Chapter Twelve: Psychological Issues in Advancing and Terminal Illness

Question 1

Causes of death in infancy & childhood:

Answer 1

Lack of free or low cost maternal care programs
Congenital abnormalities
Sudden Infant Death Syndrome (SIDS)

Question 2

Def: Sudden Infant Death Syndrome (SIDS)

Answer 2

Condition where an infant stops breathing
More likely to occur in lower-class urban environments (if mom smoked while pregnant, if baby is put to sleep on its stomach or side)

Question 3

Main causes of death among kids under the age of 15:

Answer 3

Accidents
Cancer

Question 4

Kids understanding of death at around age 5:

Answer 4

Thinks of death as permanent sleep
Curious about what death is

Question 5

Kids understanding of death between the ages of 5 & 9:

Answer 5

Idea that death is final
No biological understanding of death

Question 6

Kids understanding of death of ages 9&10:

Answer 6

Moderate understanding of the processes involved in death
Realize that the person who had died will not return

Question 7

Causes of death in adolescence & young adulthood:

Answer 7

Unintentional injury
Homicide
Suicide
Cancer
Heart disease
AIDS

Question 8

Young adults facing a terminal illness:

Answer 8

Feel shock, outrage, & an acute sense of injustice
Might face a long & drawn out period of dying

Question 9

Death in middle age becomes more realistic bc…

Answer 9

It’s more common
Chronic health issues leading to death can develop
Premature death

Question 10

Def: Premature death

Answer 10

Occurs before the projected age of 79
Mainly caused by heart attack or stroke

Question 11

Most ppl prefer a sudden death bc:

Answer 11

It facilitates a more graceful departure
Their families don’t have to witness their worsening condition
Finances & other resources aren’t as severely taxed

Question 12

_____ is a strong determinant of age of death.

Answer 12

SES

Question 13

Death in old age:

Answer 13

The elderly are more prepared to face death bc they have experienced seeing friends & other relatives die & they thought abt their own death while making some preparations for their departure.

Question 14

Cause of death in old age:

Answer 14

Degenerative diseases
Physical decline that predisposes them to infectious diseases or organ failure.

Question 15

Factors that predict mortality in the elderly:

Answer 15

New illnesses & the worsening of preexisting conditions
Poor mental health & reduced satisfaction with life

Question 16

Women live ______ than men.

Answer 16

longer

Question 17

Def: The Patient Self-Determination Act

Answer 17

Requires health facilities to have policies concerning patients’ wishes for life-prolonging therapy.

Question 18

Def: Right to die movement

Answer 18

Maintains that dying is more a matter of personal choice & personal control.

Question 19

Def: Do Not Resuscitate (DNR) order

Answer 19

when patients might choose to sign or not in order to provide explicit guidance regarding their preferences for medical responses to cardiopulmonary arrest

Question 20

Def: euthanasia

Answer 20

ending the life of a person who is suffering from a painful terminal illness

Question 21

Def: Living Will

Answer 21

instructions & legal protection for the physician.
To ensure that life-prolonging interventions will not be indefinitely undertaken
Doesn’t always ensure that the patient’s requests are met.
Many physicians fail to follow the wishes of their dying patines & will prolong the patient’s pain & suffering.

Question 22

The living will & related tools aren’t completely _________ in allowing patients to fully express their wants & to ______ that they are met.

Answer 22

successful, ensure

Question 23

Psychological & social issues related to dying:

Answer 23

Changes in the patient’s self-concept. This is bc the patient can have more difficulty presenting themselves efficiently.
Issues of social interaction
Communication issues

Question 24

Reasons why ppl fall prey to dubious remedies:

Answer 24

Hope for a miracle cure
Deteriorating relationship with the formal health care system
Desire for a more humanistic care

Question 25

Kübler-Ross’s Stages of Dying:

Answer 25

Denial Anger Bargaining Depression Acceptance

Question 26

Def: Denial

Answer 26

Patient's initial reaction on learning the diagnosis Defense mechanism by which ppl avoid the implications of an illness May act as if the illness isn’t severe Causes them to deny said illness Could be caused by one’s subconscious blocking out the full realization of the implications of the disease

Question 27

Def: Anger

Answer 27

Hard response for family & friends to deal with Patient isn’t angry with them but at fate itself or a higher power. Why me? May show resentment to others who are in good health

Question 28

Def: Bargaining

Answer 28

Trading good behavior for good health. Might try to make a pact with a higher being May become more charitable

Question 29

Def: Depression

Answer 29

Time for anticipatory grief Patient mourns the prospect of their death Realization of their inevitable death has set in May feel nauseated, breathless, & tired This is referred to as “anticipatory grief.”

