Death & Dying

Question 1

Thanatology:

Answer 1

The Study of Death and Dying

During the past thirty years social patterns that call for the “hiding of death” have in large measure been reversed and the field of thanatology - the study of the study of death - has grown.

Question 2

Defining death

Answer 2

Over the past thirty-five years, technological advances have rendered the traditional definition of death obsolete.

●Such advances have included methods to resuscitate victims of cardiac arrest, mechanical respirators, and artificial heart pacemakers.

●A growing acceptance in medical and legal circles of the need for an additional criterion of death resulted in a legal definition that includes the absence of spontaneous brain function.

Question 3

life review process

Answer 3

Some psychologists have suggested that the elderly tend to take stock of their lives, to reflect and to reminisce about it in a life review process.

Question 4

Confronting dying

Answer 4

A realistic acceptance of death may well be the hallmark of emotional maturity.

●People differ considerably, however, in the degree to which they are consciously aware of and think about death.

●Death is a highly personal matter, and its meaning tends to vary from individual to individual.

Researchers agree that only a relatively small proportion of the elderly express a fear of death.

Question 5

Kubler-Ross

Answer 5

Kubler-Ross identifies five stages through which dying persons typically pass:

   1. denial
   2. anger
   3. bargaining
   4. depression
   5. acceptance

Question 6

Criticisms About Kubler-Ross’ Theory

Answer 6

Criticisms About Kubler-Ross’ Theory
●Psychologist Robert Kastenbaum has raised criticisms about Kubler-Ross’s theory:

   This stage approach encourages an    attitude in which medical personnel or the    family of a dying person might dismiss    concrete, realistic sources of anger.

Question 7

A Living Will

Answer 7

A Living Will
A legal document that states an individual’s wishes regarding medical care in case the person becomes incapacitated and unable to participate in decisions about his or her medical care.

Question 8

The Right to Die Movement

Answer 8

The Right to Die Movement
●Over the past twenty years public and professional awareness of the dying person’s experience has increased dramatically.

●The death awareness movement asserts that a basic human right is the power to control one’s own dying process.

●Much criticism is currently leveled at the way modern technology is applied to the terminally ill.

According to this view, too much is done for too long a period at too high a cost, all at the expense of basic human considerations and sensitivities.

●Probably the most controversial position of the right-to-die movement concerns the issue of euthanasia (mercy killing).

●Physician-Assisted Suicide (PAS)

Trend: basing decisions less on legalistic interpretations regarding specific treatments and more on balancing benefits on a case-by-case basis

Question 9

Palliative Care

Answer 9

Palliative Care
●Relieve pain and physical discomfort
●Support family’s emotional needs
●Role of spirituality and religion
●Hospice is a type of palliative care

Question 10

The Hospice Movement

Answer 10

The Hospice Movement
●The hospice approach entails a variety of programs that are designed to afford an alternative to conventional hospital care for the terminally ill, especially cancer patients.

●The emphasis of the movement falls on “comfort-care.”

Comfort-care involves an aggressive treatment of symptoms, both physical and emotional, through the use of counseling, anti-depressive medications, and high-dose morphine preparations.

●Most hospice programs are centered around care of the dying person at home.

Question 11

Adjusting to the Death of a Loved One

Answer 11

●Bereavement is a state in which a person has been deprived of a relative or friend by death.

●Grief involves keen mental anguish and sorrow over the death of a loved one.

●Mourning refers to the socially established manner of displaying signs of sorrow over a person’s death.

Question 12

Bereavement

Answer 12

●Bereavement is a state in which a person has been deprived of a relative or friend by death.

Question 13

Grief

Answer 13

●Grief involves keen mental anguish and sorrow over the death of a loved one.

Question 14

Mourning

Answer 14

●Mourning refers to the socially established manner of displaying signs of sorrow over a person’s death.

Question 15

Adult Bereavement

Answer 15

●In adult bereavement the individual typically passes through a number of phases:

1. Shock, numbness, denial, disbelief
2. Pining, yearning, and depression
3. Emancipation from loved one and adjustment to new circumstances
4. Identity reconstruction

Question 16

OT Role

Answer 16

OT Role
●Palliative Care
             ●Home assessments
             ●Positioning
             ●Pain prevention/relief
             ●Occupational engagement
             ●Life review
Hospice Care
             ●Environmental adaptation
             ●Caregiver training for ADLs
             ●Counsel/coping strategies