Terminal Illness

How Can I Ever Let Go?

By June Hunt

The statistics are amazingly consistent, one out of one people die! The ultimate reality is: all of life is terminal! God’s masterpiece of creation is destined for death. Yet, since we were originally created for life, dying becomes an unwanted intrusion. Even the knowledge of our own impending death can become an unwanted reality. Like a flower clutching its last petal of pride, our hearts cry out, Not me . . . not now!
1 Peter 1:24

DEFINITIONS

A. Facing a Terminal Illness
The word terminal means “final, concluding, closing; occurring at the end of a period of time.”1
Gen 3:22

“There seems to be no hope when we hear the word terminal. Do all serious illnesses such as cancer end in death?”
No. Not all cancer is terminal. More importantly, medical science is never the last word. Miracles do happen. The miraculous story of Lazarus reveals that we cannot always know the will and ways of God.
John 11:4

The word illness refers to any unhealthy condition of the body; a disease or sickness.2
· The Old Testament Hebrew word makob means “mental and physical pain and anguish.”3 It refers often to the mental or psychological aspect of illness. The Old Testament reference to the Suffering Servant in Isa 53 contains the word makob in connection with the sorrows and anguish associated with physical pain.
Isa 53:3-4

· The New Testament Greek word most closely associated with terminal illness, astheneia, means “sickness, weakness or disease.”4 Lazarus, a close friend of Jesus, had an illness that resulted in death . . . temporarily.
John 11:1; 1:14

“Is it morally right for Christians to take pain medicine, or is that putting faith in prescriptions and not in God?”
God created everything in the earth and called it “good”—including plants with pain relieving properties. With the medical knowledge available today, patients should not have to suffer great physical pain.
Ezek 47:12

· Terminal illness is a physical sickness with the prognosis that a person’s life expectancy will be less than a year, although many patients do live longer. The person pronounced terminally ill first hears a diagnosis, then a prognosis.
—Diagnosis . . . the identification of a disease based on its signs and symptoms5
—Prognosis . . . a forecast of the probable outcome of a disease based on its usual course6
“Is it always best to reveal the truth to a person who has been diagnosed as having a terminal illness?”
Yes. Most terminally ill patients instinctively know when they are not getting well. Dishonesty and deception rob them of dignity and the motivation to get their relationships and affairs in order before they die.
Lev 19:11

B. Facing Death
Eccl 9:5

· Death is Designed
Embracing the God-given gift of life means accepting death as part of life’s package. The moment you are born, you take the first step toward death. One of the characteristics of spiritual maturity is recognizing death as a natural part of God’s design.

Eccl 3:1-2

“What can I say to a friend who is grieving because of a terminal illness?”
Being there and listening is more important than talking. Be slow to use Scripture, and when you do, choose only those verses that are uplifting.
Prov 12:18

· Death is a Doorway
Death can be a doorway to a more abundant (eternal) life, or it can be the gateway to eternal misery. Death is not an end to life, but a beginning. We are born with a heart’s desire to live forever, and only through faith in Christ can we reach out and embrace God’s promise of eternal life.

Matt 7:13-14

“Why is accepting death so difficult?”
For some people it is fear of the unknown, and for others it is a feeling of overwhelming regret or loneliness. Fortunately, genuine faith in Christ makes it easier to accept death. When you become a Christian, you become a part of God’s family and have God’s assurance that you are never alone.”
Ps 94:14

· Death is Divine
The reality for all Christians is that you have already died! God’s desire for you as His child is death to self and submission to the divine life of Christ living within you, expressing His life through you.

Gal 2:20

“Isn’t all joy in life gone once you accept the fact that death is near?”
As a Christian, when you begin to accept your own impending death, each day will become more meaningful. Valuing the little things in life that you had once taken for granted, you can actually experience more joy in life.
Ps 30:11

CHARACTERISTICS

Hearing the words—“I’m sorry to have to give you this report,” or “The tests have confirmed what we suspected,”—hits your heart like a bombshell. . . . The initial shock is devastating. Once all medical hope is gone, a residue of shattered emotions leaves both you and your family fighting your way through a minefield of emotional pain. But with each step on this precarious and disorderly path of grief, you can make progress toward accepting the reality of death.
Ps 55:4-5

