Chapter 16 - Death and Dying

Question 1

Biological Death

Answer 1

hard to define because it is not a single event but a complex process

Different systems of the body die at different rates

Question 2

total brain death

Answer 2

An irreversible loss of functioning in the entire brain, both the higher centers of the cerebral cortex that are involved in thought and the lower centers of the brain that control basic life processes such as breathing.

Determining total brain death requires extensive testing following specific guidelines that differ some from state to state in the United States

Question 3

Comas - total brain death

Answer 3

A person in a coma must be observed to be totally unresponsive to stimuli, show no movement in response to noxious stimuli, and have no reflexes such as a constriction of the eye’s pupils in response to light

An electroencephalogram (EEG) or other measures should indicate an absence of electrical activity in the cortex of the brain

This definition means that a coma patient whose heart and lungs are kept going only through artificial means such as a mechanical ventilator but who has no sign of functioning in the brain stem is dead.

Question 4

Euthanasia

Answer 4

Literally, “good death”; specifically, hastening, either actively or passively, the death of someone suffering from an incurable illness or injury.

Question 5

Active euthanasia

Answer 5

“mercy killing,” is deliberately and directly causing a person’s death—for example, by administering a lethal dose of drugs to a pain-racked patient in the late stages of cancer or smothering a spouse who has advanced Alzheimer’s disease

Question 6

Passive euthanasia

Answer 6

by contrast, means allowing a terminally ill person to die of natural causes—for example, by withholding extraordinary life-saving treatments (as when Terri Schiavo’s feeding tube was removed)

Question 7

assisted suicide

Answer 7

Making available to individuals who wish to commit suicide the means by which they may do so, such as when a physician provides a terminally ill patient who wants to die with enough medication to overdose

Question 8

Surveys tell us that there is overwhelming support among medical personnel and members of the general public for ____________ euthanasia

Answer 8

passive

Question 9

Who tends to be more supporting of the right to end life?

Answer 9

Attitudes tend to be most accepting among younger generations, men, and highly educated respondents

Question 10

Who tends to be less accepting of the right to end life?

Answer 10

African Americans and other minority group members tend to be less accepting of actions to hasten death than European Americans, whether because they do not trust the medical establishment or for religious or philosophical reasons

Question 11

the law and active euthanasia

Answer 11

still treated as murder in the United States and most countries

Question 12

the law and passive euthanasia

Answer 12

it is legal to withhold or withdraw extraordinary life-extending treatments from terminally ill patients when that is the wish of the dying person or when the immediate family can show that the individual had expressed a desire to reject life-support measures

Question 13

living will

Answer 13

A document, also called an advance directive, in which people state in advance that they do not wish to have extraordinary medical procedures applied if they are hopelessly ill.

Question 14

First state to legalize physician-assisted suicide

Answer 14

Oregon became the first state in the United States to legalize physician-assisted suicide - as patients in European countries such as the Netherlands, Belgium, Luxembourg, and Switzerland can do (when they have 6 or fewer months to live)

Question 15

denial of death

Answer 15

Since the late 19th century, Ariès argues, Western societies have engaged in a “denial of death.” - taken out of the home and put it in the hospital and funeral home to be managed by physicians and funeral directors; as a result, we have less direct experience with it than our ancestors did

Question 16

Is there a universal emotional response to death across cultures?

Answer 16

sadness is a common response, but there are no universal emotional responses to death

Question 17

average life expectancy for a newborn in the United States now?
in 1900?

males now?
females now?

Answer 17

almost 79 years
compared with 47 years in 1900

—76 for males, 81 for females

Question 18

Why do females tend to have longer lives?

Answer 18

Female hormones seem to protect women from high blood pressure and heart problems, and they are less exposed than men to violent deaths and accidents and to health hazards such as smoking and drinking

Question 19

Which ethnic group has the highest life expectancy in the US? Lowest?

Answer 19

highest for Hispanics, medium for non-Hispanic whites, and lowest for African Americans

Question 20

What is the average rate of infant mortality?

Answer 20

dropped to six out of 1,000 live births

Question 21

During which period of life do we have the lowest chance of dying?

