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.

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