Stages of adaptation to the diagnosis

How to report a diagnosis

The first difficulty faced by carers of patients (relatives, doctors, priests, nurses), the question: to inform or not to inform the patient about his diagnosis? More recently, a patient of "deontological" considerations do not report the true diagnosis and prognosis, even if he insisted on it. It was believed that the truth, tell the doctor takes away hope, causes depression and can cause the patient to suicide. Today, based on the fact that the patient has the right to comprehensive information about their health status, including information on diagnosis, prognosis, plan of remedial measures and the possible consequences of refusing treatment.

Stages of adaptation to the diagnosis

One of the most authoritative experts in the field of psychological help dying patients Dr. Elizabeth Kubler-Ross based on his many years of research identified five stages or phases through which a person is forced to pass from the time when he receives the fatal news:

· shock and denial (refusal to believe);

· anger (irritation, facing outward);

· bargaining, the deal, negotiations;

· depression (irritation, facing inward) sorrow;

· acceptance or consent.

The first stage is characterized by the reaction of denial of mourning. Upon receiving news of the chronic, including life-threatening disease, and / or loss of life coming close to him, experiencing the loss of experienced psychological shock, which can go into seizures or mental tantrum. "That can not be!" - He says to you or others. The disease is still something is negative, the internal debate is rejected or seen as a sign of weakness, which further exacerbates the situation. As the deterioration of health, denying the possibility of death can be combined with a presentiment of the true situation, and in some cases even with full knowledge of imminent death. At this stage it is not necessary to interfere with the patient.

The second stage of mourning manifests acute reaction of anger, rage, aggression, directed both at himself and the person who directly, according to the suffering, is responsible for what happened. Anger may be directed at families or nurse, it interferes take care or nursing. Man angry, indignant. He asks himself: "Why me fell?". He suffers from this idea and is willing to do anything to prevent the loss. Anger and rage have other emotions - fear and frustration that encourage it "to make a deal," "negotiate" with the supreme spiritual being. At this stage it is necessary to enable the patient to speak.

Negotiating with the highest spiritual being is the third stage of mourning. Man promises "him" to do something (usually it is making a large sum of money to the church for the transmission of "Him"), if "He" will give him a reprieve, the ability to live up to a certain date, or heal it. At this stage it is necessary to divide the experience with the patient.

However, none of this happens, and the person falls into a depression, confusion and disappointment - the fourth stage of mourning. While at this stage, he starts to feel really close to the arrival of death or loss of a loved one to feel sad because of past pleasures of life, resentment due to unfulfilled plans. He often cries, alienated, lost interest in the home, loved ones. He is only interested in your own comfort. At this time we should give him to speak out and not try to cheer him up.

The fifth and final stage of mourning - making losses, death is accompanied by the desire of human (dying) to do everything possible to alleviate the pain of losing loved ones have. That means farewell to life, awareness of death. It is important to give the patient time and opportunity to realize "accept" the mountain.

Most people survive the loss, gradual transition from one stage to another mourning. But he may return to the stage already completed. Strong grief associated with the loss of a loved one, can last from 6 to 12 months, and sorrow, which then comes - from 3 to 5 years. The fear of death in most cases is associated with the fear of the dying process, which is chronic incurable diseases as usually accompanied by an increase of helplessness due to loss of physical abilities and the normal functions of the body, the feeling of depending on others and the associated humiliation of dignity. Therefore it is necessary to convince the patient and his relatives that their loved one will not throw, and will take care of it until the last minute of his life. The most important thing he wants to hear the patient during the impending end of the nurse and relatives: "What would whatever happens, we will not leave you. " Therefore, it is necessary to continually create the opportunity to appeal to someone for support, to encourage the ability to grieve, because it helps him cope with their feelings. No need to prevent the manifestation of negative emotions. Tact, shutter speed, sensitivity, attention and empathy can help to gain the attention of a doomed patient and his family.

Communicating with dying patients should not only be verbal. It is very important friendly touch to the patient to take up his hand, gently put her hand on his shoulder and said: "I am delighted to be with you," shut up. Let verbosity back down, give the place a deep, filled with genuine human diligence silence. Dying need not insignificant words and simulated emotions. If a patient with an incurable disease is at home, taking care of it for the most part fall on the shoulders of family members. Therefore, the latter should be prepared for what to choose and prepare a suitable patient foods administered analgesics and other necessary drugs to solve specific health problems (eg, care for patients with urinary and fecal incontinence).

One of the main goals of palliative care - support relatives and friends of the patient experiencing loss. Since the period of the loss of life includes not only the disease but also death, assistance in the form of psychological support should be directed at families experiencing and suffered loss.