Introduction
Terminal illness is a term used by medical practitioners to describe a disease that cannot be cured. When a person is diagnosed with a terminal illness, it means that the patient will have to cope with the situation until his /her death.
Terminal illness may not stay for long because it results in the death of the patient after a certain period of time. Thus, terminal illness describes a disease that will terminate the life of the patient. People who have this disease are often referred to as terminally ill or sometimes terminal patients. Cancer is a good example of a terminal disease.
People who have been diagnosed with terminal illnesses usually react differently. Some people may not believe it while some may be filled with anxiety. Others may be shocked while others may become angry with despair. Some patients who have been diagnosed with terminal illness have been reported to have some guilt.
Depression usually follows thereby calling for external help so that the patient can manage their problem. As a way of management, care given by a health worker, a close friend or a family member does a great deal of help in ensuring that the patient accepts their condition.
Background
Terminal illnesses like cancer and other malignant diseases account for 25% of all the deaths in industrialized countries. Since the diseases cannot be treated, therapeutic methods have been used to counter the challenges they pose to the society. There have been major developments of new strategies for improving the success rate of therapeutic options in the recent past. Together with these therapeutic methods, the family as the basic unit of the society becomes quite crucial in the management process.
Malignant diseases are quite painful and thus require proper attention both from the healthcare sector and the family. Together with explaining certain aspects of terminal illnesses, this work tries to figure out how people cope with malignant diseases and terminal illnesses, emphasizing the importance of the family in helping patients who have been diagnosed with these kinds of diseases.
Methodology
The main method used in this research work was the use of literature. Medical journals and books offered substantial materials which enabled the success of this work. A brief analysis of the data and materials used help in determining some specific parameters that resulted into the recommendations given herein.
Some magazines were used, although their use was restricted to issues related to information awareness. Scholarly articles like journals, books and articles in books were used to provide the necessary data for this work. In addition to the above sources, the internet was also used to provide up to date information on the various research sub topics.
How People Cope With Terminal Illness
Modern developments in therapeutic and care options in trying to alleviate the effects of terminal illness have contributed a lot in the rise of the quality of health care given to diagnosed patients. The quality of analgesic therapy has continued to grow especially in alleviating pains caused by terminal diseases such as cancer (Klaschik, 2003). Therapeutic and care giving methods have come in handy to help reduce the negative impacts of these illnesses to patients, family members, and friends.
Counseling services have also contributed much in helping patients and family members cope with the situation. Among the religious societies, clergy men can be of valuable help because most religions believe that there is life after death. Thus, by giving the patient some hope of life after their death, it alleviates the suffering of these terminally ill patients. Otherwise, in non religious families, professional counselors can be consulted to help the patient and their family deal with the situation in a way that will not involve a lot of emotions.
Alleviating the Pains Caused By Terminal Illness
Alleviating the pains is done by pain management strategies. For cancer patients, the use of both invasive and non-invasive strategies is commonly used. It should be noted that destruction measures are becoming more uncommon because of their side effects. Intravenous and subcutaneous administration of drugs is also pretty common in treating cancerous situations.
Another way of dealing with this situation is through coping. Coping includes anything people do to manage problems or emotional responses whether successful or not. Coping helps in dealing with stressful situations of the terminal illness. Thus, it can be used to minimize the pains of the patient (Gurung, 2010). A person finding out that they are HIV positive or has test results showing cancer, can experience a surge of fear and anxiety and is therefore driven to cope with these feelings.
The person may deny the results of the test or not want to talk about it for some time. Thus, emotional-focus-coping is the name given to these mental or behavioral methods of dealing with the feelings resulting from the stress. Problem focused and emotional focused approaches of dealing with these pains can be quite effective especially in the hospice service providers (Singh, 2010).
The Reactions of Dying Children
Children’s intellectual development and experiences in the past and present should reach a level where they have to comprehend the essence of the beginning and the end of life. This is usually more apprehended by the time children reach puberty. The child’s idea of death comes to resemble those he will have as an adult only when he reaches adolescent (Smith & Schneider, 1969). Their reactions are quite varied depending on the personality, age, and other factors.
Most children never ask directly whether they are going to die or not. They are often seen acting fearfully and apprehensively. Younger children are concerned about feeling safe thereby trying to stay near a safe person. They will often want to face a situation that is free from pain than to face the situation of actual survival. Older children however consider success in repression of this anxiety rather than the lack of awareness. Children may even express anxiety through curiosity (Smith & Schneider, 1969).
A vivid example of this situation can be seen when some children peruse through their medical record when they are hospitalized for palliative radiation of malignancy. Such children decline to take on the activities programs in hospital wards. They spend time alone. Their behaviors and reactions are frequently related to their diseases.
