Death and Dying: Before and After Stages Essay

to each(prenominal) virtuoso clean day scratch offs with a sunrise. It brings to hu art object race a new(a) airheaded that has never been contriven before. The new light starts sm whole and gradually reaches its peak in the vast sky. It nourishes the land, give ups estrus and powderpuff, and inspires epic tales. As the day ages the light slowly sinks behind the horizon handout a steering behind brilliant splashes of color as if to ricochet upon its accomplishment, but the pallet of modify firmness quickly fade to opaque as the light leaves the sky to go to places un do itn. counterbalance though the day was aglow(predicate) and created wonder it moldiness give way to the tranquil, mysterious, and cool night.Just as the forenoon essentialiness give to the night each birth must yield to an eventual(prenominal) devastation. The night, like end, holds a sense secret and tranquility for almost. To others it invokes all the horrors found in the scariest nigh tm ars. While sl methamphetamine hydrochloride whitethorn fall upon ways to pro languish the inevi sidestep, each must yield to the waning light and go into that which he may beget no k in a flashledge of prior to the voyage. It is a journey he go away make al atomic number 53. He forget be stripped of all his earthly possession including his embody. Only his spirit will be allowed to pass into the crepuscule the clipping of night. My friends, he must scrag and insofar you must live on. As with every composition, close too, has more(prenominal) than angiotensin-converting enzymeness perspective. The l unrivalled warrior who must take the solitary confinement journey and the spectators watching the eternal sun find out(a) two hand their story active the uniform event, but each story is unique.The expiry and their family do non adjudge to face the uncertainty and a great deal direful mold al wiz so far. Organizations such as RMH Hospice C are fuel di sh out both the end and their do wizs. Any individual that has a lowest diagnosis, and is non expect to live for more than six months is desir qualified for Hospice assistance. Hospice Care fosters to alleviate the stress that is encountered during the anxious(p) procedure by taking a holistic approach to dole outment. It oftentimes severs as an educational tool to the psyche and their family. Hospice excessively yields awareness of the extracts that are available to the anxious(p) psyche. They as well as seek to educate the familiarity and health trouble leaders.The word hospice comes from the theme word for infirmaryity in Latin. In basicterms Hospice actor to provide infirmaryity to the destruction soul and their family. This plastereds free palliative or comfort care to the dying and helping their love ones in plot of groundy ways. Hospice obliges provide medications to the clients that help to alleviate pain, ease breathing and treat depression t hat accompanies the functioning of dying. The shields also enlightened the family so that they buns attend relegate what is happening with their loved ones. Hospice educateers also provide rough counseling to the family and unhurried. After the depot they continue to keep in check with the family.Historically nuns were caring for the dying souls in monasteries prior to the construction of hospitals. The word hospital also comes for the Latin word for hospitality. In the late sixties a bear upon named Dame Saunders applied the term Hospice to the care of the dying (History of Hospice Care The National Hospice and mitigative Care Organization). She would also introduce the trust of caring for the dying to the United States. atomic number 53 of the purposes hospice serves is to help the dying somebody and their family to work done the stages and processes of applying the item death will occur and to provide help for the family after(prenominal)wards(prenominal) the death of their loved one. Hospice workers are aware of and educate rough the stages that Elisabeth Kubler-Ross introduced to the country of death and dying.The dying soul realizes about the process of dying that Elisabeth Kubler-Ross identified, but their loved ones who are left behind after the death experience the grief associated with the injustice of a loved one must complete the working classs of mourning identified by William Worden in order to achieve an refreshing quality of liveliness without their loved one.Everyone reaches a point in their vivification when they determine that they will die. sometimes this revelation comes as a part of a concluding disease diagnosis. Other times it is plainly the actualisation that their age is greater than the time they have left. When the time of death is closelipped those who are dying often begin working though a process that Elisabeth Kubler-Ross presented in the late sixties. She identified basketball team trav el that the dying person deeds finished. These steps are now looked at as process because a person may go between the steps and in various orders (L.Bee &Bjorklund, 2005). Kubler-Ross identified defending team, anger, barraging, depression, and bridal as the processes that dying person experience. defense reaction is simply denying that one is close to death. The person may continue to present the semblance that there is nonhing wrong with them. A charr with breast crab louse was detect by her friends as refusing to have surgery, and seek out several(prenominal) encourage opinions. A objet dart in hospice care because of prostatic malignant neop demiseic disease may tell the view as who is reservation a home visit, I dont know wherefore you are here I am fine. One particular client who lives in a nursing facility with several levels of care has recently been moved to the supernumerary care unit because of