Answer 21

dying during childhood or adolescence

Question 22

Main causes of infant mortality

Answer 22

mainly associated with congenital abnormalities that infants bring with them to life, low birth weight or short gestation, and complications of pregnancy

Question 23

Main causes of childhood death

Answer 23

leading cause of death among preschool and school-age children is unintentional injuries or accidents (especially car accidents but also poisonings, falls, fires, drownings, and so on)

Question 24

Main causes of death of adolescent/emerging adult

Answer 24

Accidents (especially car accidents), suicides, and homicides are the leading killers

Question 25

Main causes of adult deaths

Answer 25

Accidents continue to kill young adults, but cancers and heart diseases also begin to take a toll

45–54 age group, cancers have become the leading cause of death, followed by heart diseases, which then competes with cancer for the top spot thereafter, with chronic lower respiratory diseases often in third place - These and other chronic illnesses become more likely causes of death as age increases

adults age 65 and older, heart diseases lead the list, followed by cancers and chronic respiratory diseases

Question 26

Two main categories of theories of aging/dying

Answer 26

programmed theories

damage theories

Question 27

programmed theories

Answer 27

emphasize the systematic genetic control of aging processes

assume that aging will unfold according to a species-specific genetic program - a predictable genetic timetable

Question 28

maximum life span - what is it? what is it for humans?

Answer 28

A ceiling on the number of years that any member of a species lives; 120 years for humans. (Among land mammals, humans have the longest maximum life span, estimated at around 125 years) - the maximum life span has changed very little over the past century

Question 29

Genetic differences account for how much variation among us in age at death

Answer 29

about a third

Question 30

a fairly good way to estimate how long you will live is to average the longevity of…

Answer 30

your parents and grandparents

Question 31

Leonard Hayflick

Answer 31

discovered that cells from human embryos could divide only a certain number of times

Question 32

Hayflick limit

Answer 32

The estimate that human cells can double/divide only 50 times, plus or minus 10, and then will die.

Question 33

the maximum life span of a species is related to the Hayflick limit for that species: The long-lived Galapagos tortoise’s cells can divide _____ times whereas the cells of the short-lived fruit fly can divide far less than this

Answer 33

90–125

Question 34

Telomeres

Answer 34

A stretch of DNA that forms the tip of a chromosome and that shortens after each cell division, serving as an aging clock and timing the death of cells

the mechanism behind the “cellular aging clock” suggested by the Hayflick limit on cell division

Question 35

telomere length is a yardstick of…

Answer 35

biological age

Question 36

What determines how long your telomeres are?

Answer 36

both genes and environment

differences in telomere length at birth that are partly genetic in origin but can also be influenced by the prenatal environment

chronic stress later in life is linked to shorter-than-average telomeres

shorter telomeres are associated with diseases of aging such as heart disease and diabetes, as well as with psychological disorders such as depression and anxiety

lack of exercise, smoking, obesity, and low socioeconomic status (SES)—all risk factors for age-related diseases—are also associated with short telomeres

Question 37

Epigenetic aging clock

Answer 37

A measure of patterns of DNA methylation that are closely associated with aging

Based on analysis of DNA methylation patterns, a person’s biological age can be estimated

Question 38

What influences a person’s epigenetic aging clock?

Answer 38

highly genetically influenced and can also be affected by environmental risk factors such as stress, unhealthy lifestyles, and low SES

Having an epigenetic biological age that is greater than one’s chronological age turns out to be correlated with a number of environmental risk factors known to be associated with chronic diseases of aging, including cardiovascular disease and Alzheimer’s disease

Question 39

Damage Theories

Answer 39

generally propose that wear and tear—an accumulation of random damage to cells and organs over the years—ultimately causes death

maintain that biological aging is more about random damage than genetically programmed change

Question 40

Free radicals

Answer 40

a damage theory

Chemically unstable byproducts of metabolism that have an unpaired electron and react with other molecules to produce toxic substances that damage cells and contribute to aging.

toxic and chemically unstable by-products of metabolism, or everyday chemical reactions in cells such as those involved in the breakdown of food - produced when oxygen reacts with certain molecules in the cells

They have an unpaired, or “free,” electron and are highly reactive with and damaging to other molecules in the body, including DNA

Meanwhile, the body’s mechanisms for repairing genetic and epigenetic damage are also becoming more impaired with age and cannot keep up with the chaos - causes aging and eventual death

Question 41

a visible sign of the damage that can result from free radicals

Answer 41

Age spots

Question 42

free radicals have also been implicated in which of the major diseases that become more common with age

Answer 42

cardiovascular diseases, cancer, and Alzheimer’s disease

Question 43

what is the damage of most concern from free radicals?

