This is a really difficult book to read. Death has always been distasteful, especially the slow process of dying due to a terminal illness. Kubler-Ross, a physician, compiled a finding based on a series of dialogues conducted with cancer patients on how they handled grief, which she pioneered it as The Five Stages of Grief; denial, anger, bargaining, depression and acceptance. These stages aren't sequential, some may not even experience all of them as these studies aren't empirical or a complete psychology on dying. This book can serve as a guidance towards family, doctors and chaplains on how to provide the needs of patients based on the stages they're going through.

#1 Denial stage, patients refuse to believe the initial diagnosis and indignantly ask for re-examinations to nullify their fatality. They put on a facade; cheerful and ignorant attitude and heavy make-up to cover any physical signs of fatigue. Deny themselves from being confined to hospital beds and refuse to follow diet and medications.

#2 Anger stage, patients are angry at God and believe that they deserve to dodge such a tragedy. They often displace their anger at other people namely families which makes them shorten their visits and hospital staff which causes them to be tended with haste and less care. Instead of taking the patients' anger personally, we should see it coming from a place of pain and not treat the sick as a huge 'inconvenience'.

#3 Bargaining stage, patients realise that their angry pleas to God won't be answered so they change tactics into a more good-natured agreement. As an exchange for life extension or pain-tolerant days, they devote themselves to become good worshippers or pledge to donate their organs for society's use.

#4 Depression stage, a huge sense of loss replaces anger. Reactive depression is when patients mourn over past losses such as the inability for some bodily functions such as giving birth for uterus cancer patient or incapacity to take on familial roles as a breadwinner after being bedridden. This can be alleviated by words of encouragement on their other positive attributes and reassurances that their family is subsisting well. Next is preparatory depression when patients mourn over impending losses; that of their own life. This type of depression cannot be healed by positivity mantras. Patients have to be given space to process their anxieties completely so that they can slowly move on to the next final stage.

#5 Acceptance stage, previously where patients elicit strong emotions, in the "final rest" there is only void. The pain is over, the struggle has ended. Patients are no longer communicative and are detaching from all meaningful relationships in life. Offering a life-prolonging intervention at this stage will only be met by retaliation because the patients only wish to continue their life with dignity. They believe that although more treatment may be life-lengthening, it reduces the quality of life.

Throughout all stages, a constant element is hope. Doctors must maintain hope in patients that there are possibilities of remission or new breakthrough treatments. However, hope cannot be enforced during the final acceptance stage. Arguably, those who went to the acceptance stage too early should be guided rationally. God works through humans and God inspires doctors. The doctor-patient approach shouldn't be depersonalizing patients to mere mechanical objects in the service of prolonging life, but instead must be a humanitarian and respected approach to diminish human suffering itself.

This book had a lot of exciting research done by Kübler-Ross within her life, and how within her culture they handled death in a way that was unnatural to the western world, how she created this class by accident. It became so popular because everyone wanted to understand the emotions, and the thoughts of a dying patient, and how she broke each stage and conversation to us, to give us a perspective of that person's emotions. This book was very touching and very emotional but also gave insight within a world that most people do try to avoid. I highly recommend reading this if one is curious or dealing with grief.

Pēc filmas "Dead Man" noskatīšanās, es pēc ilgāka laika aizdomājos, cik aizkustinoši bērnišķīga ir ilūzija, ka "mirst viņi, citi" - ka mirst viņš "Dead Man", ne es. Un vēl es aizdomājos, kur gan ir robeža starp to, ka dzīvojam un to, ka lēni mirstam. Kurā brīdī mēs dzīvojam un kurā sākam mirt? Sirds sitas straujāk, domas grib aizmukt no šīs tēmas. Bet nevar. Dzīves krāsas kļūst spilgtākas un laiks rit lēnāk, lasot par nāvi un nomiršanu. Un dzīvot kļūst dzīvelīgāk.