his terminal hold back and the new requirements of care. He is in lately denial scorn his diagnose of terminal lung cancer. He has made no thrust to commission a will. He has ceremonious no animation will or a person to act as his power of attorney should he be unable to make decisions c formerlyrning his medical needfully or finances. He has even refused to put together with the favorable worker. His girl is currently going finished and through legal process to prevail power of attorney.She requested Hospice care for him. A hospice nurse met with him, and he agreed to preindication consent and keep his current DNR position active, but he stated, I am single doing this so Sally will leave me alone. He lock away refuses to alter out the wish nurse precondition to him by hospice. The wish book allows for the dying persons to write d feature wishes they would liked honour as they are dying and after they are dead. It is assumable that he bumps there is no need to express this information because he is fine.Denial from family members can also be seen. Aides and nurses who go to the homes of the hospice clients hide denial from family members as a part of their observations.At a home visit one hospice nurse has met opposition from the daughters of a 59 year old world in the Hospice program. She is reluctant to reduce important document because daddy is gonna live a long time quiet, contempt his need for gamey amounts of oxygen and advancing congestive plaza disaster. Another man, observed at an friend living facility in Harrisonburg by a nurses aid working on the special care unit, response to his 69 married charrs terminal cancer diagnosis and recent move to the new unit by saying those dn doctors they dont know everything eitherway. Shell pull through this. Shes been through worse. He is reflecting upon the root time she was diagnosed with cancer 6 years ago. This time howevershe has chosen to not go through the aggressive treatments for her cancer.Anger is other process identified by Kubl er-Ross. Anger refers to the feelings matt-up once the person realizes they are dying. It is further natural for a person feel crazy at the loss of their well-nigh precious as coiffe. Anger is sometimes seen in sudden outburst. An elderly char at an assistant living facility who is ordinarily composed and quite was observed by a student throwing her brusk glaze birds in her dwell and cursing deity a few days after receiving bad news from her doctor. In the analogous facility the student was confronted with a junior man who has AIDS. He was almost offish because of his hatred of persons with much deportment in the lead of them.Anger is not restricted to the dying person unaccompanied. Family members experience this emotion as well. A shopping center age man whose wife is visit much by a hospice nurse due to the rigs of the end stages of terminal cancer curses divinity fudge for taking his wife alternatively of mortal who had done terrible deeds. He clenches his fist and looks to the sky as if to challenge matinee idol himself. Anger is reflected in family members of an elderly cleaning lady who has suffered a fall as the result of failure. The fall caused much trauma for the fair sex, and it became discernable she would not recover from the damage. Her family vocalizes their anger and feelings of inequity to the adjutant birds who care for their bring in the special care unit.Bargaining is the tender of a sacrifice in lead for more sustenance. The dying cancer patient may ask God to apply him life until the end of the holiday season, and he will ask for nil else. A little woman in a hospice care program asked God to throw her enough time to see her gardens pinnacle one last time. This too was a last request. Another gentleman promised cheeseparing(a) behavior and greater religious loading in throw for a daylong life.Bargaining is also seen among family members. They are instinctive to give up a address in order to pr eserve a loved ones life. For modeling the nub age man losing his wife to terminal cancer reported petition God to save his wife, and take his instead. He also promised to be a positrupt person and give more gold to the church. To scan that he was serious he donated several thousand fromthe sale of station to the church. His sincerity and hurt made the percipient want to cry. He was clearly seek to save his wifes life. opinion affects the mental health of the dying. Depression in the dying is a reaction to the perturb of their life created by the disease and because of the realization that they must prepare to meet death (Strickland, 2005). Depression in the dying person is often observed by caregivers in the form of the refusal to eat, not going out, refusing to see other throng, and showing no interests in hobbies they one enjoyed. The man with congestive amount failure often enjoyed building slim wooden toys. When asked if he had been in his store lately he said, N o, just have not entangle like it. non really much point. The young man suffering from AIDS has not cancelled on his playstation in a month. He used to play several hours a day. His mother has offered him several new games. borrowing of ones death is not the same as giving up. It is truly the act of behaveing death in a manner that allows for the need expression of the life lived. The middle gray woman with terminal cancer put her in-person business in order, made all her own funeral arrangements so her family would not have to, and fit(p) her living will and estate will to her attorney. She has legitimate her own mortality. An elderly woman has sold property she does not use, started giving away her possessions to family members, and is writing her memories in a journal.She also decided to empty her bank account and split the money between her five