Answer 43

damage to DNA because the result is more defective cells replicating themselves

Question 44

Antioxidants

Answer 44

such as vitamins E and C (or foods high in them such as raisins, spinach, and blueberries) or resveratrol (a natural substance in grapes, red wine, and peanuts)

can donate one of their electrons to chemically unstable free radicals, thereby reducing their damage to the body

Question 45

what casts doubt on the value of the free radical theory as a major explanation of basic aging?

Answer 45

While antioxidants can promote healthier aging with less frailty in later life, they do little to actually lengthen life

Question 46

A technique demonstrated to extend the life span of laboratory animals

Answer 46

a highly nutritious but severely calorie-restricted diet

caloric restriction reducing intake by 30–40% extends both the average longevity and the maximum life span of a species and that it delays or slows the progression of many age-related diseases

reduces the number of free radicals and other toxic products of metabolism - also appears to alter gene expression and trigger the release of hormones that slow metabolism and therefore decrease oxidative damage

Question 47

KÜBLER-ROSS’ STAGES OF DYING

Answer 47

denial

anger

bargaining

depression

acceptance

Question 48

Kübler-Ross emphasized a sixth response that runs throughout the stages:

Answer 48

hope. She believed that it is essential for terminally ill patients to retain some sense of hope, even if it is only the hope that they can die with dignity

Question 49

four problems with the Kübler-Ross stages

Answer 49

emotional responses to dying are not stagelike

the nature and course of an illness affects reactions to it

individuals differ widely in their responses

dying people focus on living, not just dying

Question 50

terminal decline

Answer 50

Many dying patients display symptoms of depression and other signs of decreased well-being as part of a deterioration in functioning and emotional well-being shortly before death

Question 51

Bereavement

Answer 51

A state of loss that provides the occasion for grief and mourning

Question 52

Grief

Answer 52

The emotional response to loss.

Question 53

Mourning

Answer 53

Culturally prescribed ways of displaying reactions to a loss.

Question 54

Anticipatory grief

Answer 54

Grieving before death for what is happening and for what lies ahead.

Question 55

Parkes/Bowlby attachment model of bereavement

Answer 55

Model of grieving describing four predominant reactions to loss of an attachment figure: numbness, yearning, disorganization and despair, and reorganization.

Question 56

Numbness:

Answer 56

first few hours or days after the death
sense of unreality and disbelief and almost empty of feelings

Question 57

Yearning:

Answer 57

a time of acute separation anxiety, which motivates efforts to reunite with the lost loved one

Grief comes in pangs or waves that typically are most severe from 5 to 14 days after the death

panic, bouts of uncontrollable weeping, and physical aches and pains

pines and yearns and searches for the loved one, longing to be reunited - may sense a presence or smell articles of clothing, etc.

anger and guilt are common during these early weeks and months

Question 58

Disorganization and despair:

Answer 58

depression, despair, and apathy increasingly predominate

most of the first year after the death, and longer in many cases, bereaved individuals often feel apathetic and may have difficulty managing and taking interest in their lives

pangs of intense grief and yearning become less frequent, although they still occur

Question 59

Reorganization:

Answer 59

invest less emotional energy in their attachment to the deceased and more in their attachments to the living. If they have lost a spouse, they begin to make the transition from being a wife or husband to being a widow or widower, revising their identities

Question 60

Typical grief for widows and widowers:

Answer 60

the worst of the grieving process for widows and widowers is typically during the first 6 months after the loss

the process of overcoming depression symptoms may take a year or so for widows and longer for widowers

Question 61

Dual-process model of bereavement

Answer 61

A theory of coping with bereavement in which the bereaved oscillate between loss-oriented coping in which they deal with their emotions, restoration-oriented coping in which they try to manage practical tasks and reorganize their lives, and periods of respite from coping.

