Dear friends ,
As I am dealing with terminating ill patiens since last 15 yrs. Though their terminal illness up to their deaths, I observed many things about there fealing regarding their life and deaths. They have many needs that are basically the same as those of other patients: spiritual, psychological, cultural, economic, and physical. What differs in these patients may be best expressed as the urgency to resolve the majority of these needs within a limited time frame. Death comes to everyone in different ways and at different times. For some patients, death is sudden following an acute illness. For others, death follows a lengthy illness. Death in chronic illness especaily with end stage reanl ds not only affects the individual patient; it also affects family and friends, staff, and even other patients some times it affects treating physican too. Because of this, it is essential that all healthcare providers understand the process of dying and its possible effects on people. Individual’s Perspective on Death Patient,s view death from their individual and cultural value perspectives. Many patient find the courage and strength to face death through their religious beliefs. These patients and their families often seek support from representatives of their religious faith. In many cases, patients who previously could not identify with a religious belief or the concept of a Supreme Being may indicate (verbally or nonverbally) a desire to speak with a spiritual representative. There will also be patients who, through the whole dying experience, will neither desire nor need spiritual support and assistance. In all these cases, it is the responsibility of the Physican to be attentive and perceptive to the patient’s needs and to provide whatever support personnel the patient may require. Cultural Influences An individual’s cultural system influences behavior patterns. When we speak of cultural systems, we refer to certain norms, values, and action patterns of specific groups of people to various aspects of life. Dying is an aspect of life, and it is often referred to as the final crisis of living. In all of our actions, culturally approved roles frequently encourage specific behavior responses. I observe that patients on end stage illness faces five stages of death, denial, anger, bargaining, depression, and acceptance. The first stage, denial, is one of nonacceptance. “No, it can’t be me! There must be a mistake!” It is not only important for the doctor to recognize the denial stage with its behavior responses, but also to realize that some people maintain denial up to the point of impending death. The next stage is anger. This is a period of hostility and questioning: “Why me?” The third stage is bargaining. At this point, people revert to a culturally reinforced concept that good behavior is rewarded. Patients are often heard stating, “I’d do anything if I could just turn this thing around.” Once patients realize that bargaining is futile, they quickly enter into the stage of depression. In addition to grieving because of their personal loss, it is at this point that patients become concerned about their family and “putting affairs in order.” The final stage comes when the patient finally accepts death and is prepared for it. It is usually at this time that the patient’s family requires more support than the patient. It is important to remember that one or more stages may be skipped, and that the last stage may never be reached. Support for the Dying Despite the fact that we all realize our mortality, there is no easy way to discuss death. To the strong and healthy, death is a frightening thought. The fact that sooner or later everyone dies does not make death easier. There are no procedure books that tell healthcare providers “how to do” death. The “how to” will only come from the individual doctor who understands that patients are people, and that, more than any other time in life, the dying patient needs to be treated as an individual person.

About my Blog

Dear Friends
,बचपन से ख्वाबों में जीता आया हूँ, ख्वाब देखना मुझे बहुत अच्छा लगता है... हाँ! कई बार जब ये टूटे तो तकलीफ तो हुयी, पर मैं नहीं टूटा... जब-जब ये ख्वाब टूटे मैंने इन्हे शब्दों में ढालने की कोशिश की... बस इन्हीं टूटते ख्वाबों ने लिखना सिखा दिया...

बातें जो दिल से निकलीं ...पर ज़ुबां तक न पहुंची ...बस बीच में ही कहीं कलम से होती हुयी पन्नों पर अटक गयीं... यही कुछ है इन अनकही बातों में...
Today I was browsing the Internet for information on some additional means of promoting my website apart from online promotion which I have been doing। I then came across Web Windows and found blogging is the best way to express my ideas and posting good articles.

ज़िन्दगी में कुछ लम्हे हाइपर्लिंक्ड से होते है....बस एक जरा सी क्लिक के साथ एक नया सफ्हा खुल जाता है.................और कभी कभी लिक नहीं भी खुलता, और पेज नाट फाउन्ड का बोर्ड आ जाता है.......बार-बार क्लिक करने पर भी कुछ याद नहीं आता.......पता नहीं क्या लिखना था और क्या लिख रहे हैं,फिर कभी.......

After reading many articles on net , I started to think a little about how I’ve been writing my posts, both on this site and my Livejournal account I write for my family and friends . Here on this site, I’ve more or less tried to keep them brief and to the point, because writing too much its gets difficult sometimes for me to keep coherent and people don’t always have time to read ridiculously long posts/rants. However, if I at some point I really am into what I was writing, the above would be mute, however, my strategy of writing would change somewhat. Through this blog I am attempting to write about thoughts and experiances about the life. This is something I’m not doing on my other blog, I realized however, but I feel that since I’m writing for my family and friends, I’d want to make it a story, not information sharing. The other thing the articles mention is linking to other sites so readers can follow up the blog post with additional information that is relevant. Since I’m still relatively new to blogging, this idea was something I had to get used to doing and remembering to do so. I think however that I’ve gotten a handle on it and am getting better at it; it changed my LiveJournal blog in that now I can link to the pictures that relate to the story that I’ve been telling people about which makes then make the stories more lively. I feelthat it will also help me accomplish my goals this semester with this site, which for the most part are to report what I am learning in class, report on things as I walk around, and any other random things I want to talk about. This will allow me to organize my thoughts so to more easily convey my ideas and messages to my near and dear ones…and specially those with whom I am not in contact now….though, their absence admires me and boost me lot to write this blog. And thinking I must do some more of right now so I’ll be back later with my thoughts. Happy Blogging! in the end i can say.......

dosti me doston se kakabhi judai nahi hoti,
dosti me dost ko kabhi ruswayi nahi milti,
zindagi me jeene ka maksad doston ke saath se bina shuru nahi hoti,

dosti ek anjaam hai aisa aghaaz dosti hai,
doston ki duaen dosti me hamesha kubool hoti hai,
dosti ek shaam hia aisi jo kabji dooba nahi karti,
dosti ek din hai aisa jiski subah hamesha rahti hai.

Creating my blog

Dear friends,



Today i m creating my blog, Hope u will add comments on what ever i will publish.



Thanking you,



Dr Sanjay