Coping with Terminal Cancer
Sometimes, cancer can’t be cured. When that is the case, patients and families are faced with complex emotions and decisions, and many end-of-life issues.
A terminally ill person is not expected to be cured of their disease or illness. But they still need a lot of physical and emotional care and comfort. Knowing what a dying person understands about their condition, as well as their fears, feelings, emotions, and physical changes that occur may help those around them make the diagnosis and dying process easier to cope with.
The emotional, physical, and spiritual impact a dying friend, family member, or spouse has on a family and community can’t be measured. Understanding how people at different ages and developmental levels view death and dying may help to ease many of the fears and uncertainties associated with this process.
The concept of death
Everyone has their own unique idea or concept of death. This is influenced by your past experiences with death. Other influences include your age, religious beliefs, emotional development, and community. Movies, TV, and books are filled with images of death. The person with a terminal condition may have lost a family member, friend, or pet in the past. Treating death as a part of life is difficult. But it may help ease some of the fear and confusion around death. Dealing with death must be done within the belief system of the patient and family.
How children and teens view death
For a baby, death has no real concept. But babies do react to separation from parents, painful procedures, and any change in their routine. A baby who is terminally ill will need as much physical and emotional care as any age group. Keeping a regular routine is important for the baby and their caregivers. Babies can’t tell you what they need. So they often express fear by crying.
For toddlers, death has very little meaning. They may get the most anxiety from the emotions of those around them. When a toddler's parents and loved ones are sad, depressed, scared, or angry, they sense these feelings and become upset or afraid. The terms death or forever or permanent may not have real value to children of this age group. Even if they have had past experiences with death, the child may not understand the relationship between life and death.
Preschool-aged children may begin to understand that death is something feared by adults. This age group may see death as temporary or reversible, as in cartoons. Death is often explained to this age group as going to heaven. Most children in this age group don't understand that death is permanent. They don’t understand that everyone and every living thing will eventually die, and that dead things don't eat, sleep, or breathe. Death should not be explained as sleep to prevent the possible development of a sleep disorder.
At this age, children’s experience with death is affected by those around them. They may ask questions about why and how death occurs. Preschool children may feel that their thoughts or actions have caused the death or the sadness of those around them. The preschool child may feel guilt and shame.
When children in this age group become seriously ill, they may believe it is punishment for something they did or thought about. They don’t understand how their parents could not have protected them from this illness.
This same idea may make preschool-age siblings of a dying child feel they are the cause of the illness and death. Young siblings of dying children need a lot of reassurance and comfort during this time period.
School-aged children are developing a more realistic understanding of death. They are starting to understand death as permanent, universal, and inevitable. They may be very curious about the physical process of death and what happens after a person dies. They may fear their own death because of not knowing of what happens to them after they die. Fear of the unknown, loss of control, and separation from family and friends can be the school-aged child's main sources of anxiety and fear related to death.
As with people of all ages, past experiences and emotional development greatly influence a teen’s idea of death. Most teens understand that death is permanent, universal, and inevitable. They may have had past experiences with the death of a family member, friend, or pet. Just like adults, teens may also want to have their religious or cultural rituals observed.
Most teens are beginning to establish their identity, independence, and relationship to peer groups. A major theme at this age is the feeling that they won’t die, that they are immortal. Their realization of their own death threatens all these objectives. Denial and defiant attitudes may suddenly change the personality of a teenager who is facing death. Teens may feel as if they no longer belong or fit in with their friends. They may feel they can’t talk with their parents.
Another important concept among teens is self-image. A terminal illness or the effects of treatment may cause many physical changes. Teens may feel alone in their struggle and 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. They also need someone who will listen to their thoughts and help ease their fears.
How adults deal with death
Grief is a natural human response to the loss of a loved one. It can show itself in many ways. Grief, and strategies used to cope with it, vary not only between people and families, but also among different cultural groups.
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?
This occurs when someone has a long illness, and their death is expected or anticipated. Anticipating the loss of a loved one can be just as painful and stressful as the actual act of losing that person. Anticipatory grief allows the family to get ready for the inevitable death. This can be a time to resolve issues and concerns. It is a time to seek the support of spiritual leaders, family, and friends. It’s also a time to clarify the loved one's wishes for funeral and burial arrangements and other end-of-life issues.
