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 ?
The questions to be asked are familiar: which parts are painful and may therefore be made better by the easing of pain; which parts are inherited through the genome and may therefore be made better by the manipulation of the genome or the addition or subtraction of a gene or a protein; which parts are conscious, and which are unconscious, so that we may better understand how it feels to be dying and learn how to alleviate the worst of those feelings.
Beginning with Elisabeth Kubler-Ross's 1970 classic, On Death and Dying, many serious studies of dying have been built around interviews with people in the last days of their lives.
A person's last days can be the most remarkable example of dying as an aspect of living: without hope, a dying person begins to pull away from the world, sleeping a lot, not seeing anyone, not interested in anyone.
Much dying today happens poorly, with unnecessary pain.
Dying well is a matter of coming to grips with the losses and suffering associated with dying, while helping others to die well is largely a question of learning to accompany and compassionately care for them in the dying process.
In a passage that sounds very similar to Peck, Byock describes what he means by dying well and what characterizes those patients and families who manage to negotiate the pilgrimage of dying with some real grace.
In the broadest sense, it was as if dying from a progressive illness had provided them with opportunities to resolve and complete their relationships and to get their affairs in order.
But leaving the dying process "informal" has, to date, resulted in the rights of the dying being denied, ignored, and overridden in a random and arbitrary fashion by virtually everyone involved.
The Quinlan decision did not, however, remedy the needless and cruel suffering of most dying patients.
Those, however, who maintain that there is some "better" way to secure physician aid in dying for terminally ill Americans in great suffering must bear the burden of formulating and presenting that alternative.