15 - Death and dying Flashcards
True or false: Younger adults tend to be exposed to death more than any other age group.
False: Older adults tend to be exposed to death more than any other age group
→ because of loss of peers, family members, etc.
→ also increased age brings them closer to death, especially with illnesses and conditions
Older adults think about death more but ___ it less than other age groups. Elaborate on this.
Fear;
- Nevertheless, they may still experience significant emotional effects when faced with their own death
- Worry more about the process of dying rather than death itself
→ the idea of suffering sis smt that causes a lot of stress
→ more practical considerations than existential
- greater acceptance, and understanding of death as a natural life cycle; less fear of death; more inevitable and less fearful than when younger
→ may still experience emotional and psychological effects about their mortality (anxiety, stress, etc.)
Older adults may think of their death as a ___; in what cases does this occur?
Blessing;
→ can be the case after a long difficult process of dying (especially after drugs that helped and painful operations)
What do older adults state often when they have a family caregiver at home?
- They often state they do not want to be a burden to others
→ especially if they have a caregiver at home - When dying they often express more concerns about the needs of their caregivers, minimize their needs, and plan for their deaths
→ there is also a financial burden and stress that goes upon the family as well
What is caregiver burden?
- caregiver burden: stress perceived by the caregiver due to the homecare situation; subjective burden
→ one of the most important predictors of negative outcomes of the situation for the older adult, for the caregiver themselves
Most people die in a ___ (or ___ ___) despite wanting to die at ___.
Hospital; LTC facility; at home
Despite medical advances, those with terminal illness tend to experience pain and discomfort when they die; why is this?
→ big family aspect to it; family thinks the elder is getting too many drugs but in reality it’s what is easing their pain
→ not enough access to palliative care or hospice (expensive, not everything covers for at-home care)
→ under-utilized and too expensive for racial and ethnic minorities
→ if there’s any unpredictable nature to your illness, there may not be enough resources or knowledge to get you where you need
How can diversions of opinions about death between family and the older adult be made less likely?
4 factors
1) the person deciding is young and female (treated with more dignity and respect)
2) higher family income (less of a burden to the family)
3) illness is long during and if the individual is close to death
4) if the family has talked about it
With advanced age/illness, most people wish…
- To be free of pain and symptoms
- To be treated with dignity and respect
- To maintain a sense of autonomy and control over their last days
- To be informed of their prognoses and have time to put their affairs in order
- To avoid becoming burdens to their families
What are things that are often overlooked about end-of-life concerns?
- Patients often value independence and want to maintain control over their lives and want to continue participating in activities they enjoy
- The need to satisfy their spiritual needs
→ older adults can become more religious, and if no one is sympathetic to that, it can become problematic (or the opposite)
How do spirituality and religious beliefs fall into death and dying?
- dying and death often becomes a spiritual path for older adults
- Death typically involves finding meaning in the life one has lived and in your own death and dying
- Most religions mention some kind of afterlife which helps reduce death anxiety
- Christianity and Islam teach about reunited with loved ones after death
- Buddhism and Hinduism teach about a cycle of life, death, rebirth
True or false: those who have mild or uncertain religious beliefs fear death the most, and those with strong beliefs or not beliefs at all deal with death best.
True
Explain the concept of a good death.
- The concept of a good death is individualized (to each their own) and ultimately depends on the person who is dying; aligns with the individual’s and the family’s wishes
Based on what, how, where, with whom, when and why criteria, what differentiates a good death from a bad death?
Good death:
- What: Heart attack, “natural” death
- How: Quick, painless
- Where: At home, in bed
- With whom: With loves ones
- When: During old age, timely, prepared
- Why: Meaningful, expected, accuracy
Bad death:
- What: Cancer, AIDS, ALS, Alzheimers disease
- How: Slow, agonizing, without dignity
- Where: In hospital or ICU
- With whom: Alone or with strangers
- When: In very old age, untimely, unprepared
- Why: Meaningless, senseless
From the POV of the senior, vs. the POV of the family, vs. the POV of society; what constitutes a good death?
- From the POV of the senior - good death may be a lack of pain during the process, quick, at home with loved ones, and being prepared to die
- From POV of the family – good death may be when it relieves the family of burden (e.g., financial or emotional)
- From POV of society – good death may be when it minimizes demands on society (e.g., financially)