Question 30

Def: Acceptance

Answer 30

A tired, peaceful calm descends Patients decide to divide up their possessions & say goodbye to loved ones. Might be too weak to be angry Makes preparations for post-mortem

Question 31

Evaluation of Kübler-Ross’s Theory:

Answer 31

Patient’s don’t go thru the stages in order, it’s personalized Theory doesn't fully acknowledge the importance of anxiety. Anxiety is one of the most common responses

Question 32

Significance of Hospital Staff to the Patient:

Answer 32

Provides physical assistance Helps reduce pain See patients on a regular basis Are the only source of realistic info Are privy to one of the patient’s most personal acts, the act of dying. Visitors might be limited which will reduce the availability of social support from family

Question 33

Def: Terminal Care

Answer 33

physical care that is palliative rather than curative.

Question 34

Def: Palliative Care

Answer 34

designed to make the patient feel comfortable.

Question 35

Def: Curative Care

Answer 35

designed to cure the patient’s disease

Question 36

Staff might ________ from watching patients after they die.

Answer 36

burn out

Question 37

Physicians spend less time with terminally ill patients to dedicate their time for those who can ______ profit from it. Patients sometimes can interpret this as ______________

Answer 37

most, abandonment

Question 38

Achieving an appropriate death:

Answer 38

Informed Consent Safe Conduct Significant Survival Anticipatory Grief Timely & Appropriate Death

Question 39

Def: Informed Consent

Answer 39

Patients should be told the nature of their condition & treatment and might be involved in their own treatment.

Question 40

Def: Safe Conduct

Answer 40

The physician or other staff should be helpful for the patient thru this new & frightening stage.

Question 41

Def: Significant Survival

Answer 41

The physician and staff need to help the patient use their remaining time as well as possible.

Question 42

Def: Anticipatory Grief

Answer 42

Both the patient & their family members should be aided in working thru their anticipatory sense of loss & depression.

Question 43

Def: Timely & Appropriate Death

Answer 43

The patient should be allowed to die when & how they want to as much as possible. The patient should achieve death with dignity.

Question 44

Therapy with the terminally ill:

Answer 44

Short term Nature & timing of visits depend on the patient’s desires & their energy level. Visits varies & isn’t fixed like normal therapy

Question 45

Def: Thanatologists

Answer 45

studies death & dying Believes that CBTs can be constructively employed with dying patients.

Question 46

Children learn abt their condition by taking causes from:

Answer 46

Their treatments Ppl around them

Question 47

Counseling of terminal illness in kids:

Answer 47

Therapist stake cues abt what to discuss from the kid. Helps parents to cope with the impending death Restores balance in a family with other kids Provides supportive mental health services to parents who exhibit symptoms of PTSD.

Question 48

Def: Hospice Care

Answer 48

First place that provided care & comfort for travelers in medieval Europe Painful or invasive therapies are discontinued Oriented toward improving one’s social support system. Currently provides palliative care & emotional support to dying patients & their loved ones

Question 49

Def: Home Care

Answer 49

Taking care of the patient at home Very popular & economically feasible Provides psychological advantages for the patient Stressful for the family bc if the nurse isn’t there, the family has to take that place.

Question 50

Def: Greif

Answer 50

feeling the hollowness marked by: Preoccupation with the image of the deceases Expressions of hostility towards others Guilt over the death

Question 51

Grief response is more aggravated in:

Answer 51

Men Caregivers Ppl whose loss was sudden & unexpected

Question 52

___________ adults who ruminate on their death are less likely to get _________ social support, and are ______ likely to be depressed.

Answer 52

Sorrowful, good, more

Question 53

Biggest Burden for survivors:

Answer 53

Women: financial strain Men: strains of managing a household

Question 54

Death of a __________ raises complications for child survivors.

Answer 54

sibling

Question 55

Kids should be prepared for the death:

Answer 55

Questions should be answered honestly Info should be provide at the right time

Question 56

Developing realistic expectations abt:

Answer 56

What modern medicine can achieve The kind of care the dying want & need

Question 57

Colleges have developed courses on dying:

Answer 57

Volunteer work with dying patients Potential issues - unintended encouragement from self-destructive leanings.