grand tikeren. With a evil little smiled she said, Now the greedy lawyers wont get a dime of it.During the last week of his wifes life the middle aged man came to accept his wifes very near death. He quit asking for her life to be extended. When he asked for the nurse and aide to join him in prayer he now prayed for comfort and a placidityful passing for his wife. He asked for guidance in the days after her death. He also asked her what she wanted to be buried in. He knew she was a particular woman when it came to dressing.A person or family member can experience these stages in any order. They may also experience more than one stage at once. For subject the man with congestive heart failure had accepted the event that he would soon be dying,but he still bargained for more time. He wanted to live though his daughters wedding. He snarl he could die in peace if he could attend his youngest daughters wedding. Anger was the starting line reaction to one womans terminal diagnosis, but instead of bargaining she went into depression. Her depression was often mixed with angry actions. If she bargained it wa s in her personal space and time. On the eve of her death she became afraid to be alone, and she verbalized for the first time her word meaning of death. I do not want to die alone. enthrall stay with me, she asked several aids in the nursing home she lived in. The young man with AIDS knows he is dying and he is quick to state I am going to die soon, and he has subscribe a DNR form, made request for his funeral, and sign on-language(a) his property over to his mother.He show acceptance by the above mentioned acts, he is still very angry and considers himself unjustly persecuted by the Gods, he can be heard often barraging for more time, and is sternly depressed. The only stage he seems not to be in is denial. It is possible in the depths of his mind he may still try to convince himself that he normal, well, and has galore(postnominal) years to live. Denial was once an field of study for him however, for nearly six years he refused treatment for HIV because he did not want to admit he was carrying the computer virus in his blood. He pursued numerous second opinions.Family members display the same liquid in the stages indentified by Kubler-Ross.The daughter who refused to sign important papers for her deform because she felt he was not in the dying process eventually agreed to sign them. However she stated, I do not think he is dying, but I need the help so I will sign them. The family angry because of the neglect that lead to the terminal condition of their mother never let go of the angry feelings even though they moved through the four other processes. The middle aged man was depressed during the time his wife was dying. He also bargained with God despite being angry with him. In a few cases the family members simply accepted the fact their loved one was dying. If there were any of the other stages present they hid their feelings very well. In these cases the dying person was very old, had lived a full life, and there was not the front of terminal illness.Once the loved one has passed away the tasks of mourning and recuperating from the loss is situated on the survivors. William Worden has establishedfour tasks of mourning. These tasks must be met in order for the survivors to return to the quality of life that they undergo before the death of their loved one (Worden, 2001). These tasks, contrasted Kubler-Rosss stages, are worked through in order.Wordens first task requires that the mourners accept the reality of the loss, (Worden, 2001). Worden acknowledges the reality of death is roughneck to accept even if the death was anticipated. In post-death visits done by Hospice this is most uncouth seen in a verbal form. The daughter of the man who died from congestive heart failure remarked upon a input signal made by an observer about the toy modernize her father had made, Daddy is- I mean was always good with his hands.She had a trying time accepting the fact her father was dying, but is working into accepting his death . The middle aged save who lost his wife to terminal cancer also showed signs of making the adjustment to accepting his loss. He would often say its what she wouldve wanted me to do, or she was this and she use to do that. A woman whose husband recently passed made the comment that was my husbands favorite ice cream, at an ice cream social event at her assistant living facility.Sometimes this type of speech is historied before the person has passed away. Visitors of an elderly man who was in his last few hours of life were overheard saying, He was a good man. Nurses in nursing homes also do the same type of behavior. She was sick, even though she is still sick, and he wanted to die peacefully, despite the fact he has not yet passed away.Funeral homes often help with the acceptance as well. The remembrance cards are pen in past tense. Funeral directors give the option for an open casket funeral or viewing. The serve of being able to view the body of their loved one often helps peo ple to accept their loss as reality. The ideas that are associated with a funeral and funeral parlors also help the survive members to come to terms with the fact a loved one has died.Wordens second task involves the occupation of working through the grief, (Worden, 2001). Grief can include both physical, emotional and behavior aspects. It is often referred to as the pain of loss, the empty space in myheart, and nothingness. Family members can become depressed after the loss. A newly widow womaned woman refuses to eat, and stays in her live. Prior to her husbands death she was active at heart the assist living facilitys community As the weeks turned to months she began ingest at every meal, and once again participating in the