dying


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dying

 [di´ing]
the last stage of life; a process that from a medical point of view begins when a person has a disorder that is untreatable and inevitably ends in death, or the final stages of a fatal disease. Dying is a process, whereas death is an event. The essential task of the dying person is to work through psychologic responses toward the reality of approaching death to a final and peaceful acceptance of that reality.
Stages of Dying. Dr. Elisabeth Kübler-Ross, a psychiatrist, formulated a stage theory of dying. These stages represent the adaptive strategies of a dying person who is trying to come to grips with the finality of his or her terminal illness. Not every dying person proceeds through these stages in accordance with the proposed sequence; many alternate between one stage and another. Sometimes a patient will appear to have moved toward acceptance only to regress toward denial in response to some event. Dying is unique to the individual; no two people have the same life experiences or the same inner resources to deal with the vagaries of life and its inevitable end. However, being aware of what people who confront death have in common can be of benefit to those who care for them throughout the dying process.

The stages proposed by Kübler-Ross are not limited to adaptation to dying; they may also apply to anyone who has to deal with profound, unwanted change. Every change involves some loss, the end of something familiar and the beginning of something new. Unhappiness with the change can trigger denial and other psychologic responses that delay acceptance. The stages are denial and disbelief, anger, bargaining, depression, and acceptance.

Dr. George Engel proposed the theory that grief over the loss of a loved one brings about psychologic responses not too different from those exhibited by persons who are themselves dying. Moreover, it has been noted that severely handicapped and disabled persons who must change their lifestyle to accommodate the effects of illness or injury might also go through a process in which they move toward acceptance of a new self and a new way of life.

John Bowlby and C. Murray Parkes also described stages of grief, outlining four dimensions: (1) shock and numbness, (2) yearning and searching, (3) disorientation and disorganization, and (4) resolution and reorganization. These do not follow any particular order, and the stages may overlap.

Partnership for Caring is an educational council that provides programs tailored to meet the needs of laypersons and professional caregivers coping with the problems of terminal care. It also is the source of the Living Will and addresses legal and medical issues related to death and dying. Their mailing address is Partnership for Caring, 1620 Eye Street NW, Suite 202, Washington DC 20006, and their Internet web site is http://www.partnershipforcaring. org. Their telephone numbers are 202-296-8071 and 800-989-9455.
A poorly understood phenomenon characterised by a gradual systemic shutdown, followed by an absence of criteria that define life; dying and death eventually occur in the elderly, even without identifiable disease

dying

General medicine A poorly understood phenomenon characterized by a gradual systemic shutdown, followed by an absence of criteria that define life; dying and death eventually occur in the elderly, even without identifiable disease. See Brain death, DNR, Hospice.

dying

1. The end of life and the transition to death.
2. Degenerating (e.g., “dying back”).

Patient discussion about dying

Q. God! I want to die! First of all I would like to thank you all for this website - and for all your posts - it´s very supporting. Now, my story... I have Bipolar II I´ve always had been a sort of depressed / concerned during my childhood. When I was about 14 I felt something different: I felt sort of high - I was no longer shy - I did well at school and I was so happy with a great self-confidence. After two year that changed and I got depressed – school results became poorer. Got other physical illnesses - I was diagnosed chronic inflammation of the eyes - no treatment helped. Shifted to a new country was happy for a while but again started depressing. Inflammations of the eyes got better. I was happy and I was sad and so on... My father could see a strange activity in my eyes and irritability combined with deep depression. It’s Bipolar disorder. After 2 years I felt good so I stayed away from med. God! I really want to die. Thank you for your patience to hear this patient!

A. I sure can relate to how you have been feeling. I too have been so high that I danced on desk tops and then tried to kill myself many times. Thru prayer and alot of good loving caring people and doctor. I now know I must stay on my meds forever and just except that it is a chemical imbalance I will always need help with. God Bless you and Good Luck.

Q. What causes fibromyalgia? Is fibromyalgia a deadly disease?

A. The causes of fibromyalgia are not known. But there are many theories such as abnormalities in brain chemicals, infections, trauma, genetics and hormonal changes. Factors such as poor sleep, fatigue, overexertion and anxiety, may aggravate the symptoms. Fibromyalgia is not a progressive or life-threatening condition, but it affects quality of life. Fibromyalgia is only a disorder of muscles and not a disease.

Q. feel like im dying want to quit smoking and drinking want help

A. Well it is important to know how often you drink and smoke, in order to help you quit. You can ask your doctor about helpful tips for smoking cessation, for instance wearing a nicotine patch, or quitting gradually.

More discussions about dying
References in periodicals archive ?
Doctors who try to prescribe large enough doses of these compounds--morphine and its derivatives--are often suspected of inducing a dying patient's addictive craving.
This is a cruel joke to anyone who is dying with intractable pain and who may reasonably argue that one cannot be addicted when one is dead.
Beyond the tragedy of dying people having to hasten their death with the same compounds that might have given them a reason to live longer, the denial of proper painkillers damages a person's body.
The "how" of mental life--the mechanisms of gene expression, protein synthesis, and cellular communication that work so well for a century in some brains but not well at all in others--are at the intersection of basic biomedical science and the right of a dying person to full membership in society until the last moment of life.
A long-term survivor of AIDS, the author of Living Our Dying: A Way to the Sacred in Everyday Life (Hyperion, 1996) has served as a hospital chaplain and spent much of the past decade facing his own dying and learning to care for others as they die.
We learn not to hold on to possessions, titles, power, or even the solace of absolutely certain answers but to live simply and consciously up against the mystery of our dying lives.
Because we learn to look unflinchingly into the mystery of our own dying, we are not frightened by the dying of others, and we can keep them company.
Near the end of "Marvin's Room" Bessie (who is herself dying of leukemia) tells her sister Lee (Meryl Streep) that she is deeply grateful to have had so much love in her life, and Lee agrees that their father and aunt have loved Bessie a great deal.
Even if a large percentage of doctors were already providing aid in dying, the question of whether they should continue to do so covertly, free from any legal oversight or protocols, would still demand an answer.
The thought of thousands of individual doctors applying an equal number of different subjective criteria to their practice of aid in dying should be profoundly unsettling to anyone.
Our worst fears were confirmed in a recent study reported in the Journal of the American Geriatrics Society, conducted by doctors Joan Teno and Joanne Lynn at the George Washington University Center to Improve Care for the Dying and by their colleagues at seven other medical centers.
Another source of opposition to physician aid in dying comes from some advocates for America's 49 million citizens with disabilities who are rightly concerned about society's tendency to negatively regard the disabled and to devalue their lives.