Henry is facing the reality that his existence in this world is about to end—he is terminally ill.

As the weeks pass, he feels himself becoming weaker and realizes his time is short and his accomplishments are almost over.

He can no longer control his own existence.

It is an unavoidable loss.

For several months he has been expressing a range of emotions to his daughter… unhappiness (with pleasure at times, depending on the happenings of the moment), hopelessness (he wants to be in the same facility as his aged wife but realizes there is no availability and he suspects they may never live together again), futility, meaninglessness, disappointment, remorse, death anxiety, disruption of personal identity (“What makes me who I am?” “What are my values?” “I know I’m starting to forget…”)…And fear:

Fear of becoming a burden,

Fear of family desertion (of dying alone) perhaps, his daughter surmises, because Henry was controlling of relationships in the past, was often not there for his family members in the past (and when he was there he was sometimes abusive) and now he fears family members will be resistant to extending help (will want revenge),

Fear of losing dignity,

Fear of shortness of breath,

Fear of nausea…

And especially fear of pain more than pain itself.

Henry is experiencing existential suffering (mental suffering).

Existential suffering can lead to suffering in Henry AND frustration for his health care workers and for his family as members try to blame the medical community for its failures to meet Henry’s needs.

But there is a difference between fears of the dying process (that terminally ill people like Henry typically feel) and fears related to being dead (that healthy people ponder—heaven versus hell, whether we have a soul or not and what it is comprised of if we do have one, nothingness…).

When we are healthy, we normally think periodically about death only to dismiss the thoughts for later consideration. This becomes ever more difficult to do when the time remaining is clearly running out. When one is dying, it is hard to repress thoughts about what lies ahead. Accepting the reality of death is a lonely battle for each individual.

In my next Blog post I’ll share some ideas for relieving mental suffering in the terminally ill.

Melanie Hack
Author of Who Killed My Sister, My friend
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