Both loss- and restoration-oriented issues need to be confronted, but they also need to be avoided at times or they would exhaust us - have to strike a balance between confrontation and avoidance of coping challenges and between loss-oriented and restoration-oriented coping

Over time, emphasis shifts from loss-oriented to restoration-oriented coping and from more negative to more positive thoughts and emotions

Question 62

Loss-oriented coping

Answer 62

coping focused on dealing with one’s emotions and reconciling oneself to the loss.

Question 63

Restoration-oriented coping

Answer 63

coping focused on managing daily living, rethinking one’s life, and mastering new roles and challenges

Question 64

Most researchers agree that bereavement is a…

Answer 64

complex, phaselike, but not-very-stagelike process

Question 65

Infant understanding of death

Answer 65

Possibly, infants first form a global category of things that are “all gone” and later divide it into subcategories, one of which is “dead”

they lack the cognitive capacity to interpret what has happened when someone in the family dies

Question 66

Bowlby’s attachment theory for infants:

Answer 66

Only after infants form their first attachments around 6 or 7 months do they display separation anxiety when their beloved caregivers leave them

Question 67

Bowlby’s stages for infants reacting to death:

Answer 67

first engage in vigorous protest—yearning and searching for the loved one and expressing outrage when they fail

after some hours or days of protest, an infant has not succeeded in finding the loved one, he begins to despair, displaying depression-like symptoms - may be reflected in a poor appetite, a change in sleeping patterns, excessive clinginess, or regression to less mature behavior

After some days—longer in some cases—the bereaved infant may enter a detachment phase, in which he gives up and takes renewed interest in toys and companions

Question 68

Child’s understanding of death

Answer 68

young children are highly curious about death; think about it with some frequency; build it into their play, rhymes, and songs; and talk about it

their beliefs about death often differ considerably from those of adults

Question 69

In Western societies, a “mature” understanding of death has four components

Answer 69

Finality - the cessation of life and of all life processes, such as movement, sensation, and thought

Irreversibility

Universality - inevitable and happens to all living beings

Biological causality - the result of natural processes internal to the organism, even if external causes set off these internal changes

Question 70

Children between age 3 and 5 - understanding of the four components of death

Answer 70

have some understanding of death, especially of its universality

any of them picture the dead as living under altered circumstances and retaining at least some of their capacities (no finality)

Some preschool-age children also view death as reversible rather than irreversible

young children think death is caused by one external agent or another - do not grasp the ultimate biological cause of death

Question 71

Children between age 5 and 7 - understanding of the four components of death

Answer 71

make considerable progress in acquiring a mature concept of death (when, according to Jean Piaget’s theory of cognitive development, children progress from the preoperational stage of cognitive development to the concrete-operational stage)

understand that death is characterized by finality (cessation of life functions), irreversibility, and universality

Understanding the biological causality of death is the hardest concept of death for children to master

Question 72

Children’s understandings of death are influenced by:

Answer 72

cognitive development, cultural socialization, and individual experiences

Question 73

Four major messages have emerged from studies of bereaved children:

Answer 73

children grieve,

they express their grief differently than adults do,

they lack some of the coping resources that adults command, and

some experience long-term negative effects of bereavement

Question 74

Young children have mainly _________________coping strategies at their disposal for grieving

Answer 74

behavioural - 2-year-old Reed found comfort by taking out a picture of his mother and putting it on his pillow at night

Question 75

Older children are able to use ___________ coping strategies for grieving

Answer 75

cognitive - such as conjuring up mental representations of their lost parents

Question 76

children who lose their father to death have…

Answer 76

16% shorter telomeres than children who have not lost their father

Question 77

How many children who had lost a parent had serious adjustment problems 2 years after the death

Answer 77

1/5

Question 78

The adolescent’s understanding of death

Answer 78

able to think in more abstract ways about death, consistent with the shift from Piaget’s concrete-operational stage to his formal-operational stage

Question 79

dying adolescents may be acutely disturbed if their illness brings…

Answer 79

hair loss, weight gain, amputation, loss of sexual attractiveness and responsiveness, or other such physical changes

Wanting to be accepted by peers, they may feel like “freaks” or become upset when friends who do not know what to say or do avoid them

Question 80

adolescents who lose a parent may express their grief in what way?

