(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
Research has been done by interviewing terminally ill patients and their families
to gain information about psychological responses to the dying process. The
conclusions of the research are that 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 progress beyond the first stage. If
family members are present, they will usually pass through the same stages as the
patient, not necessarily at the same time.
a. Denial.
(1)
Patient reactions. The patient may:
(a) Seek opinions of other physicians.
(b) Request 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.
Patient reactions. The patient may:
(1)
(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.
MD0586
6-3