Four stages of death affecting the hospice patient (2024)

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.

Four stages of death affecting the hospice patient (1)Four stages of death affecting the hospice patient (2)

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; https://endwellproject.org/take-10-end-well-2020/#register

Four stages of death affecting the hospice patient (3)

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  1. Four stages of death affecting the hospice patient (4)

    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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  2. Four stages of death affecting the hospice patient (5)

    Sonia

    Wow! Yr story touched a place in my ♥ ♥. Tears of happy & sad,wisdom & knowledge,life & death,acceptance & courage.i know now what it is I need to do to make me feel I have lived my life to the fullest & that is to be honest in my inventory.life is how we make it…as much as I would like to be with my heavenly peeps once again it will never happen..that’s the truth in black & white..God is good.life is good..amenxx

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  3. Four stages of death affecting the hospice patient (6)

    Christine Gilliam

    Death is to hard for me can’t take the heartache when my sister passed Sept. 22st 2023 a lot being going Thur my mind every day I wonder about death and where she at I ask myself every day the same thing over and over why did u leave me alone you was my sister my best friend I find my self almost dialing your no.and I say oh can’t get death off my mind I cry everyday within me my heart is filled with sorrow I loved u dearly I was one of a kind I just can’t take death

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    1. Four stages of death affecting the hospice patient (7)

      Angela

      It is so recently you lost your sister and I am so sorry that you did. I lost my sister when I was15–she was only 31 which is so young to me now to think about as I am in my 50s. The ONLY way I got through her loss was leaning on my faith to understand why and where. My faith has been my only comfort as well through the recent loss of my mother 2 yrs ago and my best friend just 1 yr ago.
      Christine, I pray you find peace in your grief.

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  4. Four stages of death affecting the hospice patient (8)

    Michael E Sutherland

    My spouse and I have been taking care of my mom January 2020. I moved my mom about 6 months after my dad died after taking him off of life support. My brother passed away with the help of Hospice two years ago November. Now my precious mom will be assessed by Hospice 7 hours from now (10am appointment). October and November have been brutal because when I was recovering from an outpatient surgery procedure, my mom’s health started rapidly declining and now bed ridden. How can you prepare for this? You do your best, but you will never be prepared for accepting your loved one passing on. In 2012, I found my Christian faith at the age of 40. The timing is perfect because it is helping me with stability through this exhausting storm that continues. Am I getting through this perfectly? Definitely not, as I even question my faith through this. I love my parents as they really spoiled me. Letting go of my last parent is quite frankly brutal at times and sometimes a weird sense of relief. But once she is gone, it will rock my world in a bad way not doing my daily tasks, laughing with her and arguing over ridiculous things. Fortunately we do not argue that much. But the memories will be what lives on and I hold onto the hope that we will all reunite in the appointed time.

    Mike
    Jacksonville, FL

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Leave a Reply

I'm well-versed in the concepts discussed in the article you provided, and I can offer insights into the stages of death that Dr. Saul Ebema outlines. My expertise in this area stems from a deep understanding of psychology, biology, and medical concepts related to end-of-life processes.

Dr. Saul Ebema describes four major stages of death: social, psychological, biological, and physiological. Let's delve into each of these stages:

  1. Social Death:

    • This stage involves the symbolic death of the patient in their familiar social world.
    • Social contacts often diminish, leading to isolation from the community, and confinement to medical settings.
    • The patient's world as they knew it ceases to exist.
  2. Psychological Death:

    • This stage involves the death of the dying person's personality, often caused by the dying process.
    • Dr. Ebema shares a poignant example of a daughter experiencing the psychological death of her mother due to Alzheimer's disease.
    • As death nears, the individual withdraws from the external world and becomes more introspective.
  3. Biological Death:

    • This stage marks the point where the human organism, as a whole, no longer exists.
    • Artificial life support may be employed to sustain the patient artificially.
  4. Physiological Death:

    • This is the final stage, involving the cessation of all vital organ functions.
    • At this point, the patient is officially declared dead.

Dr. Ebema emphasizes the importance of support from family, friends, faith communities, and hospice teams throughout these stages to facilitate a peaceful transition.

Additionally, the article mentions an event promotion related to hospice chaplaincy and an online event called Take10 on December 10th, 2020, featuring guest speaker Dr. Naheed Dosani.

If you have any specific questions or if there's a particular aspect you'd like more information on, feel free to ask.

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