Emotional Issues at End of Life

GOAL: To consciously begin the process of facing one’s own death and to explore the feelings about this event.

OBJECTIVES: Upon completion of this session, the participant should be able to:

  • Discuss her or his own attitudes toward an “unfinished life”.
  • Share her or his attitudes, feelings, and death acceptance level with her or his peers.
  • Identify the “Kubler-Ross” stages toward death and dying.
  • Explore the differences in how people cope.
  • Explore the desire to die.

Dr. Elisabeth Kubler-Ross helped to frame how we think about the emotional journey of a dying person in her famous book On Death and Dying. She found that although many terminally ill patients were eager to discuss their feelings and learn the truth of their condition, doctors often instructed family members to avoid such discussions, resulting in isolation and grief for both the patients and their families.

Kubler-Ross proposed that a dying person goes through five emotional stages:

  • stage 1: Denial
  • stage 2: Anger
  • stage 3: Bargaining
  • stage 4: Depression
  • stage 5: Acceptance

While these stages provide a framework for emotional issues, it is important to acknowledge that the stages do not necessarily happen in order, and that not every person experiences every stage. Each person's emotional journey is unique. The age of the dying person, the nature of their illness, and the cultural and social context will impact emotional issues at end of life.

This emotional issues worksheet that we use in the hospice training is valuable in thinking about your own identity, wishes and values. This is a tool that you might revisit every year or so to "check in" with yourself.

Additional Links

Recommended Library Resources

  • Video, DVD, VHS: At Death’s Door by Paraclete Productions
  • Book: On Death & Dying by Elisabeth Kubler Ross
  • Book: Dying Well: Peace and Possibilities at the End of Life by Ira Byock
  • Book: Facing Death and Finding Hope: A Guide to the Emotional and Spiritual Care of the Dying by Christine Longaker
  • Book & Audio cassette: A Year to Live by Steven Levine
  • Book: Too Soon to Say Goodbye by Art Buchwald
  • Book: The Last Lecture by Randy Pausch
  • Video, VHS: On Our Own Terms, a 4-part series with Bill Moyers