Get ready to celebrate...and spread the word about quality end-of-life care.  Tomorrow marks World Hospice and Palliative Care Day. The event is celebrated annually on the second Saturday of October to raise awareness of hospice and palliative care around the world.  Hospice and palliative care organizations are celebrating around the world in 70 countries and working hard to get the word out about choices and quality care at the end of life.

This year Voices for Hospice falls on the same day.  Voices for Hospice occurs bi-annually on the same date.  The event is celebrated with a wave of musical concerts around the world.  Want to attend a concert near you? Find locations of registered Voices for Hospice events near you by visiting the World Hospice and Palliative Care Day page.  Enjoy the music and help raise funds to support hospice programs world-wide.

Is  your hospice organization participating this year?  Share how you or  your organization celebrated World Hospice and Palliative Care Day 2009.

What is Hospice?

What is Palliative Care?

Anger is one of the five stages of coping with death.  The five stages - denial, anger, bargaining, depression, and acceptance (also known as DABDA) - we're made popular by Elisabeth Kubler-Ross in the 1960's and are still very relevant today.  Anger is, perhaps, the most universal of these stages; nearly every dying person feels angry at some point during their journey.  A dying person's loved ones and caregivers often bear the burden of this anger and may have a difficult time coping with it's repercussions.

There are some strategies caregivers and loved ones can use to cope with anger, and perhaps even help the dying person cope with it as well.

5 Tips for Coping With A Loved One's Anger

An article published last week in the New York Times, After Death, The Pain That Doesn't Go Away, deals with the sometimes silent problem of complicated grief.  Complicated grief is grief that is prolonged, persistent, and severe and is sometimes referred to as "abnormal grief".  It interferes with a person's entire life, stripping them of their interests and desires in life and often takes the form of severe depression.

Complicated grief is being considered for spot in the DSM-V,the American Psychiatric Association's handbook for diagnosing mental disorders.  Until now, complicated grief hasn't been thought of as an actual mental disorder itself but rather an aspect of another existing disorder (think depression, post-traumatic stress disorder, etc).  That will all change if the decision is made to include complicated grief in the DSM-V, which is due out in 2012.

While there is no handbook for how one should grieve and for how long, there is a point when grief becomes serious and potentially dangerous.  An example of complicated grief offered in the NYT article:

In 2004, Stephanie Muldberg of Short Hills, N.J., lost her son Eric, 13, to Ewing's sarcoma, a bone cancer. Four years after Eric's death, Ms. Muldberg, now 48, walked around like a zombie. "I felt guilty all the time, guilty about living," she said. "I couldn't walk into the deli because Eric couldn't go there any longer. I couldn't play golf because Eric couldn't play golf. My life was a mess.

"And I couldn't talk to my friends about it, because after a while they didn't want to hear about it. 'Stephanie, you need to get your life back,' they'd say. But how could I? On birthdays, I'd shut the door and take the phone off the hook. Eric couldn't have any more birthdays; why should I?"

Four years of severe grief will take it's toll on a person's emotional and physical self and needs to be treated.  How can you know if your grief is complicate?

Grief:  What's Normal and What's Not

I've been waiting all summer in desperate anticipation for the season premier of Grey's Anatomy. Last season's closer left Izzy Stevens and George both in the cusp between life and death. Despite all the rumors of who was leaving the show and who wasn't, I wanted to see for myself who lived and who died. (Don't worry, that's all I'll say just in case you haven't seen it yet. No spoilers here!)

The season premier followed the staff of Seattle Grace through their grief, using the DABDA theory of dealing with death to explain how they were coping. The DABDA theory, made popular by Elisabeth Kubler-Ross in the 1960's, was originally thought to apply to a dying persons process of grief as they prepare for impending death and has evolved to include anyone grieving a loss of any kind.

Despite modern critics who say the DABDA theory is too concrete and linear to apply to everyone, the theory is very much still relevant. Kubler-Ross herself has said that the DABDA theory was never meant to be linear nor concrete; people will move through the grieving process touching on one or more of the five stages but not necessarily all of them nor in precise order. It's important for palliative care patients, caregivers, and loved ones to understand the five stages of grief so they can recognize each stage as it comes and support each other through them.

The DABDA Theory of Dealing With Death