Death And Dying Flashcards
How do most of Canadian society view death?
In denial of death, prefer not to think about their own eventual death, struggle with finding ways to grieve, avoid planning ahead for their dissolution
How do most of the First Nations, Métis, and Inuit peoples view death?
Collectivist approach: community-based ceremonies to commemorate the death of a loved one; death feasts, traditional caskets, star blankets, “give-aways”
What is the difference between death and dying?
Death is the termination/cessation of life and is not part of life.
Dying is the universal end-stage of life when bodily processes decline which leads to death and is part of life.
What is brain death?
Basis for determining a person has died; absence of activity of the cerebral cortex (flat EEG); can continue to breathe
What does it mean when the cerebral cortex no longer shows signs of activity?
Consciousness has ceased.
Consciousness being the sense of self and all psychological functioning.
What is whole-brain death?
Death of the brain stem, which is responsible for certain automatic functions; can be kept “alive” by life-support equipment that takes over their breathing and circulation
In Canada, when is a person considered legally dead?
Irreversible cessation of breathing and circulation or when an irreversible cessation of brain activity occurs, like activity in brain stem
How did Elisabeth Kübler-Ross influenced the study of the process of dying?
She studied terminally ill patients and analyzed some important and common responses to news of impending death; hypothesized the 5 stages of dying; both younger and older people who suspect death is near may have the same responses
What are the 5 stages of dying?
- Denial - can be flat and absolute; “it can’t be me, the diagnosis must be wrong”; can fluctuate from acceptance of medical verdict to chatting animatedly about future plans
- Anger - denial gives way to anger and resentment toward the young and healthy, sometimes towards the medical establishment; “it’s unfair, why me?”; “they didn’t catch it in time”
- Bargaining - bargaining with a religious/culturally appropriate (omnipotent) forces to try and postpone death; promising to do good deeds if they are given another six months or year
- Depression - feelings of grief, loss, hopelessness at the prospect of leaving loved ones and life itself
- Final acceptance - inner peace or serenity may come as a quiet acceptance of the inevitable; “peace” may not be contentment as they still fear death, but they come to accept it with a sense of peace and dignity
What did Joan Retsinas think about the 5 stages of death?
She critiqued that the stages are limited to cases in which people receive a diagnosis of a terminal illness; she pointed out that people die because of their advanced years; doesn’t provide much help in understanding reactions under circumstances other than terminal illness
What did Edwin Shneidman say about the process of dying?
His research shows that individuals behave in dying more or less as they behaved during their earlier life when they experienced stress, failure, and threat; process of dying does not necessarily follow any progression of stages
What are the key factors that appear to affect the adjustment of the dying individual?
Type and extent of organic cerebral impairment; pain and weakness; time or phase of the person’s life; person’s philosophy of life (and death); prior experience with crises
How many Canadians would prefer to die in their home?
75%
How many Canadians die in a hospital?
70%
What was the concern regarding “Erlangen Baby”?
The ethics surrounding keeping a brain-dead mother’s body alive in order to hold the fetus until it’s born
What are the functions of hospitals?
Treat diseases; provide social workers and psychosocial support services
What are hospices?
A homelike atmosphere to help terminally ill patients approach death with a maximum of dignity and a minimum of pain and discomfort; usually provided in hospitals, nursing facilities, hospice centres, but mostly in patient’s home; provide more control over decision making compared to hospitals
35-40% of Canadians will have access to or will receive hospice, palliative care, and end-of-life services
True or False?
False, only 16-30%
What do hospice workers do?
Provide physical, medical, spiritual, and emotional support to the patient and their entire family
What are the characteristics of hospice care?
24-hour palliative care, to control pain and symptoms so patients can live fully and comfortably; treats person and not the disease, addressing the medical, emotional, psychological, and spiritual needs of patients, family, and friends; emphasizes on quality rather than length of life
What are the ways to support someone with a life-threatening illness?
- Give the gift of availability: hospital or home visits, sharing activities that are manageable for the dying person, respecting need for alone time, acknowledging energy levels
- Listen actively: having open discussions about illness and death at the person’s discretion, providing a safe place free off criticism, judgement, and advice-giving
- Respect their social-cultural or religious beliefs and practices: listen to and respect the person’s beliefs and values about how life should be lived, funerary rites, and afterlife
- Know about the condition: educate yourself about the illness to understand it better
- Show compassion: provide time and space for the person to express their feelings, “Walking with and not behind or in front”
- Give practical support and help: practical way to show support and care by making food, washing clothes, cleaning the house, and driving them to appointments
- Keep in contact; communicate: writing emails, texts, letters, and phone calls or videos to show you care and have them on your mind
- How are you coping: think about what you feel about the illness of your sick friend or family member, needing someone to talk through your feelings and thoughts
What is euthanasia?
“Good death”; “mercy killing”; purposeful taking of a person’s life through gentle or painless means to relieve them of their pain or suffering; patient has an incurable illness
What does the term “dying with dignity” means?
