Book Report: On Death and Dying – Part I

Note: Extracted from part of book report I submitted for the course Grief Counselling in 2017 Spring

Introduction

On Death and Dying was first published in 1969, authored by Elisabeth Kübler-Ross based on her experience working with terminally ill patients and their families. That was the time when medical practitioners were highly authoritarian leaving almost no room for patients to participate in decisions and society also avoided talking about death openly and privately.

Abstract

Death is a universal fear. When the time comes, patients will be increasingly fearful and lonely as they were taken out from their familiar environment and medical personnel in hospital are busily preoccupied with his heart rate, pulse, electrocardiogram or pulmonary functions, his secretions or excretions but no one try to understanding their needs, worries and feelings making the process impersonal to repressing medical personnels anxieties inside. (Chapter 1)

In Chapter 2, Kübler-Ross expressed that we are less able to defend physically as technology advanced, new weapons of increasing power of destruction continue to be invented, and this intensified our fear of destruction and anxieties towards death. Medical development to prolong life and depersonalized medical care was used to master death. Kübler-Ross invited us to face our own death for inner peace so we have the courage to encounter patients death and re-think how science and technology can bring us a more humanistic world.

Chapter 3 – 7 explained the five stage of grief, also known as Kübler-Ross model.

Stage 1: Denial and Isolation (Chapter 3)

It is a temporary defense of not accepting the shocking news. They tends to believe that the diagnosis is not right or they are recovering and need not to go through further diagnosis and treatment in a short while.

Stage 2: Anger (Chapter 4)

Patients anger will be displaced and projected randomly to family members and hospital staff through complaints and guilt or shame induction resulting in less visit and avoidance. This, then, intensifies the anger in patients a vicious cycle of alienation is thus formed. Inside their anger and attention seeking acts are the fear of being forgotten, and sometimes envy of healthy people. Thus, anger shouldnt be taken personally.

Stage 3: Bargaining (Chapter 5)

Patients attempt to ask, towards God usually, for the last reward (i.e. postponing death according to the self-imposed deadline) in exchange with good behavior. Behind this could be quiet guilt towards God (e.g. not attending church, not devoted enough into the religion) or deeper, unconscious hostile wishes that needs to be taken care of.

Stage 4: Depression (Chapter 6)

As patients illness progress, they became weaker, more hospitalization and operations were imposed, sooner or later sense of great loss” will become dominate. This is the stage which patients are preparing themselves to separate from this world and losing everything they love through grief (aka. preparatory grief), communications will shift to non-verbal one and their circle of interest decreases. Thus, there arent need to cheer them up as this normally serves our own inability to face death.

Some complications may result if patients had unresolved griefs as a result of past losses or regrets of havent taking certain opportunities when they are well.

Stage 5: Acceptance (Chapter 7)

It is a stage which patients are void of feelings and death could be a relief. Patients family will need more support than patients themselves. Their circle of interest further shrank. Nonverbal communication reminds them that they wont be left alone until the very end.

If patients family failed to distinguish or accept that patients are under this stage, blaming them for giving up too early or try real hard to prolong their life, they will feel dismay and angry to their family.

Kübler-Ross talked about Hope in patients that exist in all stages in Chapter 8. Hope maintains that their sufferings will pay off eventually by recovering, by a new drug or treatment plan that helps, if they endure it a bit longer. Hope also gives them a sense of meaning in their sufferings. Kübler-Ross reminded family members and caring professionals to maintain hope but not reinforce hope at the stage of final acceptance.

Chapter 9 focuses on how patients family can help and the adjustment and preparation needed by family members when patients become weaker and eventually pass away. Family members should maintain a balance between taking care of patients and their own needs for their well beings during patients hospitalization. 

Direct communications, discussions and expression of feelings between patients and their family members about the impending death not only can avoid anger, alienation and isolation but bring closeness and deeper sense of meaning to all. After all, patients can see through the make-believe mask of their family members. This not only prepares patients to go through anger and preparatory grief and eventually accept their impeding death, but their family members to go through similar stages. 

Kübler-Ross suggests that family members will feel void and emptiness after the funeral when relatives depart, thus right timing for human beings to talk and care them, and allow them to express their angry, despair or loneliness. Children and adolescence should be taken care of as well. For members who are pre-occupied with fantasies with the deceased, we should understand and allow them to express their feeling and not to ridicule or confront them too frequently. 

Additional interviews, their transcripts and analysis can be found in Chapter 10. For Chapter 11 & 12, Kübler-Ross shared the adversaries and oppositions from medical personnel throughout her works of interviewing terminally ill patients, and how this helps bringing a whole new perspective to medical personnel to provide humanistic and less impersonal medical care, and the courage to face death for both medical personal, patients themselves and their families.

