Stress and the Dying Process

Courtesy of | By Angela Morrow, RN | Image by Jaime Grill/The Image Bank/Getty Images | Originally Published 03.02.2017 | Posted 01.17.2018

Stress is the body’s reaction to a change that requires a physical, mental or emotional adjustment or response. Stress can help you to grow stronger — as in the case of intense exercise, for example — or it can undermine your ability to cope. Stress can motivate you to achievement, or it can cause depression, anxiety, and other health-related issues.

Dying, of course, is a stressor, as are many of the issues surrounding death.

It is stressful both for the dying person and for the caregiver. In a basic sense, dying represents the biggest changes anyone will have to make. It may also, for the caregiver, require huge changes in relationships (the child becomes the caregiver, for example), not to mention complex changes in routines, new responsibilities, and more.

Stress Related to the Dying Process

Dying is a very person experience, and the level of stress related to death will vary radically from individual to individual. Some of the factors that will make a difference include:

  • Age and sense of “completion.” An older adult who feels they have lived a full life is sometimes (though not always) more comfortable with the idea that life is coming to a close.
  • The level of discomfort. In some cases, a combination of factors will make it possible to experience the dying process at home in relative comfort. In other cases, the process is physically painful and draining.
  • The level of concern over external factors. Is there enough money to pay for caregiving and final expenses? Will the person or people providing care be overtaxed?  Are there responsibilities which the dying person needs to manage?
  • Spiritual considerations. For some people, dying is a natural part of life; for others, it is “going home.” For some people, however, it is a terrifying prospect.
  • Point you are at in the dying process. Typically, people who are presented with a terminal diagnosis go through a five-stage process in which they experience a wide range of feelings. Stress is associated with some of those stages until the individual is able to come to terms with the facts.

It is natural and normal for a person who is dying to experience some level of anxiety and depression, and squelching those emotions — whether medically or otherwise — is usually unnecessary and can be harmful. Issues arise when the dying person is experiencing a pathological (severe) level of depression and/or anxiety which make it impossible for him or her to enjoy and participate in activities he or she typically enjoys.  In addition, there are biologically-based issues that can create mood and/or physical problems that interfere with enjoying life. When challenges arise, medical and psychological professionals can often recommend medications or other interventions to help.

Stress Related to Care Giving

In many cases, caregiving can be more stressful than dying. Why might this be the case?

  • Caregivers are coping with their own “anticipatory grief” about their loved one’s death at the same time that they are coping with their loved one’s remaining life.
  • Caregivers are coping with all the stress of ordinary daily life — traffic jams, financial issues, and so forth — at the same time that they are providing care to a dying loved one.
  • In some cases, caregivers have given up large elements of their personal lives, including work, hobbies, and more, to provide care. Not only can this lead to loneliness and boredom, but it can also lead to depression, financial difficulties, and resentment toward the dying individual.
  • Caregivers may not have the time or energy to care for their own physical needs, such as exercise, purchasing and cooking healthy foods or visiting doctors.
  • Caregivers may step into the caregiving role believing themselves to have the ability to “fix” a situation that is not fixable. The frustrations surrounding “helplessness” can be profound.

Many caregivers are stressed to the point where they are clinically depressed and/or anxious, and unable to enjoy their own lives. The solutions are fairly simple: finding supportive and respite care, taking time for oneself, choosing to get sufficient exercise, nutrition, and sleep, and accepting the reality that life — and death — are both unpredictable and, at times, unmanageable.

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