This refers to a death that happens unexpectedly and suddenly, such as a fatal accident, suicide, or heart attack. Such tragedies can leave survivors feeling shocked and confused. Loved ones are often left with many questions, unresolved issues, and many emotions, including anger, guilt, and pain. Support from family, friends, and spiritual leaders is key for anyone who has had a sudden loss.
What may happen in the case of anticipated loss?
Many people 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. Some may feel that they have unfinished work of personal importance to complete. This time is also a chance to put practical matters in order, including the following:
Is there anyone the person would like notified of their illness, or is there anyone they wish to visit while still able?
Are there places the person would like to visit, or is there something they would like to do while still able?
Can funeral expenses be prepaid?
Which funeral home would the person prefer to handle arrangements?
Can the person help with obituary information to make sure it is accurate and complete?
What are the person’s specific funeral wishes?
If there will be a religious service, can the person facing death help plan favorite readings or music?
Is cremation or burial preferred?
Has a cemetery plot been purchased?
Does the person want memorial contributions to be made to a certain charity or organization?
Can the person give information about practical issues, such as wills, bank accounts, lawyer's name, pension plans, retirement funds, and life insurance policies?
Kukabiliana na Kansa ya Mwisho Nyakati nyingine, kansa haiwezi kutibiwa. Wakati huo, wagonjwa na familia wanakabiliwa na hisia na maamuzi magumu, na masuala mengi ya mwisho wa maisha. Mtu mgonjwa asiyeweza kupona hatarajiwi kupona kutokana na ugonjwa wake au ugonjwa wake. Hata hivyo, bado wanahitaji utunzaji na faraja nyingi. Kujua kile mtu anayekufa anaelewa kuhusu hali yake, pamoja na hofu zake, hisia, hisia, na mabadiliko ya kimwili yanayotokea, inaweza kuwasaidia wale walio karibu naye kufanya utambuzi na mchakato wa kufa iwe rahisi kukabiliana nao. Athari za kihisia-moyo, kimwili, na kiroho ambazo rafiki, mshiriki wa familia, au mwenzi wa ndoa anayekufa huwa nazo juu ya familia na jamii haziwezi kupimwa. Kuelewa jinsi watu wa umri tofauti na viwango tofauti vya maendeleo wanavyoona kifo na kufa kunaweza kusaidia kupunguza hofu na kutokuwa na uhakika unaohusiana na mchakato huu. Dhana ya kifo Kila mtu ana wazo lake la kipekee au dhana ya kifo. Hii huathiriwa na uzoefu wako wa zamani na kifo. Mambo mengine yanayoweza kukuathiri ni umri wako, itikadi zako za kidini, hali yako ya kihisia-moyo, na jamii unayoishi. Sinema, televisheni, na vitabu vimejaa picha za kifo. Huenda mtu mwenye ugonjwa usioweza kupona alipoteza mshiriki wa familia, rafiki, au mnyama-mwitu katika siku za nyuma. Ni vigumu kuona kifo kuwa sehemu ya maisha. Lakini inaweza kusaidia kupunguza baadhi ya hofu na kuchanganyikiwa kuzunguka kifo. Kushughulika na kifo lazima kufanywe ndani ya mfumo wa imani ya mgonjwa na familia. Watoto na matineja huonaje kifo? Lakini watoto huathiriwa na kutenganishwa na wazazi wao, matibabu yenye uchungu, na mabadiliko yoyote katika maisha yao. Mtoto aliye na ugonjwa usioweza kupona atahitaji utunzaji wa kimwili na kihisia kama kikundi kingine chochote cha umri. Kuwa na utaratibu wa kawaida ni