Chapter #13: Death & Dying Flashcards
Sociocultural definitions of Death
Death is a universal experience
* some cultures view death as a transition to a different type of existance
* patterns of multiple deaths and rebirths
Thanatology
the study of death, dying, grief, bereaverment, and social attitudes towards these issues
Clinical Death
lack of heartbeat and respiration
Whole-Brain Death
death that is declared only when the deceased meets certain criteria established:
1. Person is in a coma
2. All brainstem reflexes have permantely stopped working
3. Breathing has permantely stopped; a ventiltor is being used
Persistent Vegetative State
situation in which a person’s cortical functioning causes while brainstem activity continues
* following disruption of blood flow, severe head injury, and drug overdose
* allows for spontaneous heartbet and respiration but not for consciouness
Bioethics
study of the interface between human values and technological advances in health and life sciences
1. Respect for individual freedom
2. Impossibility of establishing any single version of mortity by rational thought or common sense
*the minimization of harm and maximization of good
Euthanasia
the practice of ending life for reasons of mercy
* moral dilemma comes down to deciding the circumstances a person’s life should be ended
Active Euthanasia
the deliberate ending of someone’s life
Passive Euthanasia
allowing a person to die by withholding available treatment
Physician-Assisted Suicide
process in which physicians provide dying patients with a fatal dose of medcation that is self-administered
Life-Course Approach
older adults are less anxious about death and have less trouble accepting it
they realize their own mortality as they become the oldest generation of their family
Kubler-Ross’ Work - 5 Death Reactions
described 5 reactions that represent the ways in which we deal with death
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
not everyone experiences each stage or in the sequence order
Contextual Theory of Dying
The realization that there is no one right way to die
4 dimensions that individuals are tasked with facing
1. Bodily Needs
2. Psychological Security
3. Interpersonal Attachment
4. Spiritual Energy & Hope
Death Anxiety
peopole’s anxiety or fear of death and dying
* the ethereal, unknown nature of death is what makes us uncomfortable
Terror Management Theory
addresses the issues of why people engage in certain behaviors to acheive particular states based on deep rooted moral dilemmas
Neuroimaging shows
Right Amygdala, left rostral anterior angulate cortex, and right caudate nucleus have greater activity
Older adults have less death anxiety
- tendency to engage in life review
- different persepctive about time
- higher level of religious motivation
- Women more specifically fear the dying process itself
Koestanbaum’s exercise to increase one’s Death Awareness
- write your own obituary
- plan your own death and funeral services
- “What circumstances would help make my death acceptable?”
- Death Education –> increases awareness of complex emotion experienced by dying people and their family
End of Life Issues
a variety of issue management of the final phase of life, after-death disposition of body, memorial services, and distirubtion of assets
Final Scenario
making choices known about how one does and does not want to die
Hospice
an approach to asist dying people that empahsizes pain amangement, and death with dignity
* places emphasis on dying person’s quality of life
Palliative Care
care that is focused on pain relief and other symptoms of disease at any point during the process
Living Will
a document which a person states their wishes about their life support and other treatments
Healthcare Power of Attorney
a document in which an individual appoints someone to act as their agent for healthcare decisions
Do not Resuscitate (DNR) Order
a medical order that means CPR is not started should one’s heart and breathing stop
Patient Self-Determination Act 1990
requires healthcare facilities to provide information to patients:
1. To make their own healthcare decisions
2. Accept or refuse medical treatment
3. Make an advance healthcare directive
Bereaverment
the state or condition caused by loss through death
Grief
the sorrow, hurt, anger, guilt, confusion, and other feeling that one has after sufgfering a loss; responses to emotional reactions
Mourning
the ways we express grief; culture impacts this
Anticipatory Grief
grief experienced during the period before all expected eath occurs
* supposedily acts as a buffer to the impact of the loss when it does come
Grief Work
the psychological side of coming to terms with bereaverment
Muller & Thompson 5 Themes of Experiencing Grief
- Coping - what people do to deal with their loss in terms of what helps them
- Affect - people’s emotional reactions to death of their loves ones; certain topics can be a trigger
- Charge - the way survivor’s life changes as a result of the loss; personal growth
- Narrative - the stories survivors tell about their deceased loved ones, that someontimes includes detail about the process
- Relationship - who the deceased person was, and the nature of the ties between that person and the survivor
Anniversary Reaction
change in behavior related to feelings of sadness on the anniversary of the loss
* normal in grief
* grief peaks within the first 6 months
Coping with Grief
The Four-Component Model
Model that proposes grief is based on:
1. The context of loss
2. Continutaiton of Subjective
3. Changing Representations of the lost relationship overtime
4. The role of coping nad emotional regulation
Grief Work as Rumination Hypothesis
not only reject the necessity of grief procesing for recovery from loss, but views extensive grief processing as a form of rumination that may actually increase distress
Dual Process Model (DPM)
view of coping bereaverment that integreates loss-oriented stressors and restoration-orientated stressors
Model of Adaptive Grieving Dynamics (MAGD)
model of grief on 2 pairts of adaptive grieving dynamics
1. Lamenting / Heartening
2. Integrating / Tempering
What is Lamenitng/Heartening
Lamenting - expierencing and/or expressing grieving responses that are distressful, disheartening, and painful
Heartening - experiencing and/or expressing grieving responses that are gratifying, uplifting
What is Integrating/Tempering
Integrating - assimilating internal/external changes catalyzed by a grief-inducing loss, and reconciling differences in past, present, and future realities in light of change
Tempering - avoiding chronic attempts to integrate changed realities impacted by a grief inducing loss, that overwhelm a griever’s and/or community resources, and capacity to integrate
Ambiguous Loss
refers to situations of loss in which there is not closure or resolution
* e.g. Missing person, or mentally not present
Complicated Grief
expressions of grief that is disintguished from depression and noraml grief in terms of seperation and trauamtic distress
Separation Distress
expression of complicated or prolonged grief characterized by long and searching for deceased, upsetting memories, isolation, and preoccupation
Traumatic Distress
expression of complicated or prolonged grief characterized by feelings of disbelief about death, mistrust, anger, and detatchment from others
Disenfranchised Grief
a loss the appears insignificant to others that is highly consequential to the person who suffers the loss
