Ch.12: Dying Flashcards
Death Anxiety
the apprehensive, uneasy, or nervous feeling brought on by the awareness of death
Before WWII, people are dying at _______ while after WWII, half die in the __________
home, hospital
3 Aspects of Death (These can happen ay different times)
- Biological
- Psychological
- Social
Biological aspect of death
- body shuts down and ceases to function
- sleep more, digestion slows, breathing slows, circulation slows, brain no longer functions
(you’re clinically dead when your brain is no longer functioning)
Psychological aspect of death
- we have a bit of control
- accept death
- less interest in the world, socializing, engagement in activities
- you can decide when you die (can hold on)
Social aspect of death
- people know you’re dying and they stop visiting, they stop calling
- become invisible to others and lose social connectedness
- treated as if they were dead or not persons
Elisabeth Kubler-Ross’ five stages of death
- recognize the stages
- cope better
- prevent social death
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
________ adults report a sense of being cheated by death
Young
______________ adults begin to confront their own mortality and undergo a change in their sense of time lived and time until death
Middle-aged
_________ adults are more accepting of death
Older
WHO defines this as an approach that improves quality of life of patients and their families who are facing the problems associated with life-threatening associated with life-threatening illnesses
palliative care
Palliative care team involves
- specially trained physicians
- nurses
- social workers
- spiritual counsellors
pharmacists
Around 70% of palliative and end-of-like care in Canada is still provided within a ___________ environment
hospital
Characteristics of a good death
- preference for the dying process
- pain-free status
- emotional well-being
- life completion
- treatment preferences
- dignity
- family
- quality of life
- relationship with healthcare professional
- religiosity and spirituality- can give you purpose & meaning in life
This is the most important bioethical issue
Euthanasia
Active Euthanasia
- it is when death is brought by an act. For example, taking a high dose of drugs
- to end a person’s life by use of drugs, either by oneself or by the aid of physician
Passive Euthanasia
- when death is brought by an omission. For example, when someone lets the person die, this can be done by withdrawing or withholding treatment
Withdrawing treatment: switching off a machine that keeps the person alive
Withholding treatment: not carrying out a surgery that will extend life of the patient for a short time
In 2015, the Canadian federal government passed legislation that allows eligible adults in Canada to request physician-assisted suicide or “_____________________________”
medical assistance in dying (MAID)
Medically Assisted Suicide
- a physician or nurse practitioner prescribes a drug that is self-administered to cause death
- also referred to as physician-assisted death
Eligibility criteria for MAID
- be eligible for federal or provincial healthcare services
- be at least 18 years old and mentally competent
- have a grievous irremediable medical condition
- make a request for MAID that is not the result of outside pressure and influence
- give informed consent to receive MAID
Motivation for wishing to die in older adults
- Aside from irremediable medical conditions, older adults may experience a wish to die if they experience declines in mobility, vision, hearing, speaking, and cognition; loss of connection to public life, and feelings that life has no meaning anymore
Advance directives
- directions given by a competent individual concerning what and/or how and/or by whom decisions should be made in the event that, at some time in the future, the individual becomes incompetent to make certain decisions
When patient’s wishes are met, both patients and their families experience less strain and improved quality of life
Bereavement
a period of mourning following the loss of a loved one or a close friend through death
experienced more by older people than younger people
This is the natural response to the loss of someone or something that is very dear to a person, which may or may not involve death
e.g., the death of a pet, the loss of a job or a home
Grief
Bereavement is best understood from a ______________ perspective
biopsychosocial
Biological: stress on body, trouble sleeping, low energy
Psychological: range of negative emotions, impaired attention and memory
Sociocultural: altered position in family and community, financial burden, change in support network
Complicated/Prolonged Grief
- occurs in about 10-12% of bereaved individuals
- suffer adverse health effects, and become incapacitated by grief to the exclusion of other interests and concerns
- ruminate about the death
- long for reunion with the deceased
- inability to accept the loss
- inability to feel pleasure
- bitterness
- difficulty trusting others
- feeling of being stuck in the grieving process
Factors associated with the development of complicated/prolonged grief
- first-degree relationship to the deceased
- a poorly functioning marriage or insecure attachment style prior to widowhood
- emotional dependency on the deceased
- lack of preparation for the death (i.e., “off-time” losses such as traumatic or unexpected deaths) ex: loss of child
- in-hospital death of the loved one
Strategies that can help in the process of grieving
- talk about the death of your loved one
- accept your feelings
- take care of yourself and your family
- reach out and help others dealing with the loss
- remember and celebrate the lives of your loved ones