 

退修 x 書研 x 食

2014-04-05 14.40.35

一行四人去咗百大尼退修, 星期五晚到星期日, 斬前斬後其實只係得星期六。其實目的都係想抖抖同一齊書研,schedule 呢家嘢都係星期六早餐先 draft。早上食過早餐,回房安靜一下便是午餐,下午就是書硏,夜晚唱完歌仔之後各自回巢安靜然後去食宵夜。

retreat_20140404_06_schedule

上次去百大尼都無敏感,但係今次就不停今打噴嚏,咳同眼癢,今日臨走嘅時候真係忍唔到,走咗去萬寧買咗盒抗敏藥。跟據弟兄所講,呢盒「百利通」係政府診所三寶之一。$87.9 60粒,食咗一粒唔使十五分鐘見效 😀

900089

睇完就算真係有d浪費,所以睇書嘅時候 jot 咗 d notes幫助自己整理下d points

書研:  團契生活 – 獨處的日子
害怕孤寂才找團契生活、害怕羣體才自己一個也是無益的
上帝呼召你的時侯你是單獨的站在他面前,單獨的跟從他的呼召、 背十架、 戰爭襑告、死去、 向上帝交賬
這個呼召卻不是單獨對你-你在蒙召者中背十架、 戰爭襑告
獨處的標誌是靜默 slience,團契的標誌是言語 speech
靜默:
  • 讓人能聽見上帝的道 – 聽道前: 讓思想放在上帝的道上;聽道後: 上帝的道仍然向我們說話,並要活在我們心裡
  • 個人在上帝之道下一種肅然起敬的態度
  • 等候上帝的話並從之得到祝福
  • 為了讀經、禱告、代襑
* 除了純然等待上帝的話外,誰也不該期待什麼
默想(讀經)
  • 共同靈修讀的是較長及連貫的經文(寬度、整全);默想卻應選用較短的經文,並盡可能一星期不加以更改(深度)
  • 跟據上帝的應許等待上帝和自己說話教導
  • 需要弄清楚經文的內容,但卻不是釋經及作聖經研究
  • 從禱告開始,但不同咬文嚼字
  • 在一個抓住我們字眼上停下來,思想,讓道進入住在我們裡面,並留下工作的果效
  • 不去尋找新觀念以致分散注意力及助長虛榮
禱告
  • 默想聖經,讓之帶領進入禱告,準備在自己的景況中領受上帝的道
  • 祈求上帝清楚指示我們今天的生活,保守我們不要犯罪,在成聖的路上長大,在工作中有力和忠心
  • 若思想不能集中,想到別的人和事,我們可把這些納入禱告中,再耐心地返回默想的起點
代禱
  • 不能為所有人代禱
  • 首先要記念那些和我們生活在一起的人
  • 信徒團契得以存活有賴於彼此代禱
    • 若為一個給我麻煩的弟兄代禱,我也不能責備、痛恨他。因在我為他禱告時變為弟兄的面孔,使我醒悟基督也是為他而死,所以他同樣是一個蒙恩的罪人
    • 代禱就是讓弟兄站在基督面前並分享祂的憐憫
  • 是思典卻又是責任
默想的考驗
  • 獨自生活在非信徒環境的時間
  • 團契生活 – 促進個人的自由、剛強和成熟 vs 叫人不能自主,只能依賴他人
  • 默想 –
    • 把人帶到上帝的真實世界,使他剛強壯膽,身心清潔以面對白天?能將上帝的話語植根在心中,叫人清醒度日,堅忍不拔,有力行善,有愛心,謙卑順服
      vs
    • 把人帶領到一個不真實的世界,以致當他回到日常生活時大吃一驚? 令人片刻飄飄欲仙,碰到現實便告消逝?

 

Jawbone Up

呢條嘢嘅功用大概係計歩器同埋鬧鐘。如果你好耐無起身走走,佢會震你等你醒水起身走走。佢會 mon 住你睡覺嘅 movement 去計返你深淺層睡眠嘅 duration,亦會係一個你 set 定咗嘅時間區選擇最好的時間震醒你。

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不過用咗唔夠一個禮拜就成日 sync 唔到,再上網 search d 人鬧到呢 [1] [2]…好彩我係 online apple store 買, 比 原價 15%嘅 「手續費」就可以退返比佢。唔見百幾蚊總好過留舊無用嘅拉圾係屋企

Fitbit Flex [3] 除咗平 d 之外, 網上面都無乜負面評論,大概都可以一試 Gei…

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Reference

[1] Jawbone Up | Design Failure From Product to Support – http://jawboneup.wordpress.com/
[2] Amazon.com: Up by Jawbone – http://www.amazon.com/UP-Jawbone-Medium-Wristband-Packaging/dp/B00A17IAO0/ref=sr_1_1?ie=UTF8&qid=1373348618&sr=8-1&keywords=jawbone+up

[3] Comparing Fitness Wristbands: Jawbone Up, Fitbit Flex, NikeFuel… – http://blog.activepepper.com/comparing-fitness-wristbands-jawbone-up-fitbit-flex-nikefuel-s-band-armour39/