Four stages of death affecting the hospice patient

Dr. Saul Ebema

There are four major stages of death a dying individual experiences and those are; social, psychological, biological and physiological.

Social death is the symbolic death of the patient in the world the patient has known. The patient’s social contacts often diminish; the patient is often isolated from community and confined to the bed, hospital, or nursing home. The world as the patient had known it is gone.

Psychological death is the death of the dying person’s personality. This is usually caused by the dying process. One time, I was talking to a daughter of a terminally ill patient suffering from the Alzheimer’s disease. The patient’s memory was gone. She couldn’t remember her family and friends. The daughter told me, “As far as I am concerned, I lost my mother six months ago. From the day she could not remember me, I knew she was dead.” The disease process often fosters personality changes biochemically. As death nears, the dying person withdraws from the world and into themselves. The dying person, as others have known that person, dies.

The third stage of death is biological death. This is when the organism as a human entity, no longer exists. Artificial feeding tubes or life support systems may be provided to the keep the patient alive.

The Fourth and final stage of death is physiological death. This is the cessation of all vital organs. At this point, the patient is declared officially dead.

These four major stages of death normally succeed one another. The hospice psychosocial team can help facilitate for a peaceful transition from one stage of death to another. Through these stages, the patient usually needs a lot of support from family, friends and faith community and the hospice team.

EVENT PROMOTION: Hospice Chaplaincy has agreed to partner with ENDWELL to promote their FREE upcoming online event called Take10 on December 10th 2020. The event is free with an amazing lineup of guest speakers. One of the guest speakers Dr. Naheed Dosani will appear on the Hospice Chaplaincy Show as a promotion for the event. You can register here;

Hospice Chaplaincy is a nonprofit organization committed to promoting excellence in spiritual care at the end of life. We are committed to the belief that people from all backgrounds, cultures and faith traditions should experience the end of life in a way that matches their own spiritual/religious values and goals. The task of dying is complicated and often confronts us with lots of spiritual, emotional and physical suffering. Hospice Chaplaincy is dedicated to providing support and professional development resources for hospice chaplains, patient advocacy, and education services to the public, to create a cultural shift to inform and transform our thinking around the psychosocial and psychospiritual issues at the end of life .

1 comment on “Four stages of death affecting the hospice patient

  1. Miranda lovelace

    Ever since I lost my father a year ago this past March 22nd 2021 I’ve had death and life after death on my mind heavy. They are times were you have a normal day,I have days like it just happened and my heart is broken a feeling that I wouldn’t want anyone to experience,but they are also moments that I have a feeling that I have never experienced before and when I have that last day/moment with my dad they’ll be flashes and it’s a kinda scared,doom feeling. I’m not sure what I’m feeling,I have regret and guilt even though it’s not my fault if not for me my dad wouldn’t have been able to stay in his own house I made him that promise to never put him away in a home so I fought with my entire family gave up on my life to make sure that I kept my promise. I haven’t done a lot of things right in my life I’ve screwed up a lot but I got that right! My dad was my best friend,my mom left when I was very young. My life will never be the same or I’ll never be happy completely or have a good day again. I strive every min of every day to remind myself what my dad wanted for me. I know I could’ve avoided all this hurt and pain,I could’ve got married and had a machine but what and were I am I’d do it all over again. To carry a pain in your heart says a lot. It says as deep as this pain is …well that’s how deep that love was. My love and loyalty to my dad was a pure unique thing I think God for giving me that experience in this life..real love. I have a right to be hurt and mad bc we all are worse off this world is worse off without my dad in it. I just can’t wait until I see him again and I hold on to the fact he’s in a place were he really knows my heart and love and all truths.


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