Mental Health

Mandy Kloppers

Terminal Illness

Many people will thankfully never know what it feels like to be living with a ticking time bomb. To be told that you have an illness which will most likely be the reason for your ultimate demise is a huge shock. Contemplating our own mortality brings everything into immediate perspective. The quality of our life and the people that matter the most come into sharp focus.

The negative psychological effects of a terminal diagnosis include anger, denial, insomnia, depression, anxiety, and substance abuse. Studies report up to 48% of cancer patients fulfill criteria for clinical depression, and up to 25% meet criteria for anxiety.While cancer is among the most common terminal illnesses, others include AIDS, Alzheimers disease, amyotrophic lateral sclerosis (Lou Gehrigs disease), cardiomyopathy, congestive heart failure, chronic obstructive pulmonary disease, dementia, emphysema, heart disease, liver disease, multiple sclerosis, renal or respiratory/pulmonary disease, and stroke.

Psychological response to terminal illness:
Elizabeth Kubler-Ross’ five stage theory:

Denial is the initial stage when the patient finds out about the illness and is in state of shock. Denial is a strategy used to avoid the consequences of the illness.

‘Why me? feelings of resentment, envy, rage, etc. appear at this stage. Anger is displaced in all directions, the hospital staffs, family members often feel that they are blamed. Sometimes indirectly anger is displaced on friends and family.

Trying to negotiate openly with hospital staff and secretly with God to postpone death for a promise of good behaviour.

In this fourth stage, lack of control emerges. The patient acknowledges that little can now be done to stay the course of illness. Patient’s symptoms and depressed feelings often co-exist. Patient grows weaker and become depressed.

Patient is too weak to be angry and depressed. He prefers peace and calmness. Some patients use this time to make preparations, deciding how to divide up their last personal possessions and saying goodbye to old friends and family members.

Coping strategy for terminally ill:

  • Accept the fact
  • Take the help of care takers
  • Talk to your loved ones, share your feelings
  • Recollect your good memories and cherish your achievement
  • Try to change your negative attitudes towards other and think positively about them
  • Do not think too much about your illness. Learn to live with peace
  • Get involve in spiritual activity
  • Practice meditation
  • Resolve your unfinished business
  • Engage in positive talk

Coping strategy for care takers:
Significant changes:
Often, the individual with the terminal illness undergoes significant physical, emotional, and perhaps behavioral changes as the illness progresses. Loss of hair, weight loss, irritability, depression, and other manifestations may be observed. Family members should be encouraged to provide as much factual information about the illness as possible to the patient.

Listen, to the patient.
Individuals who are gravely ill consider that their loved ones are a blank canvas on which they can share their fears, hopes and other emotions. They require someone with whom they can share emotions but at the same time they do not want any interference. They expect that family member does not play the role of counselor. Rather than providing potential solutions or suggestions, it is more than enough that the individual knows you are there with them and not going anywhere.

Respect their position in the family.
If the dying loved one is a parent, then it is important to allow them to continue to live with dignity in their final days. Care for them, but don’t treat them like a child. They will be much more content knowing that they maintained the role of parent until the very end.

Share responsibility. 
A better strategy is to share and delegate care responsibilities with siblings or other family members. Sometimes only one family member takes the entire responsibility and it adds to stress or depression. Sharing the responsibility will help to reduce burden on one person and patient also get the opportunity to talk with other members as well.

Encourage them to talk. 
Giving a terminally ill individual a chance to talk about their life provides two benefits: it takes their mind off of the pain associated with their illness, and helps them find peace and satisfaction with everything they have enjoyed and accomplished throughout their lives.
Seek professional help.
The individual who is caring for a terminally ill relative will likely to be burdened with a great deal of mental stress. They may also show symptoms of anxiety or depression. Family therapy or support group or psychological counselling can help the care taker to cope.


Mandy X