According to Elisabeth Kübler -Ross, what are the five typical ways a terminally ill person responds to the prospect of death and the ordeal of dying? Provide a description of each response
What will be an ideal response?
Although her theory has been heavily criticized, Elisabeth Kübler-Ross ( 1969 ) is credited with awakening society's sensitivity to the psychological needs of dying patients. From interviews with over 200 terminally ill people, she devised a theory of five typical responses—initially proposed as stages—to the prospect of death and the ordeal of dying:
- Denial. On learning of the terminal illness, the person denies its seriousness—refusing to accept the diagnosis, avoiding discussions with doctors and family members—to escape from the prospect of death. While the patient still feels reasonably well, denial is self-protective, allowing the individual to deal with the illness at his or her own pace. Most people move in and out of denial, making great plans one day and, the next, acknowledging that death is near.
- Anger. Recognition that time is short promotes anger at having to die without having had a chance to do all one wants to do. Family members and health professionals may be targets of the patient's rage, resentment, and envy. Even so, they must tolerate rather than lash out at the patient's behavior, recognizing that the underlying cause is the unfairness of death.
- Bargaining. Realizing the inevitability of death, the terminally ill person attempts to bargain for extra time—a deal he or she may try to strike with family members, friends, doctors, nurses, or God. The best response to these efforts to sustain hope is to listen sympathetically.
- Depression. When denial, anger, and bargaining fail to postpone the illness, the person becomes depressed about the loss of his or her life—a response that intensifies suffering. Unfortunately, many experiences associated with dying, including physical and mental deterioration, pain, lack of control, certain medications, and being hooked to machines, contribute to despondency. Compassionate medical and psychological treatment, aimed at clarifying and alleviating the patient's concerns, can limit hopelessness and despair.
- Acceptance. Most people who reach acceptance, a state of peace and quiet about upcoming death, do so only in the last weeks or days. The weakened patient yields to death, disengaging from all but a few family members, friends, and caregivers. Some dying people, in an attempt to pull away from all they have loved, withdraw into themselves for long periods of time.
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