After going through the bargaining stage, the individual or family members usually becomes depressed. This is the beginning of realization that death or loss is inevitable. If the person is going through an extended illness, the realization comes after symptoms worsen and a sense of great loss occurs. Patients in this stage are usually weaker and unable to perform even the simplest of tasks. Reactionary depression occurs because there are additional losses of finances, job, independence, family role, and intimacy.
Preparatory depression is related to the impending loss, or the death of the individual.
It s common for a dying person to think that their life has been all in vain. The first reaction that caregivers generally have toward this stage is to try to cheer up the depressed individual and encourage them to look at the bright side of things. This may work somewhat for reactionary depression, but preparatory depression is more complex. A grieving person will find more comfort in expressing him or herself. Often this just means being a good listener.