Chapter 19 Life's Final Chapter Flashcards
lifes final chapter Metis
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.
brain death
the absence of activity of the cerebral cortex, as shown by a flat EEG recording.
whole-brain death
includes death of the brain stem, which is responsible for automatic functions (a person’s breathing).
death in Canada
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.
Kübler-Ross (1969) hypothesized five stages of dying:
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.
“death education”
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.
hospital death
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
hospice
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.
palliative care
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
hospice care characteristics
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
euthanasia
Literally meaning “good death,” derived from the Greek roots eu (“good”) and thanatos (“death”)
“mercy killing”
purposeful taking of a person’s life through gentle or painless means to relieve pain or suffering
voluntary euthanasia
Refers to an assisted death where the subject is competent, informed, and voluntarily asks to have their life ended
involuntary euthanasia
Refers to an assisted death where the person made an informed choice and expressed their refusal to accept assistance in dying
Non-voluntary euthanasia
Refers to an assisted death where the person has not expressed their preference in terms of an assisted death
terminal sedation
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
assisted dying
Refers to a self-inflicted death as a result of someone intentionally providing the knowledge or means to die by suicide
Medically assisted dying is legal under these circumstances: a competent adult person
(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.
living will
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
children and death
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.
adolescents and death
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.
adults and death
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.
what to do when someone dies
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.
funeral arrangements
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
legal and financial matters
Financial matters following death may include issues concerning estates, inheritance, outstanding debts, insurance, and amounts owed for funeral expenses.
mourning
Describes culturally prescribed ways of displaying grief; different cultures prescribe different periods of mourning and different rituals for expressing grief
bereavement
An emotional state of longing and deprivation that is characterized by feelings of grief and a deep sense of loss
John Bowlby (1961) was the first to propose a stage theory of grief for coping with bereavement.
He hypothesized four stages to grieving:
shock–numbness
yearning–searching
disorganization–despair
reorganization