Patient’s dying following the guidelines they specified in advance, like how they should be cared for near and at the end of life
What are the three types of euthanasia?
- Voluntary: subject us competent, informed, and voluntarily asks for their life to be ended
- Non-voluntary: subject has not expressed their preference in terms of assisted death
- involuntary: subject has made an informed choice and expressed refusal of assisted death
How does assisted dying differ from medically assisted dying?
Assisted dying is death that is self-inflected as a result of someone else intentionally providing the knowledge or means to die by suicide
What is terminal sedation?
Medical practice of relieving distress in a terminally ill patient in the last hours or days of his or her life; delivered through IV transfusion of a sedative drug
Under Canadian Law, a “competent adult person” should satisfy which two things to qualify for medically assisted death?
- clearly consents to the termination of life
- has a grievous and irremediable medical condition (illness, disease, disability) that causes enduring suffering that is intolerable in the circumstances of their condition
What is a living will?
Healthcare directive; legal document people draft when they are well; can indicate whether to use aggressive medical procedures or life-support equipment; must be drafted in accordance with provincial or territorial laws
When does a living will take effect?
When patients are unable to speak for themselves
When do children’s’ thinking become more realistic?
Ages 4-6; when they learn more about the biology of the human body and how organs contribute to the process of life
True or false: Adults may feel guilty because of the mistaken belief that they brought about the death by once wishing for a person to die
False, it’s older children
True or false: Children may revert to “baby talk” because of the death of a loved one
True
True or false: Adolescents speak of death in terms of concepts such as light, darkness, transition, and nothingness
True or false: Adults continue to engage in riskier behaviours than adolescents do
False, it’s the other way around
What are the leading causes of death in early adulthood?
Accidents and suicide
What are the leading causes of death in middle adulthood?
Heart disease and cancer
True or false: heart disease and cancer are the leading causes of death in late adulthood
True, it is the same as in middle adulthood
In late adulthood, what do social and emotional development theorists suggest about ego transcendence?
This enables people to begin to face death with an inner calm
What happens when someone dies?
- Complete death certificate/determine cause of death
- Arrangements for burial, cremation, or placement in a mausoleum
* unexpected death/suspected foul play - autopsy to determine cause and circumstances of death
What do funerals provide?
A ritual for grieving publicly and saying farewell to the person who died; grant closure to help with moving on
What guidelines should be consider when arranging a funeral?
Decisions based on reason and good sense; ask funeral homes about services and costs; awareness of unreasonably priced and unnecessary fees that cemeteries charge; avoiding expensive caskets
True or false: families should seek legal counsel to protect their own financial interests and for guidance on handling deceased person’s affairs
True; attorneys help settle the estate
What is bereavement?
Emotional state of longing and deprivation characterized by feelings of grief and a deep sense of loss
What is grief and mourning?
Grief: emotional suffering resulting from death
Mourning is the same as grief but also describes culturally prescribed ways of displaying grief
True or false: In England and North America, widows are often still expected to wear black for the remainder of their lives
False, this is common in rural parts of Mexico, Italy, and Greece; England and NA replaced black with joyous colours to celebrate life
What is disenfranchised grief?
Grief that is not acknowledged by society; occur for LGBTQ people; loss and grieving deemed as “less than” / stigamtize
True or false: Grieving lasts for 6-12 months after the loss of a loved one
False, there is no fixed period of time for how long it should last
True or false: Early non-acceptance indicates a much higher likelihood if prolonged grief response
True
True or false: Grief can compromise well-being, making people vulnerable to illness and disease
True
True or false: Grief is just a feeling of depression
False, it’s a combination of emotions like depression, loneliness, emptiness, disbelief, numbness, guilt, and even anger
What did John Bowlby do?
Attachment theorist; first to propose a stage theory of grief for coping with bereavement; includes four stages: shock-numbness, yearning-searching, disorganization-despair, reorganization
What did Elisabeth Kübler-Ross?
Adapted Bowlby’s stage theory into the 5 stages of grief: denial-isolation, anger, bargaining, depression, acceptance
How did Jacobs modify Kübler-Ross’s stage theory if grief?
Jacobs included numbness-disbelief, separation distress (yearning-anger-anxiety), depression-mourning, recovery
How did Paul Maciejewski and his colleagues test Jacob’s theory and what did they conclude?
Measured bereaved individuals disbelief, yearning, anger, depression, and acceptance 1 to 24 months after their loss; they concluded that the feelings arose in predicted order
Who is McClintock Greenberg?
Argued against the stage model of grieving and loss; assumptions about grief having a specific pattern, being finite, occurring in stages, prolonged grief as abnormal; “normal” grief vs “wrong way” to grieve
What can you do to support a grieving person?
-encourage them to take care of themselves
-encourage them to feel their loss
-encourage them to join a bereavement support group or seek counselling
-reassure them that it takes time to come to terms with loss
