Death & Dying Flashcards
Hospice
an organization that treats dying patients by focusing on palliative care rather than curative treatment
Palliative Care
treatment focused n the relief of pain and suffering, not on a cure
Euthanasia
the purposeful taking of life to relieve suffering
Voluntary Euthanasia
the intentional ending of life as a result of a competent, informed person having made a personal decision to have assisted death
Non-Voluntary Euthanasia
the intentional ending of the life of a person who has not expressed his or her preference in terms of an assisted death
Involuntary Euthanasia
the intentional ending of life of a person who made an informed choice and expressed his or her refusal to have an assisted death
Assisted Dying
a self-inflicted death as a result of someone intentionally providing the knowledge or means to die by suicide
Terminal Sedation
the practice of relieving distress in the last hors or days of life with the use of sedatives
Living Will
a document, prepared when a person is well, that outlines the person’s desires concerning medical care should he or she become incapacitated or unable to speak for him/herself
it can provide directives for healthcare providers to terminate life-sustaining treatment
Bereavement
the state of deprivation brought about by the death of a family member or close friend
Grief
emotional suffering resulting from a death
Mourning
customary methods of expressing grief
Disenfranchised Grief
grief that is not acknowledged by society
What is death and mortality?
extremely influenced by our religious, cultural and personal beliefs
denial of death is embedded in Canadian culture
What is the First Nation, Metis, and Inuit approach to death?
family takes care of preparations
conduct community based ceremonies
death feasts, making traditional caskets, star blankets, and “giveaways” to commemorate the death of a loved one
rituals help with the transition
What is children’s understanding of death?
preschoolers believe death can be reversed and that death people can still breathe and feel
but direct experience with death can speed their understanding
understanding seems to increase with learning about the biology of human bodies
by school age, children seem to have grasped the permanence and universality of death but they still think they can avoid it
cultural concepts of surviving death renders death less permanent and less frightening to many children
focusing in the concrete aspects can scaffold understanding and coping
How can experiencing death shake a child’s sense of security and well-being?
may feel guilty (wishing = causing death)
may display aggressive behaviors (anger)
may display regressive behaviors
may fear death when learning about it
What is the meaning of death for adolescents?
understands the universality, permanence, and inevitability of death
however, still underestimate their own changes of death (personal fable)
adolescents who attempt suicide seem to think that death is a pleasurable experience
personal experience with death of someone close affects their perspective
if terminally ill might feel angry and cheated
What is the meaning of death in early adulthood?
sense of unique invulnerability, time in life when people feel ready to begin their own lives
come up with reasons of why someone died early (near-sainthood)
loss of opportunities experiencing new things and loss of family
What is the meaning of death in middle and late adulthood?
beyond simple understanding of universality, permanence, and inevitability of death, but does not make it easy to accept
a death changes their role in their family and relationships
loss of time to complete inner work
may fear disability/discomfort nearly as much as death
What is the fear of death?
religious beliefs frames death as transition rather than an end
people with sense of purpose in life are less fearful
What existential uncertainties does fear of death stem from?
the finality of death
the uncertainty of what follows
annihilation anxiety or fear of nonexistence
the ultimate loss
fear of pain and loneliness in dying
fear of failing to complete life work
What is the Kubler-Ross theory of stages of dying?
denial, anger, bargaining, depression, and acceptance
critiques: just talking about terminal illness, not other causes of death
What are alternative views to stages of dying?
type and extent of organic cerebral impairment
pain and weakness
the time or phase of the person’s life
the person’s philosophy of life (and death)
prior experiences with crises, react like earlier in life when experienced threat, failure, stress
What is hospital care?
70% of Canadians die in hospitals, but 75% would rather die at home
curative, treat the disease, emphases on length of life
some think might be their best change to keep alive
What is hospice palliative care?
whole-person end-of-life care
spiritual and existential needs
grief support for caregivers
mostly happen at home
palliative not curative care, quality of life versus length
challenging for indigenous populations
What are ways to support a dying person?
gift of availability
listen actively
respect their social-cultural or religious beliefs and practices
know about the condition
show compassion
give practical support and help
keep in contact, communicate
how are you coping?