This is definitely an important book, and it had a lot of big takeaways, but once I got about 60% in or so, I realized this wasn't exactly the book I was looking for.
Through interviews with patients and their families, Kubler-Ross illustrates the process of dying when one is terminally ill and the anger, frustration, sadness, fear and eventually (hopefully) peace that comes with it. There were, and likely still are a lot of issues with how terminally ill patients are treated by hospital staff and perhaps even their own families and circles, and this study was meant to make it easier to discuss death and illness with these individuals. It'd be interesting to see an updated study if terminally ill patients feel better or worse these days in a similar setting.
As someone who is really scared of death, and not terminally ill, I was hoping to maybe explore that fear more, especially with patients who were much closer to death than I (knock on wood) currently am. And I really didn't find that. While the interviewees expressed their frustrations and fears, most were centred around worrying about how their family would cope with their death, not being able to do certain activities anymore, etc. All super valid fears, but none on death itself, on the crossing over or the beyond. Many of the patients were religious which likely had an influence on their feelings toward death, so little was talked about in that regard. Some of the interviews felt a bit repetitive and not totaaaally in line with the 5 step grieving/death process Kubler-Ross presented as well, but perhaps I wasn't being insightful enough to see it.
Overall, I'm glad I read it, and the first and last chapters in particular did hold quite a bit of value to me, but this was a bit different than what I was looking for.

I read "On Death and Dying" while witnessing my grandmother terminal phase of cancer. I think the book is greatly insightful because it's a reminder of our inevitable end, and is also a guide to well understand the terminally ill patients.
As for my grandmother, she passed away two days ago and I hope she's in a more joyful place today.

Când eram studentă, eu și colegii mei viitori psihologi obișnuiam să ne întrebăm la fiecare nou diagnostic învățat: "Oi avea și eu? Oare cunosc deja pe cineva care are?"

Dintr-o mare #empatie ne identificam cu informațiile primite în detaliu și aceasta este și acum una din cauzele pentru care cărțile despre Moarte sunt atât de greu de digerat - ai nevoie să citești porții mici, să asimilezi treptat angoasa propriei morți și a celor apropiați ție...

Ianuarie este pentru mine cea mai potrivită lună pentru curaj: n-aș zice că, gata, mi-am biruit fricile existențiale și jubilez în fața morții - nici nu ar fi sănătos - însă am mai avansat un strat, am mai cojit o pojghiță din această călătorie către înțelegerea Morții, așa cum o trăim noi cât încă trăim!

Căci este într-adevăr o carte nu despre Moarte, ci despre A muri, ceea ce-i mult, mult mai greu emoțional decât să filosofăm despre "ideea de Moarte".
Este chiar cartea de căpătâi în introducerea Fazelor Doliului, de care cred că toată lumea a auzit.

☀️Vă las câteva citate pe care să le citiți străduindu-vă să nu vă țineți respirația de stres.

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"Cred că persoana care moare poate fi de mare ajutor pentru rudele sale în a le sprijini să se confrunte cu moartea sa. Poate face acest lucru în diferite moduri. Un mod este să-şi împărtăşească în mod firesc unele dintre gândurile şi sentimentele sale cu membrii familiei pentru a-i ajuta să facă și ei la fel. Dacă este capabil să-şi elaboreze propriul #doliu şi să-i arate familiei prin exemplul său cum poate cineva să moară cu calm, ei îşi vor aminti puterea lui şi îşi vor suporta propria tristeţe cu mai multă demnitate." #sprijin #impacare #familie

"Suferinţa, ruşinea şi vinovăţia nu sunt foarte departe de sentimentele de #furie şi mânie. Procesul doliului include întotdeauna anumite calități ale furiei. Întrucât nimănui nu-i place să-şi recunoască furia faţă de persoana decedată, aceste emoții sunt adesea deghizate sau reprimate şi prelungesc perioada doliului ori se manifestă în alte moduri." #blocaj #reprimare

"De asemenea, este multă #vinovăţie şi cu cât îl putem ajuta mai mult pe aparţinător să-şi exprime emoțiile înainte de moartea celui iubit, cu atât mai confortabil se va simți acel membru al familiei. #exprimare

