Death & Dying

Question 1

Holmes & Rahe (1967) Stress Scale

Answer 1

• Also known as the Social Readjustment Rating Scale (SRRS)
• Survey of over 5000 medical patients and asked them whether they had experienced 43 stressful events (Life Change Unit)
• Each Life Change Unit is associated with a stress score
• –The more units, the higher the score
• –The higher the score, the more likely you are to experience illness

Question 2

Later-Life Transitions: Widowhood

Answer 2

• More women than men
• –50% of women over age 65
• –80% of women over age 85
• Widowhood effect
• Grieving can alter physical functioning

Question 3

Later-Life Transitions: Widowhood

Answer 3

• Don’t just “get better” – emerge as different, hopefully resilient
• Impact of beliefs about afterlife (Bonanno et al., 2002)
• –Belief in reunion after death = less angry BUT may experience intrusive thoughts; religious activities may strengthen social support
• –Uncertain = fair worse even than those who don’t believe in an afterlife at all, tend to experience chronic grief/depression
• Impact of children/friends – early mourning, children rally around, families grieve together, share memories (temporary)
• –Key idea: Provide support (assistance & help), not comfort (trying to make them feel less unhappy)

Question 4

Death

Answer 4

• Early adulthood, many avoid thoughts of death
• Late adulthood, think more about death – closer!
• Death anxiety – fear and apprehension of death and dying
• Thorson & Powell (1994) – Revised Death Anxiety Scale
• –15 questions on 5 point Likert Scale
• —-“Never feeling anything again after I die upsets me”
• —-“I hate the idea that I will be helpless after I die.”
• —-“The total isolation of death is frightening to me”
• —-“The feeling that I will be missing out on so much after I die disturbs me”

Question 5

More death

Answer 5

• Spirituality – sense of life’s meaning – helps with death anxiety
• Religiousness itself doesn’t protect from death anxiety
• –Especially contradictory beliefs and behaviors (ex., believe in afterlife, but don’t pray)

Question 6

Stages of dying

Answer 6

• Kubler-Ross (1969) – interviewed over 200 terminally ill people, 5 responses:
  1. Denial – deny seriousness, refuse to accept, avoid discussions
• –Reduces emotional distress (temporarily)
• –Problematic: hinders social support & closure
  2. Anger – Haven’t had chance to do all one wants to do
• –Targets: family members, doctors3. Bargaining – Death is inevitable, make deals with family, friends, doctors, God

4. Depression – Denial, anger, bargaining fail to postpone illness – depressed, intensified suffering
5. Acceptance – Most reach acceptance, peace and quiet about upcoming death

Question 7

Dying—Context matters

Answer 7

• Nature of disease – course of illness, symptoms
• Personality and coping style – poor adjustment (bad relationships, many disappointments)  more distress
• Family and Doctors’ Behavior
• –People close to dying person acknowledge illness  BEST outcome.
• –Doctors not fully clear about prognosis  not so good
• –Dealing with terminally ill patient – difficult  can affect behavior, need support and counseling