Acceptance. The final stage among the 5 stages of grief. Interesting isn’t it? To think that there could be any other stage that would end the grief cycle and allow us to die. At some point, whether it be in that final breath, or weeks before, there comes a time, where one accepts the inevitable reality that life as you have known it will end. Perhaps you decide to sign the DNR (Do Not Resuscitate) that you had been so reluctant to earlier. Maybe you find the time to create a Will, or you choose a Healthcare Surrogate to be your decision maker when the time comes that you are no longer conscious. Perhaps you are able to work through the messy connections of relationships that have been the fabric of your life. You may, or may not, forgive those who have hurt you in the past, and you may, or may not choose to offer apologies to those you have hurt. What you recognize is, is that you are ok with that, as there will never be another time for it to occur.
A patient of mine, a very quiet, gentle, man, was tearful one afternoon when I visited him in his room. He told me he was struggling with the fact that he felt he had not been a good father to his children. ‘I just cared about myself back then, when they were younger, my job, my friends were more important…I drank too much.’ I had to reconcile this with the image I had, which was seeing his three daughters come every day to sit with him for hours. They laughed, they joked, they attended to his every need. As far as I know, they’d never missed a day. When I saw his daughters later, I mentioned how their dad was wrestling with the guilt that he had not been there for them when they were children. ‘He wasn’t’ one said ‘it was my mom who really was there for us when we were younger. But he’s been there for all of us since mom died awhile back.’ ‘And besides.’ another said, ‘he’s our dad and he’s dying, this is all we’ll ever have with him.’
I met a lovely couple one night on a continuous care case. A very elderly gentleman had just been brought home from the hospital that day so he could die, as were his wishes. By the time I got there he was unresponsive, his breathing was very, very shallow, and the skin discoloration, called mottling, went from his toes all the way to his knees. He was actively dying. His wife was very calm as she sat by his bed in the living room holding his hand. A few hours later the man’s sister arrived with her daughter, the couple’s niece. The sister sat down on the opposite side of the bed, held the man’s other hand and thanked him for waiting for her, then told him it was alright to go. The niece, it turns out, was a physician’s assistant. She pulled me to the side and asked ‘Are you sure he is dying? I mean, do you really think this is it?’ I looked over at the two women who were talking quietly to each other and to the dying man, whose breathing was almost nonexistent. I reassured the niece with the facts before her, but I don’t think she was convinced. A bit later I gently woke the wife who had fallen asleep in her chair to tell her that her husband was taking his last breaths. On either side of him, his sister and wife, told him how much they loved him and how much they would miss him, and what a wonderful husband and brother he had been in their lives. The niece stood at a distance crying, then mouthed the words ‘do you really think this is it?’ And then, on one of the rare cases that I have experienced this, this man opened his eyes, turned his head to his wife, smiled the sweetest smile, and died.
The 5 stages of grief: denial, anger, bargaining, depression, and acceptance, are the labels given to to the vast well of emotions and behaviors one goes through after hearing the words ‘you are dying, there is nothing more that can be done.’ After having experienced your own version of these stages will, hopefully, come acceptance. Acceptance doesn’t have to mean you like the fact that you are dying. It doesn’t mean you give up and stop taking your medications. It doesn’t mean that you will make amends to those you have hurt, or stop hoping, perhaps, that those who have hurt you may come forward to provide closure. Acceptance just means that you acknowledge the reality that your life really will end and that the rest of the world really will go on without you.
To read more on the 5 stages of grief…..