Answer 80

may express their anguish instead through delinquent behavior and somatic ailments

reluctant to express their grief for fear of seeming abnormal, out of control, or overdependent

Question 81

responses to the sudden loss of a parent through suicide, accident, or sudden natural causes like a heart attack were studied closely by David Brent and his colleagues - ranged in age from 7 to 18 at the time of the death and were assessed periodically until 5 years after the death:

Answer 81

About 30% experienced significant grief reactions in the first year that then gradually diminished, while another 10% continued to experience significant grief reactions even 3 years later - The remainder (almost 60%) had milder grief reactions.

more likely than nonbereaved comparison youth to suffer from major depression, alcohol and substance abuse, and, in the first year, posttraumatic stress disorder

cortisol levels were higher

disrupted the completion of key developmental tasks of adolescence

outcomes were poorest for those who lost their mothers

Question 82

how many adolescents ages 12–17 experienced the death of a close friend in the past year

Answer 82

1/5

Question 83

how did death of a friend impact a teenager?

Answer 83

32% of teenagers who lost a friend to suicide experienced clinical levels of depression after the suicide

experiencing such a death was associated with higher rates of substance abuse

Question 84

Do most bereaved adult partners become clinically depressed?

Answer 84

No, most bereaved partners do not become clinically depressed, but many feel lonely and experience symptoms of depression in the year after the death

Question 85

widows and widowers as a group experience what kinds of physiological changes?

Answer 85

chronic inflammation and cardiovascular disease and have a higher-than-average risk of death

Question 86

widows and widowers often experience what types of disruptions in functioning and for how long?

Answer 86

disruptions in physical, cognitive, and emotional functioning are common, usually lasting for a year; less severe, recurring grief reactions may then continue for several years

Question 87

George Bonanno found what five patterns of adjustment in bereaved adults?

Answer 87

resilient pattern in which distress is at low levels all along

Common grief, a recovery pattern with heightened and then diminishing distress after the loss within a year or so

Chronic grief in which loss brings distress and the distress lingers

Chronic depression in which individuals were depressed before the loss and remained so after it

A depressed–improved pattern in which individuals who were depressed before the loss become less depressed after the death; many of these individuals were likely experiencing caregiver burden before the death and felt relieved of stress after the death

Question 88

resilience

Answer 88

a low level of depression all along—is the most common response, characterizing almost half the sample. This result runs counter to our belief that all bereaved people must go through a period of significant distress.

Question 89

What type of people are more likely to be resilient?

Answer 89

before the death they seemed to be well-adjusted and happily married people with good coping resources

experienced emotional pangs in the first months after the death, but they were more comforted than most by positive thoughts of their partners and simply coped effectively with their loss

Question 90

Frank Infurna and Suniya Luthar - five measures of adjustment

Answer 90

life satisfaction, negative affect, positive affect, self-perceived health, and physical functioning (ability to carry out activities of daily living)

The percentage of people judged to be resilient varied considerably depending on which indicator was used

few showed a resilience across all five measures

Question 91

Complicated grief

Answer 91

An emotional response to a death that is unusually prolonged or intense and that impairs functioning; pathological grief

persists for 6 months or longer and may involve intense distress over separation from the deceased, as well as a sense of meaninglessness, bitterness over the loss, difficulty getting past the loss, and difficulty functioning

Question 92

how many people experience complicated grief?

Answer 92

a minority of bereaved individuals, up to about 15% or so

Question 93

what are some people who are experiencing complicated grief sometimes diagnosed with?

Answer 93

sometimes diagnosed as having a depressive disorder or, if the death was traumatic, posttraumatic stress disorder (PTSD)

some experts have concluded that complicated grief, also called prolonged grief disorder, has unique symptoms, is distinct from these other conditions, and should be viewed as a distinct psychological disorder

DSM-5 recognizes complicated grief as worthy of further study as a distinct disorder but does not define it as one

Question 94

Most of what we know about same-sex partner grief comes from what?