Stages of Grief

A. Shocked! (First Stage)
The world has stopped. . . . Time stands still. When you first hear a diagnosis of terminal illness, the initial response is shock. Your heart is gripped with the agony of paralyzing fear, and reality seems far away.7
2 Sam 22:5

· Numbness
— “This can’t be happening. . . . This isn’t real.”
· Terror
— “I feel gripped with fear. . . . I am afraid to die.”
· Confusion
— “What do I do first? . . . I don’t know what to do!”
· Panic
— “I can’t face this. . . . I just want to escape.”
How to Respond in Love
· Go with your loved one to the doctor’s office. (When receiving a negative diagnosis, most people hear only 30 percent of the doctor’s words.)
· Ask questions and take notes of what the doctor says.
· Listen to thoughts and feelings.
· Look for different ways to offer encouragement and hope.
Gal 6:2

B. Shattered! (Second Stage)
Emotional fallout! Your lifelong dreams are now shattered, creating unpredictable movement through denial, anger, bargaining and depression. Unfortunately, many people never move beyond the borders of this emotional defense against reality.8
Isa 38:10

· Denial
— “The doctor didn’t say I was incurable.”
— “I really think I’m getting better.”
How to Respond in Love
· Don’t insist on forcing the truth.
· Avoid making any negative comments or responding to untrue statements.
· Repeat the doctor’s words.
· Make gentle suggestions toward the truth.
Ps 51:6

· Anger
— “God, why have You let this happen to me?”
— “Why didn’t the doctor detect this sooner?”
How to Respond in Love
— Allow your loved one freedom to be angry.
— Avoid any judgmental attitudes toward the display of anger.
— Face your own anger and hostility.
— Seek to uncover the fear that anger is masking.
Prov 12:16

· Bargaining
— “If I dedicate my life to God, maybe He’ll let me live.”
— “I know I’m going to die, but just let me live long enough to see my daughter get married.”
How to Respond in Love
· Realize it is natural not to want to die.
· Accept bargaining as a legitimate part of the grief process.
· Adopt a wait-and-see attitude about what God is going to do.
· Recognize that sometimes God honors bargaining.
Job 11:7

· Depression
— “I have lost all control of my life. I feel so helpless.”
— “I am so tired of searching for answers. I feel like giving up.”
How to Respond in Love
· Know that depression is often anger turned inward.
· Look for ways to affirm the patient’s worth and usefulness.
· If necessary, care enough to compassionately confront. (Sometimes severe depression needs to be addressed directly.)
· Lovingly seek to encourage expression of emotions and feelings.
Prov 20:5

C. Sheltered (Third Stage)
Shelter of safety . . . territory is gained in the emotional battlefield of acceptance. When your heart is willing to trust in God’s love, you depend on His grace to live day by day. A new freedom emerges within . . . the freedom to live or die under the “shelter of His wings.”
Ps 61:4

· Acceptance
—“Do I really want to fight God’s will? I realize that I will die soon.”
· Peace
—“God is in total control of my life. He is working out His plan for me.”
· Growth
—“Life is much more meaningful when I live one day at a time.”
· Freedom
—“I no longer fear death. . . . I know I will live with God forever.”
How to Respond in Love
· Communicate with a cheerful spirit.
· Share your love and affection.
· Pray for and with your loved one.
· Stay involved. (Frequent brief visits and offering practical help are more desirable than a few lengthy stays.)
1 Thess 5:16-17

“How is it possible to live with the emotional stress of knowing that you are going to die?”
Such knowledge should force you to focus on God’s purpose for your life and teach you to live for what is really important.
Rom 8:28-29

CAUSES

The universal response to news of a fatal illness is why? why me? why now? Accepting your own impending death is one of the most difficult challenges in life. While Scripture holds no promise that you will always know the why’s in life, it is not wrong to ask, “Why?” Face to face with His own death, Jesus Himself cried out to the Father—
Matt 27:46

A. Why, Lord? Why?
· Sin (Illness is sometimes the normal consequence of sin.)
— Adam and Eve’s disobedience before God (original sin) brought the reality of pain and death into the life of everyone. (Read Gen 3.)
— Our personal habits or sins may sometimes carry consequences of sickness and death. (God does not cause sickness as a punishment, but He may allow natural consequences.)
1 Cor 11:27-30

