You may already be familiar with the five stages of grief, as defined by Elisabeth Kubler-Ross in her 1969 book On Death and Dying. Although the five stages of grief can apply to any type of loss, in hospice care, we most frequently associate them with the diagnosis of a terminal illness. At Suncrest Home Health and Hospice of Austin, we work to help patients and their families through the five stages of grief.
The five stages of grief can come in any order, and those coping with them may revisit any stage at any time. However, they frequently follow the familiar pattern below:
1. Denial
When a person receives bad news of any kind, their first reaction is often shock and disbelief. They may even exclaim, “No!” or, “I don’t believe it!” Usually people don’t mean this literally; they are just reacting to the news. But sometimes, when patients receive a terminal diagnosis, they or their families may go into denial. They may insist the doctor is wrong, the diagnosis is wrong or the prognosis is not as dire as it is.
2. Anger
The second stage — anger — comes after the patient or family members realize they can no longer deny the reality. The patient may began suffering new or worse symptoms, their appetite may worsen, they may be tired more frequently, suffer pain or have trouble ambulating.
3. Bargaining
In the bargaining stage, the patient or their family members may make silent or internal bargains with God or a higher power. They may promise to make amends for wrongs they have committed, make positive changes or their lives or repent in exchange for deliverance from the diagnosis.
4. Depression
When patients or their families realize that bargaining is futile, they may become depressed. Through each stage, they have held out hope that the truth was not as it seemed and that something along the way would change. During this journey, many people focus on improbable stories of improvement or recovery and hope that they will be one of the lucky few. When it becomes apparent they won’t, it can be a difficult time.
5. Acceptance
This is the final stage of grief in which patients and their families give up on the expectation of the patient being spared. While no one need ever give up hope, acceptance of the situation in which we exist can bring a peace that the other stages cannot.
The Role of Hospice Workers
At Suncrest Home Health and Hospice of Austin, our hospice nurses, certified nursing assistants, social workers, therapists and counselors are here to help patients and their families through the five stages of grief by offering comfort and understanding in a nonjudgmental environment.
We talk with and listen to patients, or sometimes we just sit quietly. We hold their hand, rub their back or just keep them company. We pray with them, sing with them or we say nothing at all. We have had experience working with hundreds of patients in hospice and their families, and we use this knowledge to assist, soothe and calm those affected by the illness and diagnosis.
For more information about hospice care or the five stages of grief, contact Suncrest Home Health and Hospice of Austin today.