Answer 94

studies of the partners of gay men who were infected with HIV and died of AIDS

Many of these men not only experienced the burden of caring for their dying partners but were also HIV infected themselves and therefore stressed by their own illness and possible death. They also had to contend with the stigma surrounding both AIDS and homosexuality

Question 95

disenfranchised grief

Answer 95

Grief that is not fully recognized or appreciated by other people and therefore may not receive much sympathy and support, as in the loss of a gay partner

Losses of ex-spouses, extramarital lovers, foster children, pets, and fetuses can also result in disenfranchised grief

generally harder to cope with than socially supported grief

Question 96

How many parents of an adolescent or young adult child died of an accident, suicide, or homicide said they had found meaning in the death 1 year later? 5 years later?

Answer 96

12%

57%

Question 97

years after their loss, bereaved parents tend to be less ___________ than adults who have not lost a child

Answer 97

happy

Question 98

The age of the child who dies has what type of relation to the severity of the grief?

Answer 98

little relation

parents grieve for an adult child as much as for a younger child or adolescent

Question 99

death of a child does what to the family system?

Answer 99

rattles the whole family system, affecting the marital relationship, parenting, and the well-being of surviving siblings, grandparents, and other relatives

Question 100

Siblings of a child who dies are more likely to face what?

Answer 100

often remain deeply affected and may struggle in school and develop behavior and mental health problems

Question 101

loss of a parent is what type of life experience?

Answer 101

a normative life transition that most of us will experience - most of us do not have to face this event until we are in middle age

Question 102

Which type of loss is usually not as difficult to adjust to?

Answer 102

adjusting to the death of a parent is usually not as difficult as adjusting to the death of a romantic partner or child

Question 103

The Grief Work Perspective

Answer 103

The view commonly held, but now challenged, that to cope adaptively with death bereaved people must confront their loss, experience painful emotions, work through these emotions, and move toward a detachment from the deceased.

grew out of Freudian psychoanalytic theory

Question 104

What perspective is commonly held in our society about grief?

Answer 104

The Grief Work Perspective - among both therapists and members of the general public, and it influences what we view as an “abnormal” reaction to death

Question 105

Challenges to the Grief Work Perspective

Answer 105

may be culturally biased

little support for the grief work perspective’s assumption that bereaved individuals must confront their loss and experience painful emotions to cope successfully - Delayed grief is extremely rare

growing evidence that too much “grief work” may backfire and prolong psychological distress

view that we must break our attachment bonds to the deceased to overcome our grief is flawed

Question 106

continuing bonds

Answer 106

Maintenance of attachment to a loved one after the person’s death through reminiscence, use of the person’s possessions, consultation with the deceased, and the like.

Bereavement rituals in some cultures are actually designed to ensure a continued bond between the living and the dead

Question 107

internalized continuing bonds

Answer 107

involve keeping the loved one psychologically close through mental images and memories,

tend to aid adjustment

Question 108

Externalized continuing bonds

Answer 108

involve seeking physical proximity and may depend on illusions and hallucinations—for instance, seeking comfort from the loved one’s possessions or visiting the grave every day—reflect continued efforts to reunite

associated with difficulty coping

Question 109

What factors affect coping well with grief?

Answer 109

Personal Resources
Nature of the loss
Supports and Stressors

Question 110

What are Personal Resources?

Answer 110

personality and coping style

Attachment style

Question 111

personality and coping style - how does it affect grief?

Answer 111

individuals who are emotionally stable cope well, whereas those who score high on the Big Five personality dimension of neuroticism have more difficulty coping

Many also rely on ineffective coping strategies such as denial or avoidance, escape through alcohol and drugs, or unproductive rumination about their loss

people who are optimistic, look for and find positive ways of interpreting their loss, and use active coping strategies experience less intense grief reactions and are more likely to report personal growth after their losses

Question 112

Bowlby’s 4 attachment styles

Answer 112

secure attachment style

resistant (or preoccupied) attachment style - being highly anxious about being abandoned

avoidant (or dismissing) attachment style - difficulty expressing emotions or seeking comfort

disorganized (or fearful) attachment style - rooted in unpredictable and anxiety-arousing parenting

Question 113

Bowlby’s attachment theory - coping with death

Answer 113

emphasizes that early experiences in attachment relationships influence whether one has a secure or insecure attachment style - systematically related to reactions to death

Question 114

How do each of the 4 attachment styles typically relate to coping with death?