· Satan (God allows Satan limited power to cause affliction.)
— Although Job was a godly man, God allowed him to be afflicted by Satan.
Job 2:3-6

— God allowed His servant Paul to be afflicted by Satan.
2 Cor 12:7

· Spiritual Growth (God’s purpose for suffering is the strengthening of faith.)
— The Lord uses affliction to help us learn what He has said.
Ps 119:71

— The Lord uses affliction to teach us to obey what He has said.
Ps 119:67

· Spiritual Glory (The result of suffering can bring great glory to God.)
— As a Christian your right response to a terminal illness will bring honor to God.
Job 2:7-10

— God is honored through the blessing of a supernatural healing.
Luke 18:35-43

B. Root Cause
When life is threatened, your emotions wage war in the battlefield of your mind. If bitterness is allowed to control your thinking . . . you will continue to fight God’s ultimate plan for your life.
Wrong Belief:
“God is not fair! Why can’t I live the expected number of years or an average life span?”

Right Belief:
My life is not my own. Since I belong to God, I can rest in the assurance that He will act with total fairness and love toward me, both in my life and my death.

Rom 14:8

STEPS TO SOLUTION

A. Key Verse to Memorize
Ps 23:4

B. Key Passage to Read and Reread
2 Cor 4:16-5:5

Do Not Lose Hope . . .

· Though outwardly you waste away,—2 Cor 4:16
· Your inner life grows day by day,—2 Cor 4:16
· And present pain will be replaced,—2 Cor 4:17
· With grandest glory interlaced.—2 Cor 4:17
· Let go this view of what life brings,—2 Cor 4:18
· And turn your heart toward godly things.—2 Cor 4:18
· Your earthly tent can never stand,—2 Cor 5:1
· For your new home is from God’s hand.—2 Cor 5:1
· Though hearts may long for what is lost,—2 Cor 5:2-4
· Soon heaven’s doorway can be crossed.—2 Cor 5:2-4
· The Holy Spirit whispers clear,—2 Cor 5:5
· “I am in you—have no fear.”—2 Cor 5:5

C. Facing Eternity
The Reality of Heaven

No matter how desperately you cling, this earthly life will never satisfy the longing for eternity that the Lord has placed in your heart. You were created to enjoy unending fellowship with God and His children in heaven. Yes, heaven—a real place—a place of beauty called the Holy City, a perfect place where all believers will worship God forever.
Rev 21:11

Heaven is not . . .
· the end of all existence
· a state of unconscious bliss
· union with some spiritual life force
· the final destination for everyone
· a myth to make you feel better
Heaven is . . .
· the place where God lives
1 Kings 8:30

· the place of no hunger or thirst
Rev 7:16

· the place of no crying or pain
Rev 21:4

· the place of no death or mourning
Rev 21:4

· the place of no impurity or evil
Rev 21:27

The Reality of Hell

Satan is the supreme master at convincing people that eternal punishment does not exist. Many people think a loving God would not create such a horrible place as hell, much less sentence someone to spend eternity there. The truth is, God does not send people to hell—people choose their own destiny through unbelief.
John 3:18

God is indeed a God of love, but He is also a God of wrath based on His holiness and justice. His character will not allow an unrepentant heart to go unpunished. God created heaven as a home for His people, but He also created hell—a real place for Satan and his rebellious angels. After judgment, hell is the final destiny for those who have rejected the Redeemer.
Matt 25:41

Hell is not . . .
· the end of all existence
· an unconscious separation from God
· an earthly return to life in a lower form
· the misery and sorrow experienced now on earth
· a myth to induce fear
Hell is . . .
· a place of weeping and torment
Matt 13:42

· a place of wrath and anger
Rom 2:8

· a place of eternal fire
Mark 9:47-48

· a place of confinement and conscious separation from God
Luke 16:26

· a place of condemnation and punishment
2 Peter 2:3

D. Preparing for Reality
Perhaps your own emotional war is being won. But how is your family coping with your illness? The best way to overcome the concerns you may have for your family is to “put your house in order.” Many decisions can be made that will lighten the load of your loved ones.9
2 Kings 20:1