Când pot fi elaborate #furia, #resentimentul şi vinovăția, familia va trece printr-o fază de doliu #pregătitor , la fel ca și persoana aflată pe moarte. Cu cât va fi mai posibilă exprimarea acestei suferințe înainte de moartea pacientului, cu atât va fi mai puțin insuportabilă după aceea. Adesea, le auzim pe rude spunând mândre de ele că au încercat să-şi păstreze zâmbetul pe față în prezența pacientului, până într-o zi în care pur şi simplu nu au mai putut păstra aparențele. Nu au realizat că emoțiile autentice ale unui membru al familiei sunt mult mai uşor de suportat decât masca prefăcută prin care pacientul poate vedea oricum și care înseamnă pentru el mai degrabă o deghizare decât împărtăşirea unei situații triste." #conectare #onestitate #tristete

"Cei care au puterea și iubirea să rămână cu pacientul muribund în tăcerea de dincolo de cuvinte vor şti că această clipă nu este nici înspăimântătoare, nici dureroasă, ci o încetare liniştită a funcționării corpului. A asista la moartea liniştită a unei ființe umane este ca și cum ai privi o stea căzătoare. Una dintr-un milion de luminițe de pe cerul vast licărește o clipă, pentru ca apoi să dispară în noaptea ne-sfârşită pentru totdeauna. A fi terapeutul unui pacient care moare ne face să fim conştienţi de unicitatea fiecărui individ în această vastă mare a umanității. Ne face conştienţi de finitudinea noastră, de durata noastră de viață limitată. Puțini dintre noi trăim mai mult de 70 de ani şi, totuşi, în acest timp scurt majoritatea creăm şi trăim o biografie unică și ne țesem pe noi înşine în tapiseria istoriei umane." #iubire #efemeritate

Cu drag,
Psihoterapeut Ioana Neacșu

This book was on my recommended reading list in nursing school. I never got to it until 5 years after I graduated because I figured the required reading list was more important. Nevertheless, I am glad I finally got to it.
Don't be fooled by the diminutive size; this book packs a powerhouse. It took me awhile to get through this 277 page book (with extremely small font) because I really wanted to digest everything I was reading.
I can see how Dr Ross's statements were groundbreaking for 1969, but they are common practice now. A doctor who brusquely informs a patient that they are dying is not respected like they were then.
Some of the writing was *cough* out-of-date (I am thinking in particular when she refers to a patient as "a Negro man") to the point where it was laughable.
Despite these faults, I thoroughly enjoyed the shared wisdom of dealing with the dying. I feel it will enrich my practice at the nursing home greatly.

This book is considered a classic in the field of the psychology of dying and death, but personally I found it to be a bit of a dry read, almost more of a clinical discussion. I would have preferred more anecdotes and stories, similar to Sherwin Nuland's "How We Die."

I HIGHLY RECOMMEND ON DEATH AND DYING!!

I read On Death and Dying way back in 1986 when my father was dying with Lung Cancer. I just recently re read it becasue of a shocking accidental death in my family. This book helped me today as much as it did 28yrs ago. If you are going through the grief process or if you are supporting someone who is dying, This book is a must have an will greatly help you!! It written with the average person in mind. The narrative comes across for even young teens. I highly recommend On Death and Dying.

Although this book was written in 1969, it is still relevant to anyone working in a helping profession. Although much of it now seems like common sense it's filled with lessons that we many times forget in the day to day encounters in our jobs.

So far I have attempted to write and post a review of On Death and Dying not once but two times. Both attempts were wiped out into the Goodreads ether immediately. Apparently this topic has bad mojo. But, three is a charm and I am stubborn. Here goes attempt number 3.

This year I have confronted the dismal reality that I am about to encounter profound loss in my life. I now have both parents with aggressive and challenging cancer diagnoses and it has been a brutal year filled with intense hospitalizations, constant rounds of chemo and radiation therapy and countless doctor appointments. In my role as a support person and caregiver I have become exhausted emotionally and physically and overwhelmed with the seriousness of my task: namely to help my parents as much as possible and to hold myself together in order to lessen their burdens rather than to merely add more stress. Typical for my culture, I have spent almost no time contemplating end of life issues up until the point where this was forced upon us by unhappy circumstance. So I have decided to read up on death and dying.

