There is an old 15th century folk saying that says: “To cure sometimes, to relieve often, to comfort always.” Knowing the fears we experience as we are dying may be very helpful while providing comfort.
1. Fear of the process
Will death be painful? Will it be frightening? What will happen to my body? Body image creates fear, especially if the person has cancer and has experienced severe weight loss. The good news is that pain can be relieved, and death is not frightening, but peaceful.
2. Loss of control
As well as fear of loss of control of body functions, there is a loss of control over life and everyday events. If hospitalization becomes necessary, it should be in an environment which exists for the convenience of the patient and family, not the hospital.
3. Fear for loved ones
They are concerned about what will happen to the loved ones who will survive them: Will there be enough money? How will they cope?
4. Fear of the aloneness of dying
People sense the isolation imposed on them by friends and staff. This is where it becomes important to stay, even though as death approaches, the person may not respond. Hearing and touch are the last two sensations we lose. A loved one’s presence can alleviate the aloneness until the moment of death, which we must all face alone.
5. Reflected fear
In his book How Could I Not Be Among You, Ted Rosenthal said, “I never knew what fear was until I saw it in the eyes of the people taking care of me.” People read how we are reacting to their illness more clearly than we think. It is important to be free to share our grief and how we feel.
6. Fear that life will have been meaningless
This is a time when we look back over our life to find meaning: Is my world better because I was here? If a person feels life has been meaningless and begins to question the reason for their creation, the process can be devastating. Now is the time to help patients identify positive aspects of their lives.
7. Fear of the unknown
It is here that our faith system comes into play. Is there life after death? What kind? There is hope: first for a cure, then for extension of life, then for more immediate hopes, such as living to see the flowers in the spring, a grandchild born, or a holiday celebrated.
Adapted from material by Tom Leicht, M.D., in the “Caring Concepts” newsletter
Dr. Tom Leicht is in private practice in Los Angeles where he also serves as a hospice consultant.
