PSYCHOLOGICAL CONCERNS FOR TERMINAL ILLNESS

Sign and symptoms of terminal illness

1. Change in self image. For instance, hair breakage, loss of weight, and body weakness.

2. Loss of independence. For instance, bathing, washing, and walking, depending on others in decision making.

3. Financial dependence. E.g. loss of employment, family breakdown,

4. Loss of property.

As Doctor, counselor, Nurse how would you address the psycho-social concerns of the terminal illness of patients? Wheel ridding, spiritual counseling, drug adherence, comforting them, and family support.

Stages of terminal illness

1. Denial is the initial reaction for those who are dying.

2. Anger, this sometimes follow denial, these happened when the patient become overwhelm with anxiety as information is accepted into the sub- conscious mind.

3. Bargaining, patients engage in bargaining in an effort to survive.

4. Depression,

5. Acceptance, this is where the patients accept that death is inevitable and then strives to understand the meaning of his/her life.

BEREAVEMENT AND GRIEVING

The psycho-social effects of death (bereavement and grieving) Bereavement is the loss through death. The person who has lost some one is bereaved; grieving on the other hand is the feeling part of the state of bereavement. The process of grief normally follows bereavement and this is displayed in the psychological, physiological and behavioral responses of the bereaved. Research has systematically observed measured changes in emotional thought patterns and our behavior during grief. The first most frequent response grievement is shock; this happens regardless of whether or not death was anticipated. It is a sense of unbelief which makes everything unreal. The process of grieving often moves from shock to searching and during this stage there is emotional desire to keep looking and in touch with the deceased, the bereaved will hold the dear items, places and people who remind him/her of the dead person. This is followed by resentment as the bereaved always find someone to blame for the loss e.g. doctors, God, or self that brings anger which is later followed by depression and loneliness which take the form of crying, fatigue, sleep disturbances, loss of concentrations and interest in life. Like any other severe stressors, grief frequently leads to hormonal changes and disturbances in the immune system. This will lead to greater susceptibility to bacterial and viral infections. The strongest effect of grief seems to occur on the cordial vascular system. It may lead to sudden cardiac death or congenital heart failure. Socially the grieved may give up favorite activities and avoid socialization. The person may experience difficult concentrating, feelings of anger, irritability smoking etc. such behaviors represents an attempt to defend self from the painful grieve and depress. 

Crisis Intervention

 It is always important for those around the grieving to evaluate and understand which stages the grieved is, such an understanding helps us to be able to take the person through the emotions that accompany that particular stage. The most important thing is to listen and appreciate what the grieved is going through. We have to give time to slowly go through the grieving process until when they learn to say goodbye to the deceased. Never wish a person nor force them to suppress their feelings or pretend that they are not hurt.