Dying patients’ common fears

Issue: BCMJ, vol. 51, No. 9, November 2009, Page 404 News

Here are some common fears of dying and how to help patients and their loved ones address them.

The process of dying
• Will death be painful?
• How will I get through this?
Make sure patients know they will experience little or no pain (unless they choose to). Staff members at hospice facilities are trained to interpret what patients need using verbal and nonverbal cues, and they will discuss the benefits and drawbacks of each option with patients and their families.

Loss of control
• Must I give up independence?
• Can I cope with being dependent on others?
Encourage patients to live a normal lifestyle for as long as possible. When it becomes clear they will need to accept care from others, arrange for them to meet and get to know caregivers in advance. Becoming ac­quainted with them before accepting their services can alleviate discomfort and fear.

Loss of loved ones
• What is going to happen to them?
• How will they manage without me?
Only the patient’s loved ones can alleviate this fear. Loved ones should be willing to frankly discuss what will happen to everyone when he or she dies. If children or dependent adults are involved, ensure the patient has help formulating a detailed plan for their future care.

Others’ reactions
• What if I see fear in the eyes of others?
• How do I respond to differences in their body language?
Explain to patients’ loved ones that it’s natural to feel fear and sadness when faced with the loss of a loved one, but after the initial shock has worn off, they should try to behave normally. A loved one should ensure that all caregivers and visitors are told in advance what to expect. This way, displays of shock or fear can be avoided.

• What if my visits with health care professionals and friends decrease?
• Will I die alone?
A loved one should ensure that regular visits with close friends, family members, and other volunteers are scheduled, especially if medical ap­pointments have decreased because a cure is no longer possible. Hospice care or church ministries can visit when the patient lives far from friends and loved ones. End-of-life care from these establishments includes comprehensive pain management and dramatically increases quality of life.

The unknown
• What can I expect? 
• Will there be life after death?
Everyone, even self-professed skeptics, wonders what will happen to them after they take their last breaths. Addressing this concern has physical, emotional, and spiritual implications. Even if your patient is not religious, consider asking the patient if he or she would like to talk to a priest, rabbi, minister, pastor, or monk. Outside resources such as these can present a gift of peace, regardless of past doubts and skepticism.

That life was meaningless
• What did I accomplish during my life?
• Did I have a positive impact on the world?
People who are leaving this world need to hear that they are valued and that they won’t be forgotten. Loved ones should be encouraged not to miss the chance to tell patients how much they love them, and remind them of all the good they did. Patients need reassurance their lives had purpose and meaning.

Adapted from Donna Authers’ A Sacred Walk: Dispelling the Fear of Death and Caring for the Dying (A&A Publishing, 2008).

. Dying patients’ common fears. BCMJ, Vol. 51, No. 9, November, 2009, Page(s) 404 - News.

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Ramona Muegge says: reply

There are many things worse than dieing. I have seen many a person pass and the peace that washes over them is amazing. Hopfully we can instill that in a person that there is nothing to be afraid of. None of us know what happens to us when we die but I hope that we will join our loved ones in heaven.

Ping Wang says: reply

As a published author and a public speaker on the topic of Happiness, I have been thinking about death, the meaning of life and what is happiness all about for many years. I am still in the process of learning and hopefully this training and my continued service as a piano player for the elderly at our facilities will further help me deepening my understanding and acceptence of death peacefully.

Mary L Ralian says: reply

As I read and listen to this module in my training to become a great volunteer, I realize that every patient is going to feel differently. I can only listen and comment not change that patient's mind about how they will feel. My own fear lessened as I realized that for me I believe in a higher power - not god, gods or God but something in that my soul or energy will live on as my thoughts, deeds and memories of my life or lives and also in the minds and hearts of those that loved and cared for me. My openness of everything including death will allow me to talk and communicate with the patient about their feelings and thoughts about the subject.

Barbara Reineke-Rutz says: reply

I’ve seen several people that l loved pass, to me it was very peaceful and believing in a higher power is comforting.

Tyler D Laskey says: reply

I love the article

Manuel A. Quinto says: reply

I learned different prespective about that i didnt know before.

Patty says: reply

I've seen a loved one experience all of these fears during the process of a long illness and ultimately dying. As a hospice volunteer, I'm glad that I will be aware of these underlying fears that the patient will likely be experiencing.

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