Health Care and the Dying


The Dying are Living !

The Dying are Human beings!

The Dying are Persons !


The term “patients” works against realizing all three.


Persons have rights, feelings, emotions, and ought to be given the respect, love and concern that humans deserve.  Persons deserve CARE based upon understanding and understanding based upon the TRUTH.


AVOID Harmful words and phrases:


1. “Dying”  well we all are, aren’t we.  Who knows the exact date and time for death?

     It separates the living from those they think are different or not like them, “dying”.


2. “Terminally Ill” as a phrase is not given an exact definition.  It is a guesstimate!

But the phrase hurts people because it separates them from others and serves to setup a harmful “stereotype”.


3. “Dying patient”.  This is two steps removed from a living human being!


Respect for Persons

Respect for Personality

Personality can be maintained in the face of impending death.

People react differently according to their personalities.  Yet there are some emotions shared in common by many, not all.


What sort of reaction or attitude to your impending death do you think that you would have?

What sort of reaction or attitude to your impending death would yo want to have?

What sort of reaction or attitude to impending death would you want your loved ones to have?

The  Theory  of   Elizabeth Kubler-Ross, M.D.,  RN


Description of “Stages of Dying”

A theory, based upon observations

NOT a prescription!!



NOT everyone HAS experience these five emotions.

NOT everyone MUST experience these five emotions.

NOT everyone WILL experience these five emotions.

NOT everyone SHOULD experience these five emotions.


It is a helpful guide to understanding.


It is NOT a manual for how to die “correctly” or “better.

You cannot impose these feelings or “stages” on others!



Five (5) --  more or less

            These are just the most frequently observed and in the order most frequently observed by Dr. Kubler-Ross.


Stages – not exact, not definite, there are overlaps and regressions and accelerations

Dying- NO not only for approaching death but for any event that is approaching and is horrible and that can not be stopped or altered.

                    e.g., loss of job, break up of a marriage, death of a friend


There are regressions, fixations and accelerations.

 The Stages


1.    Denial-  easy to get into , hard to keep up.




2.    Anger- not directed at actual persons but at what they represent




3.    Bargaining- doe not last that long




4.    Depression – two (2) types, quite different and calling for a different response from those who wish to help!


a. Reactive Depression- looking to the past and losses already incurred, losses that are physical and social.


b. Anticipatory or Preparatory Depression – looking to the future and the impending loss of EVERYTHING and EVERYONE.


5.    Acceptance




Learn from those facing death what others can do to help them.

Alternative Forms of Caring


Home Care

Palliative Care  


Palliative Care Web Sites

Hospice Program

Provide comfort with care on the journey toward death!

Hostels are places to rest on a journey

Hospitals are places for a person on a journey towards health



        Programs not places

        80% in Home

        Diversified Team supporting FAMILY

        Pain Control- variety of chemical Agents

                Drugs are effective 99.5% of the time

        Intractable pain exists only .5% of all cases


          e.g. Morphine, cocaine  and potentiators


Hospice Program Web Sites 



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