Valerie Gayle De la Cruz BSN III

Preliminary Exam: Elective class

Death and Dying

We fear death and thats an undeniable fact. We don't know when will death come and take
us. It is inevitable. But what truly is the meaning of death? So many questions are asked but the
reality behind the nature of death is very complex. According to a biologist named Nasif Nahle, death
is the state of a thermodynamic biosystem in which it cannot get and organize autonomously the
energy from the environment. This definition of death was basically based upon biological
perspective. The Harvard Medical School Committee also developed a definition of death.
According to them, a person is brain dead when he or she has suffered irreversible cessation of the
functions of the entire brain, including the brain stem. This is determined by a number of tests that
determine unawareness of all stimuli, no spontaneous muscular movement or respiration, no reflexes
of any kind and a flat electroencephalogram, indicating the cessation of electrical activity in the
brain. If after 24 hours there is no change, the person can be declared dead. The Harvard Medical
School Committee explained that when a person no longer responds to equipment and intervention
then he or she can be declared dead.

I would also like to share my own understanding about death. For me, death happens when
we become nothing. If our bodily organs cease to function and our consciousness is gone, then thats
death for a human being. For Christians like us, we believe that God created human beings from dust.
Ecclesiastes 12:7 says "Then shall the dust return to the earth as it was: and the spirit shall return
unto God who gave it." Meaning our body will again turn to dust and that the spirit God gave us
which is the breath of life, sinful or not will go back to Him. Body and breath must be combined in
order to become a soul. According to the scriptures, we are souls and we have to die because we are
mortal and only God is immortal. The world has so many perspectives about death from different
cultures, religious rites, beliefs and much more. In some cultures, the concept of death and dying is
very unique. Hinduism strongly believes in reincarnation and rebirth. They believe that a soul will
continue its journey and will return to earth but with a different living body.The Muslims believed
that living will prepare them to the next realm of existence. Buddhist worships Buddha and they
believe that death is just a form of awakening. The role of death in culture is very powerful because it
influences peoples way of living and their perception towards death and dying. If we knew that well
be dying soon, do we still need something or well just accept the fact that well be gone?

As nurses, we need to respond to the needs of the dying. Psychologically, the dying needs
understanding. Help the sick person find meaning in life and death. Aspire them with positive
thoughts and if possible instill to their mind thoughts such as dying without regrets. It's a natural
thing for the dying to feel down. Emotions such as anger, fear, grief, guilt etc. are all due to the
difficulty of acceptance. Aside from that, the dying person needs respect. We must appreciate them
for being courageous and brave. Let them feel that they're good deeds will be remembered. Then let
them feel that they are loved. Share happy memories with them and always give them kind words.
Let the dying person feel that you are compassionate and honest to them. The dyings social needs
include communication. Show concern to them by talking to them. Give the dying person high value
because they experience fear so that they may not feel abandoned and alone. Encourage the family
members to share time and memories because even though the person will die memories will stay
and that it will help the family not only the patient to accept the reality of death.Always respond to
their questions appropriately Physically, the patient needs medications to relieve pain that is caused
by their underlying illness. Most palliative patients are not responsive to curative treatment thus,
relief of suffering is one of the center goals of palliative care. Ensure that the dying persons
remaining life is the best possible quality of life for them.

Identifying the last stages of life is also very important. It can be very stressful. Changes will
be upsetting and sometimes unfamiliar. As the end of life approach, a person may be detached from
the physical world. They will lose interest in worldly things because they carry the burden of death
with them. They may experience visions, hallucination, and loss of appetite. They may get confused
and their breathing will become shallow. The Dying will experience that first stage which is Denial.
They will be shocked and deny their impending death. Some will not believe and will look for other
doctors for second opinion or sometimes cure. The second stage is Anger. It's hard to accept death. A
person may feel frustrated if they are sick and will soon to die. Bargaining, the third stage describes
the person's attempt to negotiate to physicians or in other circumstances even God. The fourth stage
is depression. The person will show clinical signs of depression such as withdrawal, sleep
disturbances, hopelessness and even suicidal ideation. And the final stage is acceptance. In the end,
they will realize something important. They will reflect upon themselves that death is a natural way
of life. They will accept that death is inevitable. They will not be afraid to talk about dying anymore.
They will be willing to share their thoughts about dying and accept support. In some instances, they
will find peace and comfort in their faith and believe that something unknown awaits them after
death.

Not because a person is dying means that they dont deserve legal rights. It's also important
that the dying deserve thoughtful consideration . The dying has a right to refuse to treatment because
they still possess the power to think and decide for themselves. They still the capability to think
rational. As a nurse, it will be difficult for us to deal with dying patients but they deserve a quality
life even in their last days. Each people have different beliefs about death, but that doesn't mean that
we will not give them the care they deserve. We are the same as them. We are all humans and we feel
the same emotions. I have come to understand that death is nature's way of controlling the world's
population. God is great because he made sure that everything is balanced. Not even advanced
technology can prevent a person from dying. In order for us to truly grasp the meaning of death and
its impact on a person life, we must first understand what is life. Even I am scared of death because
the truth is, it will come to everyone. So let us live our lives to the fullest because when the day of
our death comes, we will not have something to regret.