5 Stages of Patient Treatment and Grief
Patient Treatment and Grief
Often, when needing to deal with someone in a life or death situation, having to deliver them news that they have a terminal illness and that things are not going to get better, when delivering this news and trying to plan for the future to help someone work through the news that they’ve just received in order to convince them to pursue treatment, the patient will often go through grief.
Grief traditionally has had five distinct phases. When people first hear the news their initial response is denial. They’ve just been told that they have a terminal illness, that they need to pursue immediate procedures and a treatment in order to prolong what life they have left, and to give them any hope for the future. Often in the initial stages of receiving this information that is ordinarily very traumatic they will deny.
They will laugh it off, they will make jokes about it. “Oh you must be thinking about someone else not me.” They basically have no motivation to pursue treatment whatsoever. “Oh no I’m fine. I’m really.” “How could you say that? There’s nothing wrong with me.” “I don’t need that kind of treatment.” “Not interested.” “It’s not me.” They deny that they even have the problem that they have been diagnosed with nor do they accept the fact that they are terminal and need to pursue treatment immediately.
The first step in grief is denial. “Not me.” The second step that many patients go through, and working through them to help get them to the point of treatment, the second step of grief, is anger. At this stage they move past denial they know it’s true and now they get disruptive and angry and upset. “Why me?” “Why is this happening?” And they will blame others and when shown that the treatment is having a good effect that they won’t admit it.
“No it’s not. I’m not getting any better.” “This is over, I’m done.” It’s others fault, disruptive, angry, will not admit any improvement. This is the second stage of grief. You certainly don’t want to give up at these stages you want to help the person move through the grief process and learning to deal with their situation. After they’ve denied, then they’ve accepted and gotten angry, the third step in grief is usually bargaining.
At this stage they get desperate. They’re no longer mad but they want things to get better and so they will make promises. They will say, “I’ll do anything whatever it takes please restore me to health or don’t let me get any worse.” They make promises in order to get better, “I’ll do whatever it takes to get better,” or they make promises in order that their health not get any worse. “Whatever it takes so that I don’t go downhill from here.”
“Please just help me. I’ll do anything. I’ll give anything.” They’ve gone from denying that it’s true, to being angry that it’s true, to bargaining in order to try to deal with it at this stage. None of these things, obviously, are ultimately beneficial. You can’t bargain your way out of a terminal illness, but knowing that these are the standard steps that someone goes through in grieving that kind of news, can help those who are trying to help them.
We could say, “Okay, I see that they’re at this stage, we’ll just keep working with them knowing that ultimately, they will work through their grief and get to a place that is healthy and good.” After they’ve gone through denial, anger, and bargaining, the fourth stage is often depression. Here you need to be especially watchful over the patient because when they get to the stage of depression if they’re not assisted through that stage things can get much worse.
At this stage they basically withdraw, they lose interest in treatment, there’s no motivation whatsoever to pursue treatment, they have basically given up, and they have an overwhelming sense of loss. “I’m at a loss.” “I don’t want to do anything.” “There’s no point. It’s, it’s, it’s over. I give up.” You need to nurse them through that stage of depression realizing that ultimately, as someone processes grief and they get to the place where they need to be, they’ll get to a place of acceptance.
Acceptance. At this stage they have fully psychologically and otherwise processed their grief. They’ve worked through it, all the other stages, and they now are willing to pursue the treatment, as it’s been prescribed for them, and they start making plans for the future and this is a healthy place. “Okay, I may or may not get better, I probably won’t, but here’s how I need to think about the future.”
“I’m not fixated on me, I’m thinking about others and I’m thinking about the future.” Once again, in thinking about patient treatment and grief, there are ordinarily five distinct phases that most people pass through in dealing with grief and getting this kind of news. You need to know that these phases exist, that most people will move through them, and as you try to help them not only with a treatment but also with acceptance, realize that you need to help them along the stages.
Don’t be alarmed when you come across these various stages of grief. First, denial. Not me. Second, anger. “It’s someone else’s fault. No I’m not getting better.” Bargaining. “I’ll do whatever it takes please just help me.” Depression. “It’s pointless, it’s hopeless, it’s worthless. I give up.” Then finally, acceptance. “I understand I’m here. It’s going to happen. What do we need to do and how can I best prepare for the future?”