Death is a natural element of existence, a continuation of birth. All that exists in this universe will vanish at a certain point. Since what happens following a death is unclear, many individuals fear dying. Nonetheless, everyone has to contend with the loss of a loved one at some point in their lives. Likewise, humans must confront their eventual death as they develop. Unfortunately, despite immense technological improvements, medicine cannot treat all ailments, and research has not unraveled ways of stopping the process of aging. Thus, nurses in hospice mainly deal with dying patients and often advise such patients to acknowledge death as a natural occurrence. This paper investigates death as the last phase of human growth and development in this context.
Aspects of Death
Death is among the most powerful emotional encounters that humans have. Since modern medicine and ideologies are premised on protecting life, it can be hard to acknowledge that an individual cannot be cured or revived. For most people, resolving sentiments regarding death is a never-ending issue. There are different aspects of death and dying, including biological, social, and psychological. Biological death describes the failure of essential organs (Lumen Learning 12). The body gradually stops working when an individual undergoes biological death. This might result in increased sleep, cessation of eating due to slowed digestion, and blood pooling on the underbelly of the body, causing black spots or discoloration as circulation reduces. Social death refers to the loss of social connection between terminally ill people and their loved ones, including health care providers (Lumen Learning 13).
For instance, when people stop visiting or checking up on the patient. Psychological death happens when individuals start to embrace their mortality and withdraw mentally from everyone (Lumen Learning 13). The dying patient’s physical and mental state deteriorates throughout the final days of life, leaving them unable to articulate their medical requirements (O’Connor et al. 3). Likewise, routine pastimes, global occurrences, and social connections may become less appealing.
Influences of Culture, Ethnicity, and Religion on Death and Dying
People’s thoughts regarding death are influenced by their cultural, religious, and ethnic beliefs. People die differently and have different reactions to death based on their cultural background (Ohr et al. 2). In most cultures, death is regarded as a communal affair of enormous significance for the entire community, while in others, it is seen as a private event. Other cultures rejoice when an individual passes away, assuming that they have passed on to a higher realm. Some weep for long periods and live together with the body of their dead relatives (Zand). Religion and spirituality are likewise essential factors in the patient’s and family’s reactions to grief and loss.
In particular, death frequently prompts individuals to explore serious concerns such as the purpose of life, the reality of the soul, and the likelihood of a resurrection. According to Fredman et al. (23), spiritual beliefs can assist people in coping with sickness and accepting mortality. Thus, when confronted with mortality dying patients frequently engage their inner belief patterns to enable them to deal with stress and fear. Assistance can consist of empathic care and tolerance of unique views for persons whose religiosity does not incorporate convictions established in organized religion. Many studies have demonstrated that religious and spiritual convictions can impact individuals’ medical choices, interfere with therapeutic strategies, and determine treatment adherence (Rego et al. 10; Peteet et al. 3). The existence of rites can offer support and comfort to persons whose faith includes an embodiment of a particular religious activity. Overall, most religions have unique rules concerning death and traditions to commemorate the loss of a loved one.
Stages of Death and Dying
Dr. Elisabeth Kübler-Ross defined several stages that an individual may undergo to cope with imminent death. Kübler-Ross’ conventional phases, once known as the stages of death and dying, are now more generally connected with the stages of grief and loss (Portland State University). This is because sorrow, bereavement, and dying have been classified as independent subjects with comparable stages of human behavior. Everyone experiences grief; yet, not everyone experiences grief in the same manner. Caregivers should understand that there is no one-size-fits-all approach to grieving or no proper or improper way to express the agony of death. Caregivers should also be mindful that dealing with the psychological and physical anguish associated with death and dying can be therapeutic and strengthening for individuals who are experiencing it.
Grief is a loss that does not always have to entail death. Loss may be defined as any form of emotional distress, like the loss of one’s health, the end of a partnership, or the termination of one’s job. The understanding that one’s objectives may not be realized is also a form of loss. Maslow’s hierarchy of needs, the stages of existence, and possible losses are discussed (Pentaris 25). Grief and loss are likewise linked to chronic illnesses like depression, unending suffering, or conditions like Alzheimer’s. A terminal condition is when a person is diagnosed with a clinical situation that will result in death in a short period (Pentaris 9). People with terminal illnesses go through some of these stages.
However, some stages may be skipped, especially in circumstances where death is immediate or the individual cannot reconcile conflicts. Moreover, existential and physically troubling symptoms may go unnoticed and neglected (Fay and OBoyle 7). The family might undergo the same foundational steps to complete the mourning period. These phases can intersect, and an individual might go from any to the next at any time. People who are connected to the deceased are likely to go through the Kübler-Ross phases of grief and loss. These stages have since been recognized and applied to different life circumstances.
