¶ … population ages, it will become increasingly important to know how to care for the chronically ill and dying elderly patients. An article in American Family Physician details one of the problems that arises in such cases: denial. The article tells about an incident where a man who is in constant pain repeatedly goes to the doctor, but will not accept that his symptoms could be caused by cancer. When the doctor offers to make a referral to hospice for extra help, the patient adamantly refuses the care. At first the physician does not give up his potential persuasions, which include stressing the patient's personal responsibility concerning the need for loved ones to see him free of pain. Yet the same scenario continues until, unfortunately, the man dies.
The author of the article, Dr. Karen Ogle, explains that denial is a common coping mechanism in the terminally ill. People rely on denial in different...
This denial may also vary widely on a day-to-day, or even a minute-to-minute basis. In this case, the denial is very strong and irreversible.
Dr. Ogle adds that although the doctor said he tried his best to persuade the man to get additional care, perhaps more could have been done. By coming back to the doctor's office time and time again, he may have been approachable by establishing "an alliance around the pain" and building slowly to a mutual understanding of the current situation: "You have been having a lot of pain . . . We have done a number of tests . . . The results show that . . . This means that . . ."
One of the ways to break bad news, she adds, is to retain respect patient's personal choices about coping, while expressing concerns in a balanced and clear manner: "I know…