Answer 114

secure attachment style - associated with coping relatively well

resistant (or preoccupied) attachment style - linked to being overly dependent and displaying prolonged grief and anxiety after a loss, ruminating about the death, and clinging to the lost loved one

avoidant (or dismissing) attachment style - may do little visible grieving and may minimize how much they miss their loved one

disorganized (or fearful) attachment style - associated with being especially ill-equipped to cope with loss; these individuals may turn inward, harm themselves, or abuse alcohol or drugs

Question 115

How does the nature of the loss relate to ability to cope? what is the key factor?

Answer 115

closeness of the person’s relationship to the deceased is a key factor

cause of death can also matter:
advantages of being forewarned of death when a loved one is terminally ill may be offset by the strains of caregiver burden during the illness

sudden deaths that are violent or traumatic, such as suicides, homicides, motor-vehicle crashes, and terrorist attacks, appear to be especially difficult to bear and are more likely than deaths from natural causes to result in prolonged or complicated grief

sudden deaths like heart attacks are not necessarily harder to cope with in the long run than expected deaths from illnesses, although the initial grief reaction may be more intense

Question 116

especially important for the child or adolescent whose parent dies to receive…

Answer 116

supportive parenting

Question 117

outcomes tend to be poor for widows and widowers who must cope with…

Answer 117

financial problems after bereavement, manage household tasks they are not used to managing, single-handedly raise young children, find new jobs, or move

Question 118

Posttraumatic growth

Answer 118

Positive psychological change resulting from highly challenging experiences such as being diagnosed with a life-threatening illness or losing a loved one

nearly half of people who have experienced traumas of various kinds report such growth, with the numbers varying from 10 to 77% across studies

Question 119

Hospice

Answer 119

A program that supports dying persons and their families through a philosophy of caring rather than curing, either in a facility or at home.

Participants typically must be judged to be within 6 months of death

Question 120

palliative care

Answer 120

Care aimed not at curing but at meeting the physical, psychological, and spiritual needs of dying patients even while their illnesses are still being treated

Question 121

Key features of hospice care:

Answer 121

dying person and his family—not the “experts”—decide what support they need and want

Attempts to cure the patient or prolong his life are deemphasized (but death is not hastened either)

Pain control and comfort are emphasized

setting for care is as normal as possible

Bereavement counseling is provided to the family before and after the death

Question 122

Results of hospice care:

Answer 122

Patients have less interest in physician-assisted suicide because their pain is better controlled

they spend more of their last days without pain, undergoing fewer medical interventions and operations

the relatives of dying people rate the quality of the death experience more positively and display fewer symptoms of grief

Question 123

The Family Bereavement Program

Answer 123

a well-studied intervention for families in which a parent has died

A behavioral approach involving modeling and role-playing of target skills and homework assignments to apply skills was used

Question 124

A group of 10 parents who suddenly lost their children is meeting to acknowledge the anniversary of their loss. How many of these parents have come to terms and see meaning in their children’s death within one year of the event?

Answer 124

1

Question 125

Jasmine just delivered a baby girl. What is the average life expectancy of her new daughter?

Answer 125

81 years

Question 126

what term best reflects the grief work perspective regarding people’s approaches to bereavement?

Answer 126

judgmental

Question 127

what intervention will likely be most successful in helping parents Thom and Kelly effectively support their son Caleb in the death of his twin sister Holly?

Answer 127

family therapy

Question 128

In Texas last year, 3,000 babies were delivered. About how many of them likely did not survive infancy?

Answer 128

18

Question 129

According to the Parkes/Bowlby model, a toddler whose mother leaves the room and a man whose wife has passed away will both feel which of the following?

Answer 129

yearning

Question 130

what is a biological impact adolescents who are grieving the loss of a parent may experience?

Answer 130

Higher levels of cortisol