Term Paper on "Coping With Disease and Death"

Term Paper 6 pages (2234 words) Sources: 10 Style: APA

[EXCERPT] . . . .

Disease and death [...] grieving process in patients and loved ones, and the stresses of dealing with dying patients in the clinical setting. Death is inevitable, but it is still one of the most feared and misunderstood aspects of our culture and society. Grieving is a natural result of death, but it is also misunderstood and even frowned upon in some cultures. There are many different aspects of the grieving process, and it is imperative that healthcare professionals understand the stresses, reactions, and grief so they can care for and understand terminally ill patients and their families. A healthcare professional that does not understand or empathize with patients and family cannot give the full measure of care needed in these situations.

The five stages of the grieving process, according to death and dying expert Elisabeth Kubler-Ross include Denial or Isolation, Anger, Bargaining, Depression and Acceptance. In her book on death and dying, she presents each of these stages in detail. After reading her book, these reactions are not only true - they make perfect sense. At the initial diagnosis, the normal reaction is denial, (asking for a second opinion, another round of tests, etc.). They may also deny this could actually happen to them. The patient might also isolate himself or herself to come to grips with their diagnosis and reflect on their life. Next, comes anger at the diagnosis and all the implications it brings - shorter lifespan, less time with loved ones, and perhaps even anger at themselves for improper lifestyle or behavior that may have contributed to the health problem (i.e. smoking, etc.). Dr. Kubler-Ross notes, "In contrast to the stage of denial, this stage of anger is very difficult to cope with from the point-of-view of family and staff" (Kubler-Ross, 1989, p. 44). Anger can be directed anywhere, toward anyone, and the patient may even direct anger at others who are healthy who they feel do not "deserve" their health. The third stage, bargaining, is in effect an effort to "bargain" with God or the disease to spare them, to save them from death. Often the patient promises to dedicate their lives to faith if they are only spared from the disease (Kubler-Ross, 1989, p. 74). Depression is probably the most expected reaction, and it comes when the patient realizes the diagnosis is correct, they have spent their anger, and there is no bargain to be made. They may also be worried about family matters, financial burdens, and many other pressing problems beyond their diagnosis. The final stage is acceptance, where the patient realizes there is nothing else to be done, and they must accept the inevitable. They are not happy with the outcome, but they know there is no other solution. It is interesting to note that Kubler-Ross came to these conclusions after interviewing numerous patients (Romulo, 2004). Healthcare providers must understand all these stages to help the patient through them and understand reactions of the patient throughout their treatment.

Personally, funeral customs seem quite sad to me. It seems sad that a person must die for people to recognize them and tell them how important they were in their lives. It seems more humane and loving to tell people how important and loved they are while they are still alive, and in the prime of their lives when they can enjoy and understand it. I also think burial is wrong, and that cremation is a better alternative to taking up massive amounts of land for memorial parks. I feel people should live life to the fullest, because we never know what can happen tomorrow, and that they should enjoy their good health as much as they can. They should be strong when it comes to illness, and recognize the five stages of grief and illness. Death is inevitable, but if people live their lives fully and with promise, it does not have to be a time for grief, but rather it can be a time for celebration and renewal. Spiritual beliefs help many people through death and grief, and I think they are extremely important in helping them cope with illness and death. However, I feel that too much reliance on only spiritual beliefs and hopes can lead to a person not taking personal responsibility for their own reactions and life.

Of course, every family member and loved one will grieve in their own private way. Children deal with death all the time, although parents may not recognize this. They lose a beloved pet, their grandparents, a friend to an accident - they see death more than many people realize. Many experts believe that children can be taught about death during situations such as these, so that when it happens to a parent or sibling, they are better able to cope with the loss. One writer quotes a psychiatrist, saying, "She says it is important for parents to take advantage of these opportunities for education when the family is not in the midst of a crisis" (Hunker, 1997, p. 1). Children can hide their grief, and it can return when parents might least expect it. In addition, children may have misconceptions about death, and parents should be extremely careful in their descriptions of death and dying. Adults too can hide their grief, and many feel it is not "adult" to show emotions, even at very difficult times. Both children and parents may experience feeling out of control, lacking the normal safety of their routines. Children are also very comforting to each other, and siblings are a good source of comfort and understanding during the grieving process.

Of course, chronic and terminal illnesses have a debilitating affect on the entire family, and not just the patient. Children may experience fear and loneliness if a parent is consistently away from home in the hospital. Parents may feel hopeless and lost without their partner, and may even have worries about money and other familial issues, such as who takes care of the children and how the bills will be paid. Children may suffer because their routines are turned upside down - they may feel helpless or even as if they are a hindrance. Writer Hunker continues, "Families tend to get lost at this time,' Mrs. Hoff says. 'Routine will take away some worries, such as when will I eat and where will I sleep?'" (Hunker, 1997, p. 1).

The right to die has become a major issue in the discussion of death and dying. Many patients no longer wish to remain alive if they are kept alive through exceptional measures, such as being hooked up to respirators or other machines. The Living Will is one way to ensure this does not happen, as the patient requests to be removed from life-support systems. The Do Not Resuscitate (DNR) order is similar, in that it asks healthcare personnel not to resuscitate the victim in the case of illness or accident. Right to die advocates believe that they have the right to die with dignity, and the right to choose when and where they die. Euthanasia is the act of putting that right to die belief into effect. Euthanasia is often called suicide, or physician-assisted suicide, and it is the most controversial of these many ways of dealing with death. Many terminally ill patients believe they have the right to die when they choose, rather than be kept alive when there is no hope for cure or survival. They want to die with at least some of their dignity intact. Today, only Oregon has right-to-die legislation, and it has failed to pass in numerous other states. This practice will continue to be controversial in the future, and it seems to be something each patient must decide for themselves.

The problem with all of these issues surrounding death are often the family members. Many people may not want the patient to die, because they believe there will be a miracle or a cure. Another writer notes, "Yet, not infrequently, I've heard family members say that they need to keep a dying loved one alive long enough 'for God to perform a miracle'" (Lustig, 2003, p. 7). Finally, a healthcare proxy allows a trusted family member or other loved one to make health care decisions for the patient if they become incapacitated. All of these medical and personal choices can have strong ethical issues surrounding them. This delves into the area of these practices that can be a real dilemma for healthcare professionals caught in the middle between patients and family members.

Any healthcare professional must be acutely aware of the many ethical issues surrounding death, especially in this time of rampant litigation for just about any infraction. First, the ethics of the DNR order is difficult to ignore. Patients want to die with dignity, but hospitals and healthcare workers are worried about lawsuits and legal infractions. One writer talks of the difficulties surrounding living wills and health care proxies. He writes of a woman caring for a good friend,… READ MORE

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