jambo la maana kwa mtoto na wale wanaomtunza. Watoto hawawezi kukuambia wanahitaji nini. Kwa hiyo mara nyingi wao huonyesha hofu kwa kulia. Kwa watoto wachanga, kifo kina maana ndogo sana. Wanaweza kuwa na wasiwasi zaidi kutokana na hisia za wale walio karibu nao. Wazazi wa mtoto wako wanapokuwa na huzuni, huzuni, hofu, au hasira, wao huona hisia hizo na kuudhika au kuogopa. Maneno kifo au milele au ya kudumu huenda yasikuwa na thamani halisi kwa watoto wa kikundi hiki cha umri. Hata kama mtoto amekuwa na uzoefu wa kifo, huenda asielewe uhusiano kati ya uhai na kifo. Watoto wa umri wa kabla ya kwenda shuleni huenda wakaanza kuelewa kwamba kifo ni jambo linalotishwa na watu wazima. Kikundi hiki cha umri chaweza kuona kifo kuwa cha muda tu au kinachoweza kubadilika, kama katika katuni. Mara nyingi kifo huelezwa kwa kikundi hiki cha umri kuwa kwenda mbinguni. Watoto wengi katika kikundi hiki cha umri hawaelewi kwamba kifo ni cha kudumu. Hawaelewi kwamba kila mtu na kila kiumbe hai hatimaye atakufa, na kwamba viumbe wafu hawawezi kula, kulala, au kupumua. Kifo hakipaswi kuelezwa kuwa usingizi ili kuzuia uwezekano wa kusababisha ugonjwa wa usingizi. Katika umri huu, uzoefu wa watoto wa kifo huathiriwa na wale walio karibu nao. Huenda wakauliza maswali kuhusu sababu na jinsi kifo kinavyotokea. Watoto wa umri wa kabla ya shule wanaweza kuhisi kwamba mawazo au matendo yao yamesababisha kifo au huzuni ya wale walio karibu nao. Mtoto wa umri wa kabla ya kwenda shule aweza kuhisi hatia na aibu. Watoto katika umri huu wanapokuwa wagonjwa sana, huenda wakaamini kwamba ni adhabu kwa sababu ya jambo fulani walilofanya au kufikiri. Hawaelewi jinsi wazazi wao hawakuweza kuwalinda kutokana na ugonjwa huu. Wazo hilo laweza kuwafanya ndugu na dada wa mtoto anayekufa wa umri wa kabla ya kwenda shule wahisi kwamba wao ndio husababisha ugonjwa na kifo. Ndugu na dada wa watoto wanaokufa wanahitaji utulivu na faraja wakati huu. Watoto wenye umri wa kwenda shuleni wanaelewa kifo kwa njia inayofaa zaidi. Wanaanza kuelewa kwamba kifo ni jambo la kudumu, la ulimwengu wote mzima, na lisiloepukika. Huenda wakawa na hamu sana ya kujua jinsi kifo kinavyotokea na kinachotokea baada ya mtu kufa. Wanaweza kuogopa kifo chao wenyewe kwa sababu hawajui kinachotokea kwao baada ya kufa. Hofu ya kutokujua, kupoteza udhibiti, na kutenganishwa na familia na marafiki inaweza kuwa chanzo kikuu cha wasiwasi na hofu ya mtoto wa umri wa shule inayohusiana na kifo. Kama ilivyo na watu wa umri wote, mambo waliyojionea zamani na ukuzi wa hisia huathiri sana maoni ya kijana kuhusu kifo. Vijana wengi wanaelewa kwamba kifo ni cha kudumu, cha ulimwengu wote mzima, na kisichoweza kuepukika. Huenda wamekuwa na mambo ya zamani yanayohusiana na kifo cha mshiriki wa familia, rafiki, au mnyama-mwitu. Kama watu wazima, huenda matineja pia wakataka desturi zao za kidini au za kitamaduni zishughulikiwe. Vijana wengi wanaanza kuanzisha utambulisho wao, kujitegemea, na uhusiano wao na vikundi vya wenzao. Mandhari kuu katika umri huu ni hisia kwamba hawatakufa, kwamba wao ni wa milele. Kutambua kwao kifo chao wenyewe hutishia malengo haya yote. Mtazamo wa kukataa na wa kukataa huenda ukaubadilisha utu wa kijana anayekabili kifo. Vijana wanaweza kuhisi kana kwamba hawafai tena au hawafai pamoja na marafiki wao. Huenda wakahisi kwamba hawawezi kuzungumza na wazazi wao. Wazo jingine muhimu miongoni mwa