DEATH OVERVIEW

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Everyone experiences—not only his or her own death—but the death of a loved one. Someone in the world dies—and more are born—every second. In the U.S., several persons die every minute.

Death, the termination of earthly existence, brings feelings somewhere between terror and sadness to most people. In her well-known book, On Death And Dying, Elisabeth Kuebler-Ross says:

When we look back in time and study the old cultures and peoples, we are impressed that death has always been distasteful to man and will probably always be...It is inconceivable for our unconscious to imagine an actual ending of our own life here on earth, and if this life of ours has to end, the ending is always attributed to a malicious intervention from the outside by someone else. In simple terms, in our unconscious mind we can only be killed; it is inconceivable to die of a natural cause or of old age. Therefore death in itself is associated with a bad act, a frightening happening...

Young people—especially those between the ages of eight and eighteen—are particularly vulnerable to the fear of death. They are coming into new self-awareness. The idea of being alive in the world as an autonomous individual is dawning, and the freshness of this consciousness heightens its antithesis. Youth is also a special age for pondering the alternative to existence. Turning out the lights at night can remind a young person of death and what it might be like. Friendship is a most important part of young lives, there is still deep dependence on parents, and dying means losing all we know on earth. Just as divorce is hardest on children of these ages, so death is a very threatening possibility.

Kuebler-Ross describes the five stages in dealing with death. These stages are true for those who know they are dying as well as for those watching someone close approach death. The stages of death-grief occur in divorce, the death of a cherished pet, or any other significant loss:

• Dying people, or their close relatives, may DENY death. "Not me (her or him)! It can’t be true! The diagnosis is wrong. It was mistaken identity or a false report." Recognize that this is an important first stage. Be patient. Just be there. Do not argue because denial is a natural reaction to such news. And do not moralize. But expect some growing acceptance of reality and be ready to respond to the person’s need to talk.
• It is also natural to get ANGRY about the ending of one’s life. "Why me?" is the great question. "My life’s suspicion and fear of being rejected is now confirmed!" Remember, it is important for this anger to be expressed. Again, do not sermonize, but accept the necessity of this stage. And be aware of your own fear of death.
• A dying person may mentally BARGAIN for more time or less pain or another chance. Those close to the dying may do the same thing. "I will change may life" or "I will never do that again, if only..." Note that regrets and guilt may play a part in this stage. As these reservations are verbalized, it can be important to offer objectivity about the positive. Affirmation, hope, and forgiveness are appropriate.
• DEPRESSION may be a part of the grief process. "I’m going to miss my family, friends, or lover so." "I can’t stand the thought of what my loss may do to them." At this stage, provide appropriate encouragement or simply remain a silent positive presence. Whichever seems needed, positive reassurance is important.
• With time and understanding, dying people come to ACCEPT death. People need to know and be assured of that. They will probably want to express their new assurance, have some time alone and enjoy your presence. It is Mother Teresa’s great vision to give each person on earth a chance to die in dignity. Here it is especially important that you do not intrude with your own death-needs. Do not feel rejected if the dying one wants to be alone or silent.

IMPLICATIONS

• Children need to share in the death experience appropriately. They may feel irrational guilt for death. Questions must be faced and feelings relieved. However, children often display remarkable resilience.
• Death obviously is a time for the contemplation of one’s life and of life after death. Faith of one kind or another becomes very important for the dying and their supportive community. Family and friends expect to be supported by pastor, rabbi, or spiritual leader.
• The grief process may take place quickly, especially in the case of a terminal disease when one has done grieving before the actual death. It usually takes place over the months that follow a death. For some it may occur as a delayed reaction a year or so later. Appreciate differences, but encourage people to find help in leaving a debilitating grief.