Reality

Record Your Will.
· Be sure your will is legally documented.
· Make a list of specific items for special family and friends.
· Think about a bequest to your church and respected ministries.
· Pray about offering to become an organ donor.
· Consider making a “living will” that states your medical decisions.
Heb 9:17

Express Your Desires.
· Choose whom you want to conduct the service.
· Select meaningful poems, music and Scripture.
· Designate the pallbearers and favorite musicians.
· Name organizations that you want to receive memorials.
· Communicate where you want your funeral held.
Heb 11:22

Arrange Your Affairs.
· Select one person to have your power of attorney.
· Gather your important documents in one place
(insurance, investments, key to safety deposit box).
· Secure legal guardianship for any dependents.
· Write out the names of persons to be contacted
(lawyers, family, friends).
· Communicate your decisions to your dependents.
1 Chron 28:11,19

Leave a Legacy of Love.
· Share the significance of your Christian faith with others.
· Communicate love, appreciation and words you’ve always wanted to say.
· Record your thoughts in a journal or on tape to family members.
· Write, phone or visit special old friends.
· Mend broken relationships with, “I’m sorry” or “Please forgive me.”
Just before the death of the apostle Paul, he said to his beloved son in the faith,
2 Tim 1:3-4

Identify Your Fears.
· Fear of death—Examine your life to be sure you have a personal relationship with Jesus Christ.
· Fear of pain—Physical pain can be controlled through properly administered medication without fear of chemical addiction.
· Fear of loneliness—God has promised that He will never leave you nor forsake you.
· Fear of losing control—It is good that God is in control—He can manage better than you can.
· Fear of abandonment—The Lord will be the Provider for your loved ones. It is on Christ they should learn to lean.
Ps 46:1-2

Trust Your God.
· God has a purpose for everything that happens to you.
Prov 19:21

· God never gives you more than you can bear emotionally.
1 Cor 10:13

· God’s thoughts and ways are not your thoughts and ways.
Isa 55:8

· God promises a silver lining behind your darkest cloud.
Rom 8:28

· God holds on to you even if you let go of Him.
2 Tim 2:13

Prov 3:5-6

Yield Your Heart.
· Submit your will to God’s will and be at peace with Him.
Matt 26:39

· Choose to reflect Christ’s spirit.
“May my spirit reflect Christ’s spirit of hope and humility.”
Prov 18:14

· Allow Christ to live in your heart.
Eph 3:16

· Respond to your circumstances with the strength of Christ.
“Whatever the struggle, in Christ’s strength I will do what You call me to do.”
Phil 4:13

· Anticipate God’s promise of hope for the future.
“Lord, I look forward to experiencing all that You’ve planned for me in heaven.”
1 Cor 2:9

Josh 24:23

E. Leading the Way to the Lord
If someone you know has a terminal illness, leading that person to the Lord is a job not just for professional ministers of the church. God alone prepares the heart, but you are called to share sensitively what it means to trust Christ as Savior. Those who are close to death are often more receptive to spiritual things, thus opening the door for you to be what God calls a “minister of reconciliation” . . . explaining that Jesus is the means of reconciliation with God the Father.
2 Cor 5:20

· Start with prayer for God’s blessing on your time together.
Ps 37:30

· Seek to be alone with the person who is dying.
Mark 4:34

· Speak directly about judgment and eternal life.
— “Are you ready to meet God if He should call you today?”
— “If you were to die tonight, do you know for sure that you would go to heaven?”
Heb 9:27

· Share the problem of sin in simple terms.
— “Like a stray arrow, every person has missed the target of God’s holy standard. We have willfully chosen what we knew was wrong. God calls our wrong attitudes and actions sin.”
Rom 3:23

· State the consequences of sin.
— “You deserve a salary for your work. These wages are your deserved payment. God says because of our self-willed sin, we deserve death, which means eternal separation from God.”
Rom 6:23

· Specify God’s solution to sin.
— “If someone could and would exchange his healthy body for your diseased body, what would happen? He would die, and you would live! Jesus Christ did that for you—He took the punishment for sin that you deserved and died in your place so that you could live with God forever.”
Rom 5:8

