1. Emotional and Physiologic Elements of Death and Dying

2. Death Often referred to as the “final stage of growth”
Terminal diseases: cannot be cured; and will result in death.
Hospice(palliative care): support and comfort
6 months or less to live

3. EMOTIONAL TRANSITIONS AT LIFE’S END\
Although there are many theories about the emotional transitions encountered by dying people, the best known is

4. ELISABETH KUBLER-ROSS
Landmark work entitled On Death and Dying
Identified five emotional stages experienced by dying individuals

5. FIVE EMOTIONAL STAGES Denial - or “no not me” Anger - or “why me?”
Cannot accept the reality of death
Anger - or “why me?”
Blame on themselves or loved ones

6. FIVE EMOTIONAL STAGES Bargaining - or “Yes, but. . .”
Strong will to live; promises to God
Depression - or “It’s me!”
Sadness; overwhelming despair
Acceptance - or “It’s part of life. I have to get my life in order.”
Completing unfinished business

7. DEATH CAN INVOLVE FEARS THAT ARE PHYSICAL, SOCIAL, AND EMOTIONAL
PHYSICAL - Helplessness, dependence, loss of physical faculties, mutilation, pain
SOCIAL - Separation from family, leaving behind unfinished business
EMOTIONAL - Being unprepared for death and what happens after death

8. INTERVENTIONS FOR FEARS
Talk as needed
Avoid superficial answers, i.e. “It’s God’s will
Provide religious support as appropriate
Stay with the patient as needed
Work with families to strengthen and support

9. Right to Die
Refusal of care to prolong life
Advanced Directives
DNR