(2) Exploration of feelings. Allow the patient the time and opportunity to
ventilate his feelings.
(3)
Active listening. Be attentive when the patient talks.
6-3.
PSYCHOLOGICAL RESPONSES TO THE DYING PROCESS
There are five basic stages of dying: denial, anger, bargaining, depression, and
acceptance. A patient may or may not follow these stages in a fixed pattern. He may
stop, regress, or not even get beyond the first stage. If family members are present, they
too will usually pass through the same stages as the patient, but not necessarily at the
same time.
a. Denial.
(1)
Patient reactions. The patient may:
(a)
Seek opinions of other physicians.
(b)
Request a repeat of certain tests.
(c)
State that the test results belong to someone else.
NOTE:
These actions are usually characterized by "No, not me!" "It can't be true!" or
"There must be some mistake!"
(2)
Health care provided by the medical specialist.
(a)
Listen -- do not contradict the patient.
(b)
Reinforce prescribed medication/diet routine as prescribed by the
physician.
(c)
Respect the patient's wish to deny impending death.
b. Anger.
(1)
Patient reactions. The patient may:
(a)
Replace denial with questions, feelings of anger, rage, resentment,
and envy.
(b)
Blame, complain, find fault, and be extremely critical of the care he is
receiving.
MD0549
6-3