matineja ni kujiona kuwa mtu mzuri. Ugonjwa usioweza kupona au athari za matibabu zaweza kusababisha mabadiliko mengi ya kimwili. Vijana wanaweza kuhisi wakiwa peke yao katika mapambano yao na kuwa na hofu na hasira. Ni muhimu kwa wazazi kutambua kwamba watoto wa umri wowote huitikia kifo kwa njia ya pekee. Watoto wanahitaji utegemezo. Pia wanahitaji mtu atakayesikiliza mawazo yao na kuwasaidia kupunguza hofu zao. Jinsi Watu Wazima Wanavyoshughulika na Kifo Maumivu ni mwitikio wa asili wa kibinadamu kwa kupoteza mtu mpendwa. Inaweza kujionyesha kwa njia nyingi. Huzuni na mbinu za kukabiliana nayo hutofautiana, si kati ya watu na familia tu, bali pia kati ya vikundi tofauti vya kitamaduni. Kwa wale waliookoka, mchakato wa kuomboleza waweza kuchukua miaka mingi na namna nyingi. Ni vigumu kukubali kifo kama mwisho wa maisha, na ni muhimu sana. Ni nini huzuni ya kutazamia na hasara ya ghafula? Hii hutokea wakati mtu ana ugonjwa wa muda mrefu, na kifo chake kinatarajiwa au kinatarajiwa. Kufikiria kifo cha mtu unayempenda kunaweza kuwa na uchungu na mkazo kama vile mtu huyo mwenyewe anapofiwa. Huzuni ya kutazamia huwezesha familia kujitayarisha kwa ajili ya kifo kisichoweza kuepukika. Hii inaweza kuwa wakati wa kutatua masuala na wasiwasi. Ni wakati wa kutafuta utegemezo wa viongozi wa kiroho, familia, na marafiki. Pia ni wakati wa kufafanua matakwa ya mpendwa kwa ajili ya matayarisho ya mazishi na mazishi na masuala mengine ya mwisho wa maisha. Hilo linarejelea kifo kinachotokea bila kutazamiwa na ghafula, kama vile aksidenti mbaya, kujiua, au mshtuko wa moyo. Msiba kama huo waweza kuwafanya waokokaji wahisi mshtuko na kuchanganyikiwa. Mara nyingi watu wanaowapenda huachwa na maswali mengi, masuala yasiyo kutatuliwa, na hisia nyingi, kutia ndani hasira, hatia, na uchungu. Msaada kutoka kwa familia, marafiki, na viongozi wa kiroho ni muhimu kwa mtu yeyote ambaye amepatwa na hasara ya ghafula. Ni nini kinachoweza kutokea ikiwa upotevu unatarajiwa? Watu wengi wanaokabili kifo chao wenyewe wako tayari kuzungumzia masuala ya kifo na kufa. Wakati huo unaweza kuwa wakati wa kuzungumzia mambo ya kiroho, kutatua matatizo ya familia, kutafakari juu ya maisha na mafanikio ya mtu unayempenda, na kuonyesha shukrani. Huenda wengine wakaona kwamba wana kazi fulani ambayo hawajaimaliza ambayo ni muhimu kwao. Wakati huu ni pia nafasi ya kuweka mambo ya vitendo kwa utaratibu, ikiwa ni pamoja na yafuatayo: Je, kuna mtu yeyote ambaye mtu huyo angependa kuarifiwa juu ya ugonjwa wake, au kuna mtu yeyote ambaye angependa kumtembelea wakati bado anaweza? Je, kuna mahali ambapo mtu huyo angependa kutembelea, au je, kuna jambo ambalo angependa kufanya wakati bado anaweza? Je, gharama za mazishi zaweza kulipwa mapema? Ni nyumba gani ya mazishi ambayo mtu huyo angependa kushughulikia mipango hiyo? Je, mtu huyo aweza kusaidia na habari za kifo ili kuhakikisha kwamba ni sahihi na kamili? Ni matakwa gani hususa ya mtu huyo ya mazishi? Ikiwa kutakuwa na ibada ya kidini, je, mtu anayekabili kifo aweza kusaidia kupanga usomaji au muziki anaopenda? Je, ni afadhali kufukizwa au kuzikwa? Je, eneo la makaburi limenunuliwa? Je, mtu huyo anataka michango ya ukumbusho ifanywe kwa shirika fulani la kutoa misaada? Je, mtu huyo anaweza kutoa habari kuhusu mambo ya vitendo, kama vile matakwa, akaunti za benki, jina la wakili, mipango ya pensheni, fedha za kustaafu, na sera za bima ya maisha?