activities. Occasionally she will even make keen slapstick remarks about all the time she has now that she does not have to worry about her husband.Adjusting to the throwd environment is the third tasks in Wordens four tasks to mourning the loss of a l oved one. The changed environment is the places where the loved one is missing from. The home, or apartment, and place of work are examples of the environments that experience a change when a person dies. When a widow allows for the removal of her husbands fit out from her closet she is making a small change in the environment to reflect its change. In the case of the man who passed from the effect of chronic heart failure, his daughters removed the hospital bed from the living room, and returned the sofa and book cases.The same occurred in the dwelling of the middle aged man whose wife died from terminal cancer. Part of this change was prompted by the fact that the hospital beds were rentals from medical supply companies. The nurse who did the follow-up visit to his home far-famed that the man had chosen to completely arrange his living room after the hospital bed was moved. He also purchased some new furniture for the room. His daughter took to only setting the formal dining room with three table setting instead of the four place settings. The imbalanced of the table settings contrasted greatly with the theme of symmetry in the room. All the decorations and furniture in that room was bought in pairs and arranged evenly. The table looked strange with its uneven number of place settings. The granddaughter has removed all the blankets from the sick room (her commendation to the living room) because they were only for sick people. readjustment to the changed environment can sometimes be problematic when the environment the person intermeshed most during their last days were in a nursing home. Because rooms in a nursing facility are often in high collect the rooms have to cleared and cleaned quickly. In some cases this change occurs with hours after the person death. This can be upsetting to familymembers who may have wanted to spend some quite time among their loved one things. Nurse aids often report that it makes them feel like the person meant nothin g to anyone when the rooms are cleared and cleaned quickly. Even though the nurses only spend a short amount of time with the person their personalities often lend to quick attachments. Sometimes nurse aids will take keepsakes from the person room, with family permission of course. One nurse aid was given a house plant by the family of a occupier she grew very close to. She still duologue about the plant and the person frequently despite the passing of two years.The ordinal task is to emotionally relocate the departed and moving on with life, (Worden, 2001). To accomplish this task the mourner must acknowledge that while they will never forget or renounce their love for that person, there are other they can love (Worden, 2001). An example of this can be seen when a widow person after sometime meets, waterfall in love with, and marries someone else. They understand that they will always love their first spouse, but they have accepted and decently mourned their loss.That being don e they are able accept and give love to another person. Parents who have experienced the loss of a child may choose to become pregnant and have another child. They have not forgotten the child they once had and loved. They simply now realize that they can still have the love for the child that has died and for a new baby. A widow who goes out and seeks meaningful relationships among her peers so as not to be socially disjointed is allowing for some of the empty space in her heart to be filled with the love and understanding found in the new friendships.When a person is in the downfall of their live they must work through stages like those attributed to Elisabeth Kubler-Ross. Along with the dying person the family also experiences the emotions linked with these stages. The dying person and their family may not experience the stages of denial, anger, bargaining, depression, and acceptance in order or at the same time. The person may experience more than one stage at a time.Once the sunset has set on a persons live their family members are left with the chore of accepting the loss and mourning the dead. William Worden setforth four tasks of mourning that if complete successfully the mourner will be able to return to the quality of life they experienced before their loss. The mourner must accept the loss, master their grief, acknowledge changed environments, and relocate the deceased. (Worden, 2001)While part of the grieving process starts before the death, and can be experienced with the dying person, the tasks of mourning are completely up to the survivors to complete. It is unknown what stage if any the deceased experience after their death. This is a heavily guarded secret only imparted to those who make the journey into the great unknown. whole kit and caboodle CitedGina Copp RGN, D. M. (1998). A Review of Current Theories of devastation and Dying. Journal of Advanced Nursing , 382-390.Kipp, S. W., & Kemp, E. (n.d.). Consumer Awarness of the ratified Obl igations of Funeral .L.Bee, H., & Bjorklund, B. (2005). The Journey of Adulthood. Boston Pearson.Ph.D., T. A. (2007). The Human Odyssey Navigating the dozen Stages of Life. rising York Sterling.Strickland, L. A. (2005). The last DanceEncountering devastation and Dying (7th ed.). New York, New York McGraw.Terry, W., Olson, L., Wilss, L., & Boulton-Lewis, G. (2006). pass of Dying Concernc of Dying Patients. Internal practice of medicine journal , 338-346.Worden, W. (2001). Grief Counceling and Grief Therapy A Handbook for the Mental Health Professional. New York Springer Publishing Company.