Stages of Grief After a Terminal Prognosis

The news of a terminal prognosis has a ripple effect on the family. Not only is the patient-facing the reality of their shortened timeline, but family members are also working through a range of emotions while preparing for this upcoming loss.

Five Stages of Grief: Kubler-Ross

It’s normal and expected to go through different stages of grief during this time. However, the patient and close family members need extra support as they work through different grief stages. Dr. Elizabeth Kubler-Ross explains the common stages of grief that happen with the experience of dying:

• Denial: The first defense mechanism results in the patient rejecting the reality of the diagnosis. This can occur as a direct denial. Or, it might show up as the person avoiding this topic in conversation. Denial is typical and expected since there is a lot of complex information to process at this time.
• Anger: Once a person finally concedes to reality, then anger can start to set in. This anger can be directed at a higher power, family members, or medical providers. Or, sometimes, the anger is undirected and generalized, resulting in a loss of patience or short-temper.
• Bargaining: The mind seeks a measure of control over the situation, which is where bargaining comes into the picture. It could be internal or vocalized bargaining with a focus on medical treatments, social relationships, or religious beliefs.
• Depression: As fatigue and sadness set in, the person’s mindset can suffer. It’s understandable to experience these feelings of hopelessness, and a patient needs additional levels of compassion and care to work through this stage of grief.
• Acceptance: The final stage of grief is acceptance – the point where a patient recognizes the reality of the situation and is no longer struggling against it. Often, the focus turns to enjoying the time that is left.

Preparatory Grief Before Death

In addition to the forms of grief listed above, it’s also common for individuals and their family members to experience feelings of loss and longing before death occurs. Loved ones often expect to feel grief after the death, so it can be surprising to have grief coming up when the terminally ill patient is still alive.

Preparatory grief can occur when someone is grieving multiple types of losses, such as losing a companion, changing roles in the family, fear of losing financial security, or missing out on dreams for the future.

Full Support for Patients and Families

At Bonita Springs Healthcare Services, we offer full support to assist patients and their families through terminal diagnosis and beyond. Reach out to schedule a consultation and learn more about available services.