Coping Strategies

Reactions Chart

People react differently when a terminal illness is diagnosed. How you react may be affected by the type of illness you have, how you cope with stress normally, the support you have around you, your age, or personal circumstances.

Typical reactions on hearing your diagnosis or that of a loved are:

  • Feeling numb
  • Unable to express emotion
  • Anger
  • Wanting more information
  • Unable to take in information
  • Shock
  • Wanting to talk things over
  • Denial
  • Grief
  • Fear
  • Depression

However, there is a typical emotional process that most people with a terminal illness go through. In 1969, Elisabeth Kubler-Ross identified the stages of death and dying in her book ‘On Death and Dying’. The basic five stages are:

Denial - I can’t be dying.

Anger - Why me? I don't deserve to have this disease.

Bargaining - If I am good or if I give up x, then maybe I will live longer.

Depression - What is the point of carrying on?.

Acceptance - OK, I know I’m dying but I’m prepared.

Emotional Responses

This range of emotions could take place within hours, or it could take weeks or years to move through the stages. Research shows that it is likely that you will need to experience all the stages before you can come to acceptance.

Carers also experience similar feelings but may take longer to work through the stages. This is often due to being too preoccupied with caring for the ill person to deal with personal emotions. For carers, the actual death can often be the moment when this cycle starts and it is also perfectly normal to go through this cycle more than once, often at the point of diagnosis and then again when death occurs.

You may experience all the stages in a linear fashion and it is quite possible to experience more than one emotion simultaneously. You may also move back and forth through the stages, depending on the progress of the disease or illness and how treatment goes. It is possible to get stuck at a stage for weeks, months or even the rest of your life, raging against the world or living in denial.

You can help yourself or another person to move through the stages by talking honestly about feelings, hope and fears. If you feel you can’t cope then you should seek out the help of your GP, Macmillan nurses or other counselling professional.