When a dying person senses that he is being abandoned and that others no longer feel he is worth their time and effort, he is likely to show very understandable mental and emotional reactions. He becomes demanding and agitated or more depressed. He thinks and talks in ways that may come across as peculiar to others.
For whenever patterns of communication deteriorate, it becomes increasingly difficult for an isolated person to speak logically. Unfortunately, reactions of this type often provoke responses that compound misery. Depressed because he feels abandoned, the terminally ill person may stop eating. Sensitive caregivers may recognize the psychosocial dynamics involved and increase their efforts to provide a sense of affection and security. Less sensitive people, however, may immediately resort to forced feeding through intravenous needles or gastrointestinal tubes. Or, they may decide the person is ready to die and let him go.
There is another fairly common reaction to the distress expressed by the terminally ill elderly person. Depressed, fearful, trying to find some way to counter the loss of a normal human environment, he may behave in a way that makes him, in some people’s eyes, an ideal candidate for a mind-influencing drug. Instead of receiving a human response to his distinctly human needs and distress, he may be pacified by drugs. This approach reduces some of the symptomatic expressions of distress, especially those that disturb other people on the scene but give little true comfort to the person.
Nevertheless, mental changes in the old person are sometimes the first signs of a terminal decline. Awareness of this can help us provide more appropriate care for the individual, and encourage sensitivity to his needs and wishes.
The functioning of a person during a terminal illness largely depends on who he has been throughout his life, the type of condition afflicting him, the type of treatment being received, the special characteristics of his present environment, etc. We can relate better to the terminally ill elderly individual if we don’t load ourselves with expectations but approach him simply as the person he is with the people we are.