· Set forth the purpose of Jesus.
— “In heaven there is God the Father, God the Son, God the Spirit. Jesus, who is God the Son, knew that our sins would separate us from Him. Jesus didn’t want us to be separated, so He left heaven, came to earth and lived a sinless life. Upon His death, He chose to take the penalty for our sin upon Himself—the penalty of death that we should have paid. Jesus died for our sins. If we humble our hearts and receive Jesus as our personal Lord and Savior—giving Him total control of our lives—then He forgives us for all our sins, and we receive eternal life.”
John 3:16

· Single out Christ as the only way to be saved.
— “Assume that you were sick in Russia and desperately needed medicine that your money couldn’t buy. All of a sudden, you hear that a gift has been offered to you. Not aspirin, not cough medicine, but the only medicine that could save you—antibiotics. For the antibiotic to be effective, you would need to receive the medicine and take it. Salvation is like that. You need to receive the gift with faith and apply it to your life. God says your salvation is based on your faith in Jesus Christ alone.”
John 14:6

· Suggest a prayer of salvation.
— “Would you like to receive Christ right now through prayer?”
Acts 16:31

Prayer of Salvation

God, I admit that I have sinned. Many times I’ve gone my own way instead of Your way. Please forgive me for all my sins. Thank You, Jesus, for dying on the cross to pay the penalty for my sins. Come into my life to be my Lord and Savior. Take control of my life and make me the person You want me to be. Thank You, Jesus, for what You will do in me, to me and through me.
Amen.

HOSPICE CARE AN ANGELIC ALTERNATIVE

3 John 8

Like a bridge between expensive hospital facilities and the medically insufficient care found in most homes, hospice care is a desirable option for many families—providing a caring environment for the terminally ill as they travel to the end of this life.10
Home team effort
The hospice care team leader supervises a unified plan that includes nursing, physician calls, family counseling, homemaking services, volunteer help and spiritual support.
Overall approach
Hospice care provides a coordinated system of physical, emotional and spiritual care for the terminally ill and their families.
Specialized services
Physical therapy, medical equipment and supplies, nutritional counseling, meal planning and other similar services are supplied as needed.
Pain control
Hospice care tries to prevent pain from occurring rather than just giving relief on demand. All medical knowledge is used to keep pain under control.
Involvement with family
Hospice teams assist and educate the family members or caregivers in ways to make their job easier. Follow-up, support and counseling are also provided for family members for up to one year after the patient’s death.
Cost effectiveness
Hospice care is between 20 and 40 percent less expensive than staying in a hospital. The percentage of savings can be even greater during the final weeks of life.
Emphasis on quality of life
The main goal of hospice care is to allow the patient to die with dignity and self-respect in a worry free, loving environment.

NOTES

1. Merriam-Webster Collegiate Dictionary (2001); www.m-w.com.
2. Merriam-Webster Collegiate Dictionary.
3. James Strong, Strong’s Hebrew Lexicon (electronic edition; Online Bible Millennium Edition v. 1.13) (Timnathserah Inc., July 6, 2002); R. Laird Harris, Gleason L. Archer, Jr., and Bruce K. Waltke, The Theological Wordbook of the Old Testament (electronic ed.) (BibleWorks for Windows 5.0.033 q, 1980).
4. Strong, Strong’s Greek Lexicon.
5. Merriam-Webster Collegiate Dictionary.
6. Merriam-Webster Collegiate Dictionary.
7. For this section see Glen W. Davidson, Living with Dying: A Guide for Relatives and Friends, revised and expanded ed. (Minneapolis, MN: Augsburg, 1990), 54-58.
8. For this section see Gregg R. Albers, Counseling the Sick and Terminally Ill, Resources for Christian Counseling, ed. Gary R. Collins, vol. 20 (Dallas: Word, 1989), 9-13; Ruth Lewshenia Kopp and Stephen Sorenson, When Someone You Love Is Dying: A Handbook for Counselors and Those Who Care (Grand Rapids: Ministry Resources, 1985), 18-64, 167-89, 190-97, 201-23.
9. For this section see Kopp and Sorenson, When Someone You Love Is Dying, 201-23.
10. For this section see June Cerza Kolf, Comfort and Care for the Critically Ill (Grand Rapids: Baker, 1993), 45-47.

SELECTED BIBLIOGRAPHY

With appreciation for early editorial assistance from Jan Pettigrew, Ph.D. and R.N., oncology and grief crisis counselor.