Death, Dying, and Terminal Illness Flashcards
Brain and Cortical Death
No longer any brain function or electrical activity in the brain cells
Clinical Death
Heart stops beating or breathing stops for 10 min of more without intervention from another person
Psychic Death
Loss of consciousness, but heart continues to beat normally until they die
Social Death
Cease of interaction with others because they don’t want to be around others anymore or because others have stopped interacting with them socially for any reason
*Age-based understanding of death
Under 3 YO: children don’t have the cognitive and linguistic ability to understand
3-5 YO: Children understand death means that someone is gone, but struggle to understand permanence
5-7 YO: Most understand that death is final but it is not understood biologically
7-9 YO: Most understand that death is final and irreversible; interested in the cause and may believe that thoughts can cause death
9+ YO: Approximate time that death is understood in similar ways to that of adults
Life expectancy
An estimate of the average age that members of a particular population group will be when they die
See slide 7 and list out trends
Trend in child and adolescent mortality rates in US between 2019 and 2021. Why?
20% increase - largest increase in the last 50 years.
Reason: homicide, accidental drug OD, MVAs, suicide (ages 10-19)
Top three leading causes of death in all ages in the US (2020)
- Heart disease
- Malignant neoplasms
- COVID-19
Top three leading causes of death in ages 18-25 yo (2020)
- Unintentional injury
- Homicide
- Suicide
Indirect death impacts of COVID-19
Increases in mortality due to social isolations and reductions in access to and use of healthcare services. Increases in stress, depression, and substance-use —> increases in suicide
Cultural factors that influence perspective of death
Values, religion, personal beliefs, community traditions
Common factors of an acceptable or “good” death (4)
- Non-dramatic, disciplined, very little emotion
- Allows for social adjustments and personal preparation
- Not too early
- One dies in the service of their country or religion
Premature death and 2 common causes
Dying before the average age of 79
Commonly due to heart attack or stroke
Trend in premature deaths - Why?
Declining rate of premature dues mainly due to decreases in lung cancer rates
Euthanasia
Ending a person’s life who is in pain or suffering
Impact of long-term treatment of chronic illness on psychological well-being
Often extremely taxing and has high psychological costs
Living Will
Document that details a person’s procedures and decisions that should be enacted if they incapacitated and unable to make a judgement in a timely fashion
*Kubler Ross’ Stages of Death Theory
People spend varying times in each stage of grief. Can refer to one’s own death or a loved one
Shock, Denial, Frustration, Depression, Experiment, Decision, Integration
Criticisms of Kubler Ross’ Theory
Procession from one reaction to another is often not in an orderly fashion.
Implies that the bereaved individual has to reach the end in