The New Grief: How Modern Medicine Is Changing Dying, Death and Grief

Article excerpt

Managing the rest of my life has been so hard. 'Numbing exhaustion' is a constant state for meemotionally and physically. I feel like I can't even process and grieve because I need to keep going and doing the next thing and there is always some sort of crisis. I can hardly focus on work, plus I am constantly on the phone with doctors and taking my dad to appointments. I've been married for three years and this situation has put so much strain on my relationship with my husband in so many ways.

-Jessica, whose father has been battling cancer for two years

Today, thanks to decades of remarkable medical advances, stories like Jessica's have become the norm. The realities of death and dying have changed profoundly in a short period of time. Life expectancy in countries like ours continues to grow as modern medicine gets better at converting diagnoses such as cancer into something akin to chronic illnesses. Because of this, the nature of grief has changed, too.

Virtually every one of us will find ourselves in this situation sooner or later. The crisis begins when we learn a loved one has been diagnosed with a terminal or life-threatening illness. But the journey may last months or years, and has the potential to affect every aspect of our lives and relationships.

In her 1970 book, On Death and Dying, Dr. Elisabeth Kübler-Ross identified a process she believed individuals pass through when confronted with death. At the time, sudden and unexpected death was more common. Dramatic changes in death and dying call for a new way of understanding what "terminal" means. If Kiibler-Ross-style grief represents traditional grief, it stands in contrast to what could now be called the new grief.

A few statistics illustrate how things have changed: two-thirds of those diagnosed with cancer now have a five-year survival rate, so death is no longer imminent. More than 1.4 million cancer survivors are 20 years or more past their initial treatment episode. The same is true for heart disease: the number of deaths immediately following a heart attack has decreased dramatically, and continues to do so.

Death has become less a sudden and unexpected event and more a prolonged process whereby terminally ill individuals and their families must "live with death" for an extended period.

New Challenges of Terminal Illness

The changing nature of terminal illness has created unique challenges for patients and their loved ones. To be better prepared, I offer the following suggestions:

Meet the payers. Most people don't read the fine print in their health insurance plans and are unaware of what's covered. Health insurers not only publish the list of services and procedures that their plans cover, but also how much they will reimburse. They provide the list of healthcare providers who participate in their plans, and rules and procedures for using specialists and contesting denied benefits. This information is often available on the Internet. …