The initial phase of denial transpires when an individual does not think the assessment is accurate. Individuals may react with statements such as “this cannot possibly be occurring to me.” In the denial stage, one may solicit counsel from multiple physicians in the hopes of receiving a favorable diagnosis. Since the person maintains optimism, they are vulnerable to unconventional, unlawful, or hazardous ways of dealing with a prognosis.
The person is furious and might act out or rampage during the anger stage. They could wonder, “What did I do wrong to deserve this?” Usually, the person starts to envy young and healthy people, and they may hit out at close relatives or care providers. When individuals face degenerative illness, they are often youthful, which adds to the distress. The patient’s anger is often due to emotions of despair and powerlessness associated with the circumstance rather than the acts of their carers (Portland State University). When working with someone battling a terminal disease and appears angry, irritated, or belligerent, it is essential to remember that they are most likely behaving in the typical phases of death and dying.
Bargaining is a stage in the process of becoming conscious of the circumstance. Individuals establish agreements or negotiations with God or with themselves. For instance, they may say, “if I survive another two weeks, I will be able to see my brother’s wedding.” In general, this step can be completed in a short period (Portland State University). When the agreed-upon period has expired, the individual may negotiate a new agreement in the expectation of delaying death perpetually.
Often, depression sets in whenever an individual knows that they are destined to perish, and that little can be accomplished to prevent it. This stage’s mindset might be, “I am extremely miserable; I have no chance of healing.” Unlike certain types of professionally recognized depression, this period and form of depression are seen as healthy and natural. Nevertheless, psychological counseling involving prescriptions might be helpful to the individual and, in some instances, family members (Portland State University). Understanding that the person is fixated on previous losses is one medical consideration for despair. Nurses can help by attentively listening and ensuring that discomfort is eased. They should be hesitant to say things like “all will be fine” or “I believe in miracles.” A gentle stroke of the dying person’s hand can be beneficial. Other individuals find solace in being active, documenting their life narratives, or reflecting on prior encounters. In general, false optimism or reassurance is not a good or effective therapeutic practice.
Acceptance, instead of sadness, is shown when the person desires to prepare for life beyond death or for their close relatives following death. The mood may be perfectly described as “I have accepted my fate.” As people settle their stressful situations with death, they reach the stage of awareness and resignation of death’s certainty. An individual needs typically to have had space and help going through the preceding phases to get to this phase. When terminally ill persons accept their fate, they might appear emotionless (Portland State University). This is an especially challenging period for family members, who might take a person’s embracing of death as giving up on life or rejection. The family must accept that the patient will not die peacefully unless they assist them in giving up all ties to life. Even if the dying patient cannot or is hesitant to speak, brief calls or the attendance of a family member are always appreciated.
Detachment occurs when a person progressively isolates from the surroundings to the point that a two-way connection with others around them is nearly impossible. Considering that dying individuals might be unconscious at this period, the carers’ activities mainly focus on physical requirements (Portland State University). Nurses should ensure that they fully support the dying person’s family during this period. In some cases, families will not wish to leave their clients alone and might prefer to engage them in conversations at the bedside. Most dying patients might still hear and comprehend discussions at the bedside even though they cannot react.
Death and dying are part of the final stage of life. Unlike at this stage, most other developments over the remainder of the lifecycle reflect many alternatives. In other words, death is the point at which all human earthly experiences conclude. The five stages of death and dying addressed in this essay function as coping strategies in certain respects, helping the person understand the circumstance while learning to deal with what is occurring. In other words, they are the brain’s method of progressively comprehending the consequences of one’s coming mortality and allowing them to digest it. These stages establish a basis for perceiving death, even though they are not experienced similarly among individuals.
Fay, Zara, and Colm OBoyle. “How specialist palliative care nurses identify patients with existential distress and manage their needs.” International Journal of Palliative Nursing, vol. 25, no. 5, 2019, pp. 233-243.
Fredman, Glenda, et al. Death talk: Conversations with Children and Families. Routledge, 2018.
Lumen Learning. Lifespan Development. State University of New York Press, 2017.
O’Connor, Tricia, et al. “The Conscious State of the Dying Patient: An Integrative Review“. Palliative and Supportive Care, 2021, pp. 1–13. Web.
Ohr, Seok, et al. “Cultural and religious beliefs and values, and their impact on preferences for end‐of‐life care among four ethnic groups of community‐dwelling older persons.” Journal of Clinical Nursing, vol. 26, no. 11-12, 2017, pp. 1681-1689.
Pentaris, Panagiotis. Dying in a Transhumanist and Posthuman Society. Routledge, 2022.
Peteet, John R., et al. “Integrating spirituality into the care of older adults.” International Psychogeriatrics, vol. 31, no. 1, 2019, pp. 31-38.
Portland State University. “Human Development: Death, Dying, & Bereavement.” Pressbooks. 2019. Web.
Rego, Francisca, et al. “The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study.” BMC Palliative Care, vol. 19, no. 1, 2020, pp. 1-14.
Zand, Sahar. “Living With the Dead.” BBC News. 2017. Web.