Questions:

1. Explain why those facing terminal illnesses might experience a decrease in self-concept.

2. Explain why those facing terminal illnesses might socially withdraw and explain what, if anything, should be done about social withdrawal.

3. Apply Kubler-Ross stages of dying to the case study and explain the practical application of the theory.

Case Study:

Li is a married, 35-year-old woman with one child aged 5. She is currently active duty Navy and was the acting Executive Officer (second in command) onboard the USS Sampson. After 16 years of active duty military service, she was two months away from reaching her lifelong goal of taking command of a warship when she was diagnosed with stage 4 ovarian cancer.

Surgery was scheduled immediately after the diagnosis. In order to remove all of the cancerous growth all of her reproductive organs, her spleen, one kidney, and parts of her liver were removed. She also underwent an aggressive round chemotherapy. The effect of the surgery and chemotherapy left her experiencing many physical problems including fatigue, digestive and

urinary issues, hair loss, and pain. Due to these issues she is largely dependent on her husband for her daily care including dressing, bathing, and eating.

Despite these attempts, the cancer returned and she is not expected to recover. Li's reaction to the recurrence of the cancer has not been positive. As a devout Christian she has started to question God as to why she is facing the end of her life. She feels that she has led a good Christian life, worked hard in her career, and devoted herself to her family. She can't understand why God would do this to her. She gets easily upset when talking to others, but most especially when talking to cancer survivors. Her family is equally upset and feels that her snappy remarks about what she'll miss in life aren't helping them to deal with the loss. The family has asked for help in helping her to deal with her own death.