Chapter 19 Life's Final Chapter

Question 1

lifes final chapter Metis

Answer 1

First Nations, Métis, and Inuit peoples have a more collectivist approach to dying and death, conducting community-based ceremonies — preparing death feasts, and making traditional caskets, star blankets, and “give-aways” to commemorate the death of a loved one.

Question 2

brain death

Answer 2

the absence of activity of the cerebral cortex, as shown by a flat EEG recording.

Question 3

whole-brain death

Answer 3

includes death of the brain stem, which is responsible for automatic functions (a person’s breathing).

Question 4

death in Canada

Answer 4

Death is a legal matter; in Canada, a person is considered legally dead when there is an irreversible cessation of breathing and circulation or when an irreversible cessation of brain activity occurs.

Question 5

Kübler-Ross (1969) hypothesized five stages of dying:

Answer 5

1.Denial. Denial can be flat and absolute, or it can fluctuate.
2.Anger. Denial gives way to anger and resentment toward the young and healthy and sometimes toward the medical establishment.
3.Bargaining. People may bargain with God to postpone death, promising, for example, to do good deeds if they are given another six months.
4.Depression. With depression comes feelings of grief, loss, and hopelessness.
5.Final acceptance. Inner peace may come, quiet acceptance of the inevitable. This “peace” is nearly devoid of feeling.

Question 6

“death education”

Answer 6

suggests hospital staff and family members can help support dying people by understanding the stages they are going through, by not imposing their own expectations on patients, and by helping patients achieve final acceptance when patients are ready to do so.

Question 7

hospital death

Answer 7

Instead of dying in familiar surroundings, comforted by family and friends, patients in hospitals often face death alone; patients and their families may assume going to the hospital gives them the best chance of averting death

Question 8

hospice

Answer 8

Homelike atmosphere to help terminally ill patients approach death with a maximum of dignity and a minimum of pain and discomfort
Hospice workers provide care in inpatient settings (nursing facilities or hospitals); mostly, hospice care is provided in the patient’s home.

Question 9

palliative care

Answer 9

controls pain and symptoms to enable the patient to live as fully and comfortably as possible
Treats the person, not the disease; the hospice team addresses the medical, emotional, psychological, and spiritual needs of patients, family, and friends

Question 10

hospice care characteristics

Answer 10

Emphasizes quality rather than length of life
Considers the entire family to be the unit of care
Bereavement counselling is provided after death
Help or support is available to the patient and family 24/7

Question 11

euthanasia

Answer 11

Literally meaning “good death,” derived from the Greek roots eu (“good”) and thanatos (“death”)

Question 12

“mercy killing”

Answer 12

purposeful taking of a person’s life through gentle or painless means to relieve pain or suffering

Question 13

voluntary euthanasia

Answer 13

Refers to an assisted death where the subject is competent, informed, and voluntarily asks to have their life ended

Question 14

involuntary euthanasia

Answer 14

Refers to an assisted death where the person made an informed choice and expressed their refusal to accept assistance in dying

Question 15

Non-voluntary euthanasia

Answer 15

Refers to an assisted death where the person has not expressed their preference in terms of an assisted death

Question 16

terminal sedation

Answer 16

Practice of relieving distress in a terminally ill patient in the last hours or days of their life, usually by means of a continuous intravenous infusion of a sedative drug, such as a tranquilizer; not meant to hasten death; effect is often debated

Question 17

assisted dying

Answer 17

Refers to a self-inflicted death as a result of someone intentionally providing the knowledge or means to die by suicide

Question 18

Medically assisted dying is legal under these circumstances: a competent adult person

Answer 18

(1) clearly consents to the termination of life, and
(2) has a grievous and irremediable medical condition causing enduring suffering that is intolerable to the individual in the circumstances of their condition.

Question 19

living will

Answer 19

Also known as a healthcare directive; a legal document that people draft when they are well

Must be drafted according to provincial and territorial laws
Only takes effect when a person cannot speak for themselves
Identify next of kin who can make decisions
Many living wills are ignored

Question 20

children and death

Answer 20

Younger children lack the cognitive ability to understand the permanent nature of death.
Children’s understanding of death increases as they learn about the biology of the human body.
Children display different behaviours when handling the loss of a loved one: some revert back to younger or more needier behaviours; some are angry and more aggressive.
Most children are taught some concept of an afterlife as a comfort and to make death less frightening.

Question 21

adolescents and death

Answer 21

Adolescents know that when life functions come to an end in a particular body, they cannot be restored; they may still construct magical, spiritual, or pseudoscientific theories as to how some form of life or thought might survive.

Question 22

adults and death

Answer 22

Leading causes of death in early adulthood are accidents and suicide; in middle adulthood, heart disease and cancer are leading causes of death; prescreening is important; heart disease and cancer remain leading causes of death in late adulthood.

Question 23

what to do when someone dies

Answer 23

Call 911 and the family doctor.
A doctor is needed to complete the death certificate and indicate the cause of death; a coroner or medical examiner may need to determine the cause of death if the reason is unknown.
A funeral director may be contacted to remove the body from the home or the hospital, and arrangements for burial, cremation, or placement in a mausoleum will be made.

Question 24

funeral arrangements

Answer 24

Funerals provide an organized way of responding to death that is tied to religious custom and cultural tradition.
They offer family and the community a ritual that allows them to grieve publicly and say farewell to the person who died.
provides closure

Question 25

legal and financial matters

Answer 25

Financial matters following death may include issues concerning estates, inheritance, outstanding debts, insurance, and amounts owed for funeral expenses.

Question 26

mourning

Answer 26

Describes culturally prescribed ways of displaying grief; different cultures prescribe different periods of mourning and different rituals for expressing grief

Question 27

bereavement

Answer 27

An emotional state of longing and deprivation that is characterized by feelings of grief and a deep sense of loss

Question 28

John Bowlby (1961) was the first to propose a stage theory of grief for coping with bereavement.

Answer 28

He hypothesized four stages to grieving:
shock–numbness
yearning–searching
disorganization–despair
reorganization