Five Stages of Dealing With Dying

Unfortunately, not every patient you’ll come in contact will recover and leave the hospital, nursing home or long-term care facility. While these are not the situations you wish to dwell on, it’s imperative to hold a strong understanding of how to deal with patients who are facing their own mortality. Of course, there is no way to fully understand what the patient is going through, but by learning the five stages a patient likely goes through when dealing with their upcoming demise, you’re able to better adjust your level of care and communication to help make their last days filled with peace, happiness and empathy.

The Five Stages of Dealing with Dying

Although you’ll cover this topic in greater detail within your CNA training course (certified online nursing aides will also read about this topic), the following is considered the top five stages a human experiences when they come face-to-face with their mortality.

  1. The Denial Stage – Denial is the mental state of not accepting the inevitable. Many patients who are cognitively able to understand what’s happening to them do not wish to accept the fateful news from their physician. For example, your patient cannot accept the fact that she has a terminal condition. After learning such news, it’s not uncommon for a person to put away the reality of a situation until they’re better capable of handling such news. It’s not uncommon for a patient to slip between denial and acceptance throughout their final moments on Earth.
  2. The Anger Stage – Often times when dealing with the reality of death, patients become angry. While they are not angry at you, they often take out their frustration and anger on those who are closest to them at the time, the CNAs. It’s important to understand that anger is often the interpretation of deeper feelings, such as fear, frustration and resentment. While their anger may seem to be directed at you, they’re likely not angry with you, but rather with the situation. During these moments you must remain fully compassionate, kind and understanding.
  3. The Bargaining Stage – It’s not uncommon for a patient who’s dying to try to bargain for more time on earth. While this is obviously not a productive way to extend their days in this life, it is an opportune time for the patient to take care of unfinished business. Your responsibility during this phase is to simply be there to listen. Pay attention to what they say and if you can help in any way, do so.
  4. The Depression Stage – Many patients who discover their days truly are numbered begin to become depressed. Depression within the dying process can take on two primary forms: (1) Grief over past losses, grief over unfulfilled dreams and disappointments within their life, and (2) preparing for the forthcoming losses. The depression phase is essential for the patient to come to terms with their reality. Now is not the time to try and cheer them up. Rather, sit and listen. Try and tell them you are grateful to have them in your life and to know them. You may be the only human the patient has to speak with during his last days. These are precious moments. It’s not uncommon for the patient to begin to disconnect with reality as his present situation is too difficult tot deal with. Be supportive during all of the individual stages within the depressive state.
  5. The Acceptance Stage – For many patients, this is the final stage in dealing with their upcoming death. After all is said and done, the only actual choice a patient has is to accept the inevitable. It’s important to realize that acceptance of death does not mean they are happy, but rather are living in the moment and realizing there is nothing they can do. As a CNA, you must strive to support this stage. Do everything you can to support the natural mental flow to the state of acceptance, as it’s here the patient is truly calm and relaxed.