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2711 Midterm > 11: Dying & Death > Flashcards

11: Dying & Death Flashcards

1
Q

T or F: most deaths occur in old age

A

T

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2
Q

T or F: most death in old age follow a slow trajectory

A

T

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3
Q

Palliative Care

A

Providing relief from the symptoms, pain, physical, mental, and social distress of a terminal diagnosis
- offered alongside curative or other treatments
- hospice, hospital, home

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4
Q

Goal of palliative care

A

to improve QOL for both the person and the family

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5
Q

palliative care is part of the ______ model

A

medical model

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6
Q

the _____ approach is increasingly being adopted

A

Wholistic: “a component of comprehensive care throughout the life course.”

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7
Q

Good death
WWWWWH

A

what: natural (heart attack) vs AIDs, cancer .etc

how: quick/painless vs slow, agonizing

where: home, in bed vs hospital in ICU

who: loved ones vs alone/strangers

when: old age, timely, prepared vs very old age

why: meaningful, expected, accepted vs meaningless, senseless

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8
Q

issues with deaths occuring in hospital or long-term care facilities

A
  • Expensive
  • Focus on keeping the person alive rather than improving the QOL
  • Against ‘aging in place’
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9
Q

place of death
+ cancer
+ dementia

A

The traditional place people with severe diseases go and for the end-of-life care
- cancer = home
- dementia = nursing home/hospital

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10
Q

Stages of Psychological Reactions to Dying (BAADD)

*Kubler-Ross (1969)

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
    * may skip, overlap, back and forth
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11
Q

Grief

A

Sense of deep sorrow after a loss

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12
Q

mourning

A

expression of grief in public

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13
Q

bereavement

A

the state of having recently experienced grief

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14
Q

T or F: grief will eventually get better and human will power will overcome it

A

F: sometimes never ends, though decreases in intensity

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15
Q

Anticipatory grief

A
  • starts before and in anticipation of the death
  • Common in partners of older adults with a fatal disease
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16
Q

Disenfranchised grief

A
  • Deemed illegitimate and therefore unacknowledged
  • insignificant relationship between the grieving person
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17
Q

Complicated grief

A
  • Long and severe
  • Inability of recovering and resuming their life
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18
Q

Loss of a partner, family, friend in Old Age may result in

A

○ Social isolation
○ Financial problems
○ Depression

19
Q

Emerging Ethical Issues

A

· Share of information (who, when, how)
· Right to die
· Cease of care vs. assisting in death
○ dying person is incapable, joint
decision of family, healthcare
professionals
· Assisted suicide/euthanasia

20
Q

Assisted suicide vs physician-assisted suicide

A

assisted suicide: requires support of family members, often assisted by healthcare professional

physician-assisted suicide: you take it YOURSELF
- Asking for a lethal medicine and advice on how to take

21
Q

Active voluntary euthanasia

A

intervening actively to end a person’s life at their request
-health care professional administrates the medicine

22
Q

medical assistance in dying (MAID)

A

Either assisted suicide or active voluntary euthenasia
· Until 2019 about 5000 person received MAID; about 80% older adult (>65), no sex differences

23
Q

thanatologist

A

specialists in the study of dying or death

24
Q

social death

A

the perception or behavior of others that indicates that they view/treat a person as physically dead when the physical body has not yet died
- physical death sometimes precedes social death (not acknowledging death until funeral occurs)

25
Q

life expectancy for M and F

A

M: 79.9y
F: 84.0y

26
Q

what do most people die of in old age

A

diseases
- cancer
- heart disease
-chronic lung disease
- stroke
-diabetes

27
Q

trajectory of dying

A

the pattern or course of dying over time (ex. sudden death or slow decline)

28
Q

long dying trajectory

A

more typical of death in old age
- often occurs in a long-term care facility (nursing home)

29
Q

shorter dying trajectory

A

more often takes place at home or in hospital

30
Q

Erikson’s theory of ego development claims the last stage of life leads to a life review … what is this

A

a dying person overlooks their life, seeks conviction that their life had meaning and purpose, and prepares for death

31
Q

ego integrity

A

the acceptance of the notion that one’s life cycle is something complete and unique

32
Q

Tornstam’s gerotranscendence suggests….

A

seniors have the potential to redefine themselves in old age and rise above the constraints and demands of social expectations

  • become more accepting of life’s mysteries and uncertainties
  • find enjoyment in the little things
  • emphasize family connections, past, present & future
33
Q

The Changing Lives of Older Couples study (2006) found 5 responses to partner loss

A
  1. Chronic grief (defined as low pre-loss depression, high post-loss depression after 6 to 18 months)
  2. Common grief or recovery (low pre-loss depression and high post-loss depression at 6 months with improvement at 18 months)
  3. Resilience (low pre- and low post-loss depression at 6 and 18 months)
  4. Depressed-improved (high pre-loss depression and low post-loss depression at 6 and 18 months)
  5. Chronic depression (high pre-loss depression and high post-loss depression at 6 and 18 months)
34
Q

ADVANCE DIRECTIVES can help when family/healthcare providers need to make the decision to allow a patient to die, …. what is this

A

= a precise statement of the desired treatment and care, including what medical actions are to be taken under what conditions, and a declaration of who has the right to decide in the situation when the writer of the advance directive can no longer express their wishes

35
Q

power of attorney

A

legal document that gives someone (typically a lawyer, adult family member, friend) the right to make a decision on behalf of the ill person if they lose their mental

36
Q

Do-not-resuscitate (DNR) order

A

A person may request that resuscitation not be attempted if the person’s heart stops; the dying persons physician may then place a do-not-reuscitate (DNR) order on the patients medical care chart

37
Q

Hospice care and Palliative Care

A

Includes pain management, symptom management, social/psychological/emotional/spiritual support and caregiver support

  • Ensures family receives support
38
Q

Palliative care in indigenous communities

A
  • Often lack access to palliative care programs
    -Ending life in a hospital cuts off the patient from support networks
  • prefer to die in their own community with family and friends
39
Q

Babitz and colleagues suggestions to ease the distress of indigenous patients in a hospital setting

A
  1. Interpreters can assist communication between staff, family and patient
  2. Hospitals need rooms large enough for extended family members to visit the dying person
  3. Hospitals need to allow family members time to spend with the dying persons
  4. Healthcare professionals need to understand the values and cultural preferences of an indigenous elder
40
Q

Caring for their dying relative at home require

A
  • support of family members, often assisted by healthcare professionals
41
Q

MAID

A

-physician/nurse practitioner helps a person die either by assisting the patients suicide by euthanasia
-June 2016, the gov. of Canada legislated guidelines for MAID
-Prior to this, physician could not legally assist your suicide nor could they cause your death if you asked

42
Q

What happened in the first 2.5 years of MAID implementation:

A
  • Just over 1% of all deaths were due to MAID
  • Average age: 72
    -Most deaths took placed in hospital or patients home
    -Most common underlying medical issues: cancer (63 %)
    circulatory or respiratory diseases (16 %) neurodegenerative diseases (12 %)
43
Q

T or F: increasingly, religion and tradition have less influence on funerary rituals in Canadian society

A

T

44
Q

T or F: death occurs less often in old age today than in the past

A

F: more often
- used to be kids a lot

2711 Midterm (11 decks)

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