NAVIGATING THE ART & SCIENCE OF BEING HUMAN

Death and dying triggers plenty of emotional responses and reactions. Moreover, these emotions are difficult to address. In this post, we will present the five stages of death and dying, which were proposed by Dr. Elisabeth Kubler-Ross. We will discover more about an individual’s struggling with the death of a loved one or even with the approach of his own death. Find out these phases, below.

Initial Approaches on Death and Dying Stages

Before the 1960s, most people, when they found they were going to die, focused on ways to cure themselves rather than on accepting it and taking care of their emotions. Moreover, doctors were interested only in applying medical procedures, without considering the patient’s feelings and emotional needs. Dr. Kubler-Ross managed to change this approach, and she has shifted death perspective from curing to caring.

Her book, On Death and Dying, written in 1969, has revolutionized the care that dying people receive. All her work made doctors more aware as well as more sensitive to people’s emotional needs. Dr. Kubler-Ross was able to identify patients’ emotional responses, and she has grouped these reactions into five different stages of grief and death. In order to achieve these results, she, along with other colleagues, conducted several interviews patients who suffered from terminal diseases. Those five stages are denial and isolation, anger, bargaining, depression, and finally acceptance. We have detailed each of these phases, below.

What Are the Stages of Death and Dying?

one single white rose

Phase 1 – Denial

Denial is not only the first of all the stages of death, but it is also one of the most common emotional responses that come up when someone becomes aware of impending death. Most people use denial as a defense mechanism. They usually say things like “No, it can’t be true. Not me!”. They are forced to face something horrible and inevitable. Therefore, terminally-ill patients refuse to think this can actually happen to them.

When we hear someone else, probably a stranger to us, will die soon because of a terrible disease, we react differently. Some might ignore the news and mind their business, other might feel empathy but still not be affected. But when it comes to themselves or someone they love, it is a completely different thing and a much more impactful reaction. Instantly, a patient’s thoughts are filled with negativity, anxiety, and fear. Sometimes, certain patients might even consider doing the medical tests again just to make sure.

Until a certain point, denial is one of the good stages of death and dying, being a positive coping method. It is a way to accept the fact that death will come sooner than expected. However, most patients want to deal with this at their own pace and terms, which is not necessarily a bad thing. Denial is something that not only terminally-ill patients experience but also something that close family and relatives might deal with.

Phase 2 – Anger

Anger is the second stage of death, and it comes right after the patient accepts the diagnosis. They feel rage and resentment which might also be directed at other people as well. Once this stage was defined, specialists became better at providing necessary medical and emotional care for their patients. Kubler-Ross advises both families and doctors not to respond or react in the face of the patients’ anger. They should only support the dying person without fighting his/her emotions. Although it is not a rational anger, it is one based on emotional issues. It is basically a way to mask vulnerability. A person in this situation should talk openly with a specialist, to let go of the anger.

Phase 3 – Bargaining

In this part of the death and dying stages, a person might bargain for less pain, more time with dear ones, or a miraculous cure. Once a patient feels vulnerable and helpless, they will try to regain control by bargaining. They will start thinking about what would have happened if only they had reached for medical support sooner. Some might even go to several doctors to seek additional opinions. In their attempt to postpone what seems to be inevitable, those who suffer from terminal illnesses might even make a deal with God. It is just their way to protect themselves from the painful reality they live in.

Phase 4 – Depression

a young woman crying

Once time passes by, a dying person realizes more and more the fact that the inevitable will happen no matter what they do. This is when they might become depressed. Patients will start grieving their separation from loved ones. According to specialists, there are two depression types linked to mourning. On the one hand, there is a reaction related to practical implications of the loss. This kind of depression is characterized by regret and sadness. On the other hand, there is also a more subtle depression type and a more private one. What these people need is just a jug, kind words, clarification, and reassurance.

Phase 5 – Acceptance

Finally, there is acceptance. This period is represented by peace and calm. It is the stage in which patients truly accept their situation without trying to fight it anymore. Unfortunately, not everyone will benefit from passing through this phase of death. For some, their illness might lead to sudden death. Contrary to popular belief, is not really a bravery act to remain calm and accept the fact that you will die. Although this stage is not a depressed one, it is also not a happy or joyful phase either. Dying people might want to show dignity and grace in the face of death, as their last gift to their loved ones.

Final Thoughts

Everyone experiences these stages of death and dying, no matter where they live, how old they are, or what culture they were raised in. How people go through these phases cannot be standardized. Although these five stages are universal, individuals spend a different period experiencing each stage. Also, it is true that most terminally ill patients go through the stages of death and dying in the order we presented above. However, for some, these stages might occur in a totally different way. These phases are normal, and they prepare the patient for a peaceful acceptance of death.

Grieving is a personal process, and each individual feels and reacts in his/her own way. It has no time limit. Moreover, there is no right way to do it. So, patients should feel free to express their emotions as long as they don’t harm or negatively affect others. Those around them should offer their unconditional support.

Image source: 1, 2, 3