Although people generally wish for a quick, peaceful death, it is relatively rare. Death is usually a long, drawn- out process. While brain death is the accepted definition of the end of life in industrialized nations, controversy continues when patients are incapable of conscious functioning or when suffering patients ask to die. People can best insure that their wishes concerning medical treatment will be honored by communicating acceptable treatments or appointing a person responsible for medical decisions through an advanced medical directive.

Our understanding of death progresses gradually in childhood. While the death concept is grasped by adolescence, it is not yet fully applied to everyday reality. Both children and adolescents benefit from open, honest communication about death, and death anxiety declines with age. Kübler-Ross’s stage theory provided structure to our understanding of the psychological side of dying. However, many factors contribute to the experience of dying, which varies considerably. Although most people want to die at home, it is rarely feasible, and the pros and cons must be carefully weighed. Yet dying in a hospital can be depersonalizing. Hospice care, with its focus on the needs of the patient and family, can make death more comfortable and consistent with the context of the patient’s life.

Grieving usually takes place in three stages in which the reality of the death is avoided, the loss is confronted and felt intensely, and, finally, attention is shifted toward fostering new goals and relationships. Personal, cultural, and situational factors, such as how suddenly and at what stage of life the death occurs, influence the grieving process. The death of a child is especially difficult for parents to weather, and grieving is also extended for children who lose a parent or sibling. Bereaved individuals require empathy and understanding, and can benefit from attending self-help groups or grief therapy. Death education is helpful when it helps people confront their own mortality. Being in touch with death, although sometimes disturbing, can help us appreciate life and live more fully.