A physical abnormality or an alteration of their physical strength can easily influence their own perceptions. There is decreased energy, an inactive acceptance of their condition. Resignation and depression are also common characteristics among children who have been diagnosed with terminal symptoms (Price & Gwin, 2008).
It is important to note that children must be taught how to comprehend the implications of inevitability of death in their situations. Young children usually believe that their parents can reverse the threatening situation and protect them from every sort of frightening experience. However, they soon learn with time that their parents cannot protect them from certain events and feelings.
The Reaction of Dying Adults
When adult patients are diagnosed with terminal diseases, they undergo through various processes in their lives. Stigmatization of such diseases as cancer and aids affects their psychological well being. It is thus imperative for terminally ill patients to undertake an enormous psychological adjustment. Adults usually experience many emotional feelings when diagnosed with terminal diseases (Schweitzer, Mizwa & Ross, Not Dated).
The initial stage the patient passes through is denial. They do not acknowledge having the disease. The adult patient can even go further and refuse to accept the likely consequences of HIV, cancer and other malignant diseases that threaten a person’s life, goals, expectations, and relationships.
This is why many adult patients become reluctant to admit the diagnosis and the risks of their infections. Adults suspecting of carrying a terminal disease usually refrain from going for a diagnostic test or a medical follow up once they have been diagnosed. The need for adequate counseling is therefore necessary to counter the desperation experienced by the patients (Larsen & Lubkin, 2006).
Adults usually respond to their situations through change, adaptation, and evolution (Schweitzer, Mizwa & Ross, Not Dated). The situation is discouraging and does not help in alleviating hopelessness. The patient begins to recount different situations that make them feel guilty. Anxiety and depression often appear accompanied with guilt, body image disturbance, social isolation as well as ambivalence.
The situation is a traumatic event that results in a lot of stress that the patient is left to deal with. Stress and trauma causes the adult patient to fear and deny their situation (Dennis 2009). Fury, depression, and withdrawal are usually latter accompaniments of the trauma. Panic, extreme avoidance behaviors, and loss of proper ability to love and work often follows.
Impacts of the Family Response to the Terminally Ill
The responses of family members to the terminally ill loved ones affect the patient in one way or another. How the family reacts to such a situation will strongly influence the behaviors and responsiveness of the terminally ill person. It should be noted that the person already knows that he or she is going to die because of the disease.
So the family has got to understand how to deal with the situation of the imminent death of a loved one. For instance, if the family learns to accept the situation as it is, more quickly, the patient can be easily relieved of some of the anxieties accompanied by the illness. Acceptance levels and the ways in which the family reacts are important in determining the longevity of the patient. This is because the process of loss can never be similar for everyone.
The presence of family members is crucial in providing comfort and moral support. The actions of family members such as helping in sorting out some unfinished business brings about some comfort to the terminally ill. These actions also help family members to distract their attention from the inward thought that can negatively impart their emotional feelings. The family needs to be prepared for this by being informed.
This information helps them to make necessary arrangement and also makes the patient still feel useful. Giving the loved one some tasks to do keeps them busy and thus distracts their minds from the terminal illness as well as making them feel important. Since everyone is going to die one day, the terminally ill should be respected and helped whenever they need.
Families which have young children are usually concerned by the way these children would react should a member of the family be diagnosed with a terminal illness. It can be a tough job trying to explain how this situation ought to be dealt with among the children. It is therefore prudent enough to consider certain factors like the age, personalities and the information available about treatment of terminal illness.
Keeping the terminal illness of a loved one a secret, cannot help in dealing with the problem. For instance, children who hear the terminal illness of their parents from a neighbor may think that the situation is extremely terrible to talk about (American Cancer Society, 2010). Thus, it is better to tell them early enough so that they are well informed of the situation before things begin to happen.
Impacts of Terminal Illness on the Family
When a family has a patient who has been diagnosed with terminal illness, they also become involved in sharing of the sufferings. The emotions of the patient can also impact on the family. This is because coping with the terminal illness of a loved one is among the hardest challenges a family faces in life.
The family is faced with the pain of pending loss of a loved one caused by the terminal illness. Close family friends are also affected by the imminent loss. How such situations are dealt with differs from one family to another. It is dependent on the way that is most suitable for a particular family. Emotions are usually high during such times. It becomes important for the family to seek professional counseling from clergymen or other corporate professional counselors.
Sometimes, some members of the family may deny the fact that they have a dying family member. Some family members and friends are unable to cope and thus deny because denial is a coping mechanism. The family may be too frightened or worried about the future of their loved one.
