1. GRIEF SERIOUS CHRONIC ILLNESS ILLNESS

3. Prejudices, Placations and Platitudes Just a few of the things I’ve heard: If you have to have cancer, this is the one to have. If you have to have cancer, this is the one to have. If you can’t change the situation, change your attitude. If you can’t change the situation, change your attitude. You must be scared to death. You must be scared to death. Noone dies of prostate cancer; they die from something else while they have prostate cancer. Noone dies of prostate cancer; they die from something else while they have prostate cancer. If you are distressed by anything external, the pain is not due to the thing itself but to your own estimate of it; and this you have the power to revoke at any moment. ( Marcus Aurelius) If you are distressed by anything external, the pain is not due to the thing itself but to your own estimate of it; and this you have the power to revoke at any moment. ( Marcus Aurelius) Use the power of positive thinking. Stay positive. Use the power of positive thinking. Stay positive. Just get lots of rest. Just get lots of rest. Don’t stay in bed; get out and do something Don’t stay in bed; get out and do something Get plenty of exercise. Get plenty of exercise.

4. SERIOUS CHRONIC ILLNESS Generally Permanent Generally Permanent Entails significant medical intervention. Entails significant medical intervention. May be very expensive. May be very expensive. Entails significant change in lifestyle. Entails significant change in lifestyle. Confronting Death issues. Confronting Death issues. Often causes substantial changes to: Often causes substantial changes to: – Job choices or opportunities – Interpersonal relationships – Recreational activities – Role in one’s family – Life goals

5. Issues Emotional: Emotional: Self-image Self-image Dependency / Control Dependency / Control Social Stigma / Self-esteem Social Stigma / Self-esteem Abandonment (e.g. by God, others, one’s body) Abandonment (e.g. by God, others, one’s body) Anger (at God, undefined) Anger (at God, undefined) Isolation and fear of aloneness Isolation and fear of aloneness Stress Stress Death and End of Life Death and End of Life Physiological Physiological Fatigue (physical & mental) Fatigue (physical & mental) Depression Depression Sleep problems Sleep problems Stress (can’t do things) Stress (can’t do things)

6. STAGES OF GRIEF The stages Kubler-Ross identified are: Denial (this isn't happening to me!) Denial (this isn't happening to me!) Anger (why is this happening to me?) Anger (why is this happening to me?) Bargaining (I promise I'll be a better person if...) Bargaining (I promise I'll be a better person if...) Depression (I don't care anymore) Depression (I don't care anymore) Acceptance (I'm ready for whatever comes) Acceptance (I'm ready for whatever comes) - OR - Denial Denial Bargaining Bargaining Guilt Guilt Anger Anger Depression Depression Acceptance Acceptance

7. ILLNESS COPING FACTORS Beliefs about life Beliefs about life Beliefs about God Beliefs about God Beliefs about self Beliefs about self Beliefs about illness Beliefs about illness Beliefs about control Beliefs about control Self-efficacy Self-efficacy Life strategies (catastrophy, victim, etc.) Life strategies (catastrophy, victim, etc.) Coping strategies Coping strategies

8. POSITIVE CONSEQUENCES OF SERIOUS ILLNESS Discovering and growing community Discovering and growing community Discovering and growing family Discovering and growing family Deepening knowledge of oneself Deepening knowledge of oneself Discovering / developing a relationship with God Discovering / developing a relationship with God An opportunity for spiritual growth An opportunity for spiritual growth Growth in interpersonal relationships Growth in interpersonal relationships (Based on Viktor Frankl) (Based on Viktor Frankl)