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Coping With Terminal Cancer

Sometimes, cancer cannot be cured. When that is the case, patients and families are faced with complex emotions and a variety of end of life issues.

A terminally ill person has no expectation of a cure for his/her disease or illness, but still requires a lot of care and comfort. Knowing what a dying person understands about his/her condition, as well as his/her fears, feelings, emotions, and physical changes that occur, may help those around them make the diagnosis and final process easier to cope with.

The emotional, physical, and spiritual impact a dying friend, family member, or spouse has on a family and community cannot be measured. Understanding how people at different ages and developmental levels view death and dying may help to alleviate many of the fears and uncertainties associated with this process.

The concept of death:

Everyone has his/her own unique concept of death. Past experiences with death, as well as one's age, emotional development, and surroundings, are what most influence one's own concept of death. Movies, television, and books are filled with images of death. The person with a terminal condition may have previously lost a family member, friend, or pet. Treating death as a part of life is difficult, but may help alleviate some of the fear and confusion associated with it. Dealing with death must be done within the beliefs and mores of the family.

How children and youth view death:

Their experience with death is influenced by those around them. They may ask questions about "why?" and "how?" death occurs. The pre-school child may feel that his/her thoughts or actions have caused the death and/or sadness of those around. The pre-school child may have feelings of guilt and shame.

When a child in this age group becomes seriously ill, they may believe it is their punishment for something they did or thought about. They do not understand how their parents could not have protected them from this illness.

This idea may make the preschool-age sibling of a dying child to feel as if they are the cause of the illness and death. Young siblings of dying children need reassurance and comforting during this time period, as well.

Most adolescents are beginning to establish their identity, independence, and relationship to peer groups. A predominant theme in adolescence is feelings of immortality or being exempt from death. Their realization of their own death threatens all of these objectives. Denial and defiant attitudes may suddenly change the personality of a teenager facing death. An adolescent may feel as if they no longer belong or fit in with their peers. In addition, they may feel as if they are unable to communicate with their parents.

Another important concept among adolescents is self-image. A terminal illness and/or the effects of treatment may cause many physical changes that they must endure. The adolescent may feel alone in their struggle, scared, and angry.

It is important for parents to realize that children of all ages respond to death in a unique way. Children need support and, in particular, someone who will listen to their thoughts, and provide reassurance to alleviate their fears.

How adults deal with death:

Grief is a natural human response to the loss of a loved one. It can manifest itself in many ways. Grief moves in and out of stages from disbelief and denial, to anger and guilt, to finding a source of comfort, to eventually adjusting to the loss.

It is normal for both the dying person and the survivors to experience grief. For survivors, the grieving process can take many years and many forms. The challenge of accepting death and dying as the end stage of life is what the grieving process is all about.

What is anticipatory grief vs. sudden loss?

What may happen in the case of anticipated loss?

Many, although not all, persons facing their own death are willing to discuss issues of death and dying. This can be a time to discuss spiritual issues, resolve family concerns, reflect on a loved one's life and accomplishments, and express gratitude. It also provides an opportunity to put practical matters in order, including the following. Consider:

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