The Dying Process - Psychological Stages

As you and your loved one move into and through this time it may be helpful to better understand some of the psychological stages that may be experienced.

Dr. Elisabeth Kubler-Ross describes the “stages of dying” in detail in her book, On Death and Dying. They can be briefly summarized as follows:

1. Denial - "No, not me." This is a typical reaction when a patient learns that he or she is terminally ill.

2. Rage and anger - "Why me?" The patient resents the fact that others will remain healthy and alive while he or she must die.

3. Bargaining - "Yes me, but . . .!" Patients accept the fact of death but strike bargains for more time. They promise to be good or to do something in exchange for another week or month or year of life.

4. Depression - "Yes, me." First, the person mourns past losses, things not done, wrongs committed. But then he or she enters a state of "preparatory grief," getting ready for the arrival of death. The patient grows quiet, doesn't want visitors. "When a dying patient doesn't want to see you any more," says Doctor Ross, "this is a sign he or she has finished his unfinished business with you, and it is a blessing. He or she can now let go peacefully."

5. Acceptance - "My time is very close now and it's all right." Doctor Ross describes this final stage as "not a happy stage, but neither is it unhappy.

These stages provide a very useful guide to understanding the different phases that dying patients may go through. They are not absolute; not everyone goes through every stage. Nor does every person go through them in this exact sequence or at a predictable pace. However, knowing that these stages exist can be a valuable tool in understanding why your loved one may behave in certain ways.