The family members and friends who are supporting their loved one usually require more support from other people. It is quite unfortunate to note that some family members may be preoccupied in dealing with their own emotions that they may not be able to provide adequate support that the others need. The deterioration of the patient’s health leads to an increase in physical and emotional demands for care giving (Veach, Nicholas, & Barton, 2002).
When children have terminal illness, both they and their parents become frightened by the sudden appearance of such an acute and severe symptom. The first response of the parents is grief because of the loss of their child. Children may also experience the grief although this depends on their age and level of maturity.
Children and the family at large cope with such situations depending on the type and kind of support they receive either from each other or from other people and organizations. Thus, the family must learn to accept not only the child’s illness but also the outcome of this illness.
It can be established from this research that terminal illness can cause severe impacts to the patient, family, and friends. It is pretty crucial for the patient to receive enough care from the family and friends because this can go a long way in decreasing the pains caused buy such diseases.
People cope with terminal illness in many ways and thus there is no single restricted method for coping with these illnesses. The way patients and the families react to a particular diagnosis of terminal illness can affect both parties either negatively or positively as discussed in previous subtopics.
Recommendations
Along with therapeutic analgesic palliative measures, other symptomatic pain controls can be recommended for particular terminal diseases. Medical check ups and examinations should be done in the early stages of the disease. This is because the terminal illnesses are easier to deal with if diagnosed early enough. The causes of the pains should be assessed and diagnosis of the patient’s pain syndrome done.
Appropriate substances should be administered alongside pain control methods such as analgesic drugs therapy. Other methods that conform to the WHO standards can also be recommended appropriately for a particular terminal illness. Supportive counseling by the health care workers should be provided to patients who have been diagnosed with terminal illnesses. The stressful effects of stigma should be reduced so that the lives of the patients can be bearable. Thus, special care should be given to such patients.
In addition, inner spiritual resources should be utilized to facilitate development of coping with realities. Reminiscence and life review situations can be of great help in identifying and emulating past coping skills that are considered successful.
Patients are to be encouraged to mend damaged relationships, forgive and be forgiven and also encouraged to openly express their emotions and give a farewell to other relationships. Care givers should work closely with dying patients so that their goals can be achieved. The patients should also be encouraged to say what they most want thereby giving the caregivers an ample time in achieving their goals.
Conclusion
In conclusion terminal illness can be described as the illness which cannot be cured. Most terminal illnesses are usually responsible for the death of the patients. Terminal illnesses include cancer, diabetes, and HIV. Patients who suffer from these illnesses often undergo a lot of pain and stress.
Methods of alleviating the pains are therefore required so that these illnesses become bearable. Although doctors had estimated the longevity of some particular terminal diseases to be within a fixed period, modern analgesic therapeutic methods have helped in increasing the life expectancy of terminally ill people.
Families react differently when one of their loved ones has been diagnosed with terminal diseases. Their responses are quite crucial in determining some factors related to how the patient is going to bear the situation. Thus, a family should be close enough to monitor and help the patient deal with some of the challenges caused by the terminal illness.
This is because the patient needs to be treated in such a manner that they will feel important even though everyone, including themselves, know that they are dying. Along with the many impacts of terminal illnesses in a family, there are several ways employed to counter these impacts. One of the ways is accepting the situation and its outcome and learning to cope. This will aid in preparation for the future situations.
Reference List
American Cancer Society, (2010). Helping Children When a Family Member Has Cancer: Dealing With Diagnosis. Web.
Dennis, D. (2009). Living, Dying, Grieving. Sudbury: Jones and Bartlett Publishers, LLC.
Gurung, R. (2010). Health Psychology: A Cultural Approach. Ed. 2. Belmont: Linda Schreiber, Michele Sordi, Wadsworth.
Klaschik, E. (2003). Pain Treatment for Terminal Diseases. Business Briefing: Long Term Healthcare Strategies. New York: Springer.
Larsen, P. & Lubkin, I. (2006). Chronic Illness: Impact and Intervention. Ed. 6. Sudbury: Jones and Bartlett Publishers, LLC.
Price, D. & Gwin, J. (2008). Pediatric Nursing: An Introductory Text. Ed. 10. New York: Elsevier Inc.
Schweitzer, A., Mizwa, M., Ross, M. (Not Dated). Psychosocial Aspects of HIV/Aids: Adults. Web.
Singh, D. (2010). Effective Management of Long-Term Care Facilities. Ed. 2. Sudbury: Jones and Bartlett Publishers, LLC.
Smith, A. & Schneider, L. (1969). Clinical Problems. The Dying Child: Helping the Family Cope With Impending Death, Clinical Pediatrics.
Veach, T., Nicholas, D. & Barton, M. (2002). Cancer and the Family Life Cycle: a Practitioner’s Guide. New York: Brunner-Routledge.