And it felt like the best place to start was with this 'classic' work from Kubler-Ross. Although Dr. Ross was conducting the interviews and gathering the research for this book during the year I was born (almost 50 years ago) -- it remains a cornerstone in the canon of material about our culture and death. Certainly our contemporary hospice movement, 24 hour visitation policies, home health care options and the more 'people centered' approach to treatment have their roots in the work Kubler-Ross did with terminally ill patients in the 1960s and 70s.

Reading the interviews in this book was a very sad experience because most of the patients seemed to be lonely and isolated from their families due to rigid hospital rules and clinical attendants who did not seem to take their patients' emotional needs into consideration. The doctors were often portrayed as cold medical figureheads who developed no rapport with patients or family members. Many of the nurses were described as 'annoyed' by their patients and patients often came to the conclusion that the nursing staff avoided their rooms as much as possible.

During this time, death and dying had been removed from the home setting and into the hospital setting. It was an antiseptic approach based on 'curing' and the terminally ill were almost seen as failures or disappointments because the latest and greatest medical advancements could not save them.

Many of the individuals Kubler- Ross interviewed seemed rather desperate for somebody to take their needs into consideration...or at least to ask them what their needs were; what they were feeling; what they wished for the hospital staff and their families to know about what they were experiencing.

Through her research, Kubler-Ross identified the 5 stages of grief/death which most of us are aware of today: 1. denial/isolation 2. anger 3. bargaining 4. depression 5. acceptance

Lately I have become aware of some newer research which calls these 5 stages into question. And I do plan to read these other titles. However, my own experiences this past year allow me to believe that there is some validity to these stages.

I certainly began with denial and isolation. Denial was expressed in my latching on to the notion that the 'best doctors' could cure the cancers. As long as we ran all over Cleveland talking to specialists, this could be beaten despite the odds. Isolation quickly followed as our lives became consumed with medical treatments, surgeries, recovery periods and many extra care giving duties on top of the normal responsibilities of life. I had neither the time nor inclination to socialize with others and grew more and more withdrawn as the situation continued to swallow up every minute of our lives. {and I am addressing these stages as a care giver and loved one; I believe they also apply to those who are close to someone nearing death}

Anger certainly played a role. Fortunately, this stage has been relatively brief in my case. Almost every family I know has been attacked by cancer so it is hard to feel singled out. Yet my emotions are usually rubbed raw and I am quicker on the emotional trigger. Many things that people say during this stage in life tend to irritate me or bring out some hostility in my response. Constant stress, sadness and fatigue does little for one's charm.

Bargaining? This happens every time a difficult new procedure, treatment, or protocol is attempted. Certainly, I tell myself, if we all ban together, show good attitude and persevere through this next terrible thing...we will be 'rewarded' with a remission. And if we are? I will 'never complain again'.
I have just come off an entire year of bargaining and am only now coming to the gradual acceptance that we have no takers in this cosmic bargain.

Thus depression...where I seem to be stuck now. I can, perhaps, glimpse
'acceptance' coming somewhere further down the road. But I am not there yet.

So, despite what I may read in other books and articles on death and loss, I am fairly certain that my impulse will be to mark our progress through this ordeal by the 5 stages. It is a process and you cannot speed it up or slow it down at will. These stages appear to take their own time.

I believe that On Death and Dying is the right place to begin for anyone who is coming to terms with death and loss -- despite their stage in life or their stage in 'the process'. Use it as a baseline on which so much of our current approach to end of life issues is built.

It took me a while to get through this one for obvious reasons. I kind of got through most of the sections as I was going through them, although I am still in the middle of this process and reading of the whole process is beginning to help. Grief is not a straight line but rather a series of knots that I find myself having to untie again and again; I am moving through it and I have no idea where I'm going but I'm going there.