Chapter 16: Dying and Bereavement

Question 1

How is death defined?

Answer 1

Some cultures categorize death along with illness and old age or even sleep. Or the cultures call death “good” if the individual has made peace with others

Question 2

Legal and medical criteria used to determine when death occurs?

Answer 2

The criteria used to be
- clinical death: lack of heartbeat and respirations but this is switching to
- whole brain death:
– no spontaneous movement responding to stimuli
– no spontaneous respirations for an hour
– no responsiveness to even painful stimuli
– no eye movements/blinking/pupil responses
– no postural activity/swallowing/yawning/vocalizing
– no motor reflexes
– flat EEG for ten minutes
– no change in criteria in 24 hours.
*How to diagnose whole-brain death is under debate

Question 3

What are ethical dilemmas surrounding euthanasia?

Answer 3

• Differentiating between active and passive
• Different cultures, religions, and political parties have varying views
• Differing views depending on method
• Who gets to decide: patient, family, doctor, medical bord

Question 4

How do feelings about death change over adulthood?

Answer 4

• A shift from formal operational to post-formal thinking accompanies an understanding of mortality
• As people age they become less anxious about death and emphasis switches from ears lived to years left to live
• Joy of living diminishes with loss of people and function

Question 5

How do people deal with their own death?

Answer 5

• Kubler- Ross: denial, anger, bargaining, depression, acceptance.
  – May overlap and any order
  – Recognize that different experiences of these stages are possible
• Contextual theory: bodily needs, psychological security, interpersonal attachments, spiritual energy/hope
  – must be considered in changing environments (type of illness, socio-environment)

Question 6

What is hospice and how does it relate to end-of-life issues?

Answer 6

• Assists dying people, emphasizing pain management (palliative care) and death with dignity
• Inpatient and outpatient (o: preferrable to provide care to more people)
• person must be able to understand their condition and options, their concerns must be considered, and their family must be involved
• Can make them less anxious and depressed and improve quality of life
• May not be appropriate for all situations

Question 7

What are the feelings of grieving people?

Answer 7

• Sadness, denial, anger, loneliness, guilt
• psychological side: coping, affect (emotions), change (how life changes), narrative (stories about deceased), relationship (depends on ties to deceased)
• Expression of grief varied across ethnic groups
• Also physiological side: health may declines
• Reaction may last a long time

Question 8

How is dying and bereavement experienced across the lifespan?

Answer 8

• ~5-7 children understand death inevitable and permanent (concrete-operational) (rather than magical)
• older children: better coping instead of defense mechanism. Need simple but true explanations of death and permission to grieve
• adolescents: lack desire to discuss grieving with peers to fit in, may need to psychosomatic symptoms and may have no end of grief
• Younger the adult: more severe reaction. Depending on who they lost. Associate “young” death with robbing person of life, unfair
• Grandparents may shield grieving parents from their won grief