1. DEATH AND DYING
By: Nelson Munthali Dip/RN
16th March, 2013

2. Objectives
1. Define common terms used in death and
dying.
2. Describe the stages of dying/ grieving.
3. Describe factors that influence loss and
grief.
4. Explain the nursing process and the nurses
role in death and greiving.

3. Loss
This is when the other person, possession, body
part, familiar environment or sense of self is no
longer present
Grief
It is when emotional response to a loss manifest
in ways unique to an individual, based on
personal experiences, cultural expectation and
spiritual beliefs.

4. Mourning
It is the social expression of grief and the
behaviors associate with loss.
Bereavement
It captures both grief and mourning and includes
the emotional response and outward behavior
of a person experiencing loss.
Death is loss of life.

5. Stages of dying or grieving
There are five stages that are in an orderly
manner but some people do not experience
them in that order or length of time. They
sometimes move back and forth between
the stages.

6. 1. Denial and isolation
 Recognition and acceptance of facing
death is shortly difficult.
 A person acts as if nothing has happened
and refuses to accept the reality, shows no
understanding of what is happening
 Denial permits hope to exist and its short
lived.

7. 2. Anger
 The person asks the “Why me” question,
expresses resistance and sometimes feels
intense anger at God, other people or the
situation.
 The person is hostile to people assisting him
and anything done does not please him.

8. 3. Bargaining
 The dying person attempts to negotiate not to
die at that time
 This cushions and postpones awareness of the
loss by trying to prevent it from happening.
 It involves a deal with God, doctors, nurses.
 The dying or grieving person make promises to
self, god or loved ones that they will live or
believe differently if they are spared.

9. 4. Depression
 This happen when the person realises the full
impact of the loss
 The defensive mechanism are no longer
effective
 The person expresses sadness and anguish and
some individuals are overwhelmingly sad,
hopeless and lonely.
 Crying elicit support of the loved ones and the
nurse so they should be available for the

10.  They sometimes withdraw from relationships
and life and may have suicide attempts.
 Resolution leads to acceptance.
5. Acceptance
 The person incorporates the loss into life and
finds ways to move forward
 This time the person finds peace and
contentment.
 The patient may desire time alone with his
thoughts

11.  Some patients may ask to get out side the
room
 This time the patient reviews his past and
thinks of the unknown future.
 Patient need quietness with minimal
verbalization.
 The patient may now talk about his funeral
plans.
 Writing of the will.