What is euthanasia?
voluntary euthanasia: patient decision
non-voluntary euthanasia: person has not expressed preference
involuntary euthanasia: person has expressed preference
What is assisted dying?
different from medically assisted dying
providing the means/knowledge to die by suicide
What is terminal sedation?
relieving distress in last moments
What is medically assisted dying in Canada?
be at least 18 years old and mentally competent
have a grievous and irremediable medical condition (excluding mental illness)
make a voluntary request for MAID that is not the result of outside pressure or influence
give informed consent to receive MAID
physician or nurse practitioner directly administers a substance that causes death or provides/prescribes a drug that the eligible person takes themselves
What is terminal decline?
decline in overall cognitive function
gradual but accelerated
over the course of roughly 6 years
those near to death become more docile, conventional, dependent and non-introspective
What are living wills?
instruction directive (e.g. DNR)
specific is more followed than general guidelines
health-care proxy
What is clinical death?
heart and breathing stopped, no brain function
resuscitation is still possible
What is brain death?
flat EEG recording
whole-brain death: cessation of activity in the brain stem too
What is social death?
someone signs a death certificate
also a legal matter
What do you do when someone dies?
call family doctor, police, or 911
need death certificate with cause of death
autopsy might be performed
What is involved in making arrangements after a person dies?
burial, cremation, or placement in a mausoleum
can be extremely expensive, average traditional burial in Canada costs $11, 500, should not be planned out of guilty
legal and financial matters, should seek legal counsel, estates, inheritance, outstanding debts, insurance, amount owed for funeral expenses
What are the psychosocial functions of death rituals?
tied to religious custom and cultural traditions
grant closure
helps family and friends to manage their grief, tell them exactly what to do and how
can strengthen family ties
shared milestone for family member, organizer of past experiences and present ones
What is bereavement?
emotional state of longing and deprivation
feelings of grief
What is grief?
involve combinations of emotions
depression, loneliness, feelings of emptiness, disbelief and numbness, apprehension about the future, guilt, anger, relief that the deceased person is no longer suffering
What is mourning?
similar to grief over the death of a person
but encompasses culturally appropriate way to display grief
How does coping with loss require time?
heightened awareness of one’s own mortality
can compromise well-being
people grieve in different ways, early experiences of the non-acceptance of loss as the best predictors
supportive social network is important
grief counselling may also be useful
grief might never end though
What is LGBTQ2S+ disenfranchised grief?
invisible grief, not seen by society
stigmatized, seen as “less than” or not legit
access, privileges, and rights throughout terminal illness, dying, and death can be lower
What is bereavement and grieving in children?
express grief like many adolescents and adults will
sad facial expressions
crying
loss of appetite
anger
What is bereavement and grieving in adolescents?
more likely to experience prolonged grief
tendency to engage in “what if” thinking
How does the mode of death affect bereavement and grieving?
rational explanations allow grieving and protects from loner-term depression
sudden and violent deaths evoke more intense grief responses, due to inability to find meaning in the event
suicide is associated with feelings of rejection and anger, complicated by guilt feelings related to possibility of having prevented it
What are Bowlby’s stages of grief?
was the first to propose stages
shock-numbness, yearning-searching, disorganization-despair, reorganization
What is Kubler-Ross’ theory of the terminally ill?
adapted Bowlby’s theory
has become generally accepted, informs any kind of loss
What is Jacob’s stage theory of grieving?
adapted Kubler-Ross’ theory
numbness-disbelief, separation distress (yearning-anger-anxiety), depression-mourning, recovery
What is Greenberg’s critique of stage models of grief?
against stage model for grieving
it makes erroneous assumptions: grief follows a specific pattern, experience of grief if finite, grief occurs in stages, prolonged grief is abnormal
people grieve in all different kinds of ways: regulate their emotions differently, depends on closeness of relationship
What is widowhood?
as general rule, the most difficult death to recover from, immediate and long effects on immune system
mental health: changes are more pronounced in the year following death
What is the widowhood effect?
death of a spouse is soon followed by the other
appears worldwide and is not influenced by cause of death
risk is higher especially within 6 months of spousal death
risk is somewhat decreased by remarriage
What is prolonged grief?
yearning for and/or preoccupation with a decreased loved one plus intense emotional pain for more than 6 months
but, cultural differences on “how to properly grief” should be considered
How do you support a grieving person?
encourage them to take care of themselves
encourage them feel their loss
encourage the individual to join a bereavement support group or seek counselling
reassure the individual that it takes time to come to terms with loss
don’t worry about what to say, simply be there
What is Corr’s task-based approach to the stages of dying?
satisfying body needs and minimizing physical distress
maximizing psychological security, autonomy, and richness of life
sustaining and enhancing significant interpersonal attachments
identifying, developing, or re-affirming sources of spirituality energy, fostering hope
What is thanatology?
scientific study of death, grief, and loss from different perspectives (physical, ethical, spiritual, medical, sociological, and psychological)
death education should be part of everyone’s schooling
What are types of death education programs?
crisis intervention education
routine death education
death education for helping professionals
