosh, Silver,&Wortman, 1993; Paloutzian, 1996; Samarel, 1991; Wortman&Park, 2008).

Summary

Death marks the endpoint of our lifespan. There are many ways that we might react when facing death. Kübler-Ross developed a five-stage model of grief as a way to explain this process. Many people facing death choose hospice care, which allows their last days to be spent at home in a comfortable, supportive environment.