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ElderLaw News

ElderLaw News is a weekly e-newsletter that brings you reports of legal developments and other trends of vital interest to seniors and their advocates. This newsletter is brought to you by The Estate Planning & Elder Law Firm, P.C., William S. Fralin, Esq., President.

A Review of "On Death & Dying" (a book by Elisabeth Kübler-Ross, M.D.)

Elisabeth Kübler-Ross, M.D. is one of the foremost authorities on the subject of the dying and the ultimate state, which we all face, death.

Now deceased herself, she was a Swiss-American, who in the latter part of her life established a center in southern California to study these issues and to offer counseling and support to families who have lost loved ones. The center is called Shanti Nilaya (Home of Peace) near San Diego. Her father discouraged her study of medicine. Today, we are grateful she persisted. She graduated from the University of Zurich School of Medicine in 1957. She was the oldest of a set of all-girl triplets. (Wikipedia)

In On Death and Dying, Dr. Kübler-Ross details what she terms the 5 stages of death: denial and isolation, anger, bargaining, depression, and acceptance. Each chapter begins with a quote from the Indian philosopher and author, Rabindranath Tagore. A favorite of mine appears several times in the book. "Death belongs to life as birth does. The walk is in the raising of the foot as in the laying of it down." (from Stray Birds, CCLXVII) Modern medicine has given most of us the hope that we can live forever. When that turns out not to be the case, most of us don't know how to cope or offer comfort to those who are ill and are in the process of dying.

Dr. Kübler-Ross developed her theories through a series of interviews with actual terminally-ill patients.

She defines the first stage (when one hears one has a terminal illness or a family member is so afflicted) as denial and isolation. The length of each of these stages varies from person to person, but all must travel through them. So on hearing one has a terminal illness, the typical reaction is to deny that the illness is that serious. She cites an example of a woman who thought the X-rays were bound to have been mixed up or switched. This also to tends to occur when the patient is given the diagnosis of their illness by someone who doesn't know them well or who is rushed for time. Next, comes anger. Why me and other such questions. Thirdly, the patient will attempt to bargain with God. He/she thinks, "If He'll only heal me this time, I will promise to go and volunteer at the local soup kitchen." When this fails, the fourth stage is entered--depression. The patient realizes and is sad about what will be lost, and how the family left behind will cope. At this stage, it is very important to let the patient express these emotions. Finally, acceptance develops. This does not mean happiness, but it is a level of peace about the situation that he/she is in. It is frequently characterized by a lessening of interest in the outside world.

So what does Dr. Kübler-Ross counsel us to do to help the terminally ill in their final days? Well, it is not very hard or complicated. Mostly, she found that they want to be told the truth about their illness and what is happening to them. Terminally-ill adults do not want to be treated as children. Even though they might not have been directly told that they have a terminal illness, they usually can deduce that fact from the changed manner of medical personnel. Also, they want people to listen to them. They want someone with whom to discuss their fears and to be there for them, even if it is nothing more than holding their hand when they don't feel like talking or wiping the sweat from their brow. Even if the patient falls ill and then rallies several times before the end, they have appreciated frank discussions about their situation. They also are grateful for kind words and interest in them as people, especially by their medical caretakers.

In essence, then, attending and consoling the dying is not hard. It just takes sensitivity and time to listen. Their time is limited, so during their illness, they need to be center-stage in not just the technical sense of offering pills and the latest medical tests. If your schedule permits it, this is a book well worth reading. We all need to face this issue, just not for others, but for ourselves, too. One day our final day will come.

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The Estate Planning & Elder Law Firm, P.C. is an elder law firm. We represent older persons, disabled persons, their families, and their advocates. The practice of elder law includes estate planning, estate and trust administration, powers of attorney, advance medical directives, titling of assets and designations of beneficiaries, guardianships, conservatorships, and public entitlements such as Medicaid, Medicare, Social Security, and SSI, disability planning, income tax planning and preparation, care management, and fiduciary services. For more information about The Estate Planning & Elder Law Firm, P.C., please visit our website at http://www.chroniccareadvocacy.com.

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