Closure.org Blog

By Toni Steres

My grandfather is dying.  I tear up just typing that sentence.  He was diagnosed with pancreatic cancer in August of 2010 and without going into details, was given 6 months to a year back in December of the same year. 

As a registered nurse, I know how important it is for patients to make end-of-life decisions before you actually need them.  I have many stories of patients who planned ahead—and ones where patients did not.  As you can imagine, those who did not left their families in turmoil—“What did he want to have happen?  Do you know?  Does anyone in the family know?”

I hoped that my grandfather, being a planner himself, would be willing to discuss this with me.  But the denial stage of grief is a powerful thing.  When I first brought up the thought that plans needed to be made—he cringed and changed the subject.  Later, he told my father that it depressed him when I brought up the subject. 

My initial reaction was one of anger.  How could he not want to make decisions about his own life?  How could my father be mad that I wanted to make sure he was able to die the way that he wanted?  Why did everyone in my family avoid this topic?

It took me some time to learn that denial is a strong emotion when you are not prepared to hear the news.  And sometimes, the best way to cope with something you can’t handle is to deny that it exists at all.  As Elisabeth Kubler-Ross states in her book On Death and Dying, “Denial functions as a buffer after unexpected shocking news, allows the patient to collect himself and, with time, mobilize other, less radical defenses.”

It’s important as family members—and health professionals—that we discuss end-of-life decisions before they are needed.  But it’s also important to remember that denial is a valid way for some people to cope with what they cannot deal with at the moment.  Repeating the topic at a later date will usually lead to decisions.  And providing information and education, like what you find at www.closure.org, will allow them to review it when they are ready to think about the end.

*Toni Steres is a Registered Nurse in northern Illinois. She is currently working towards her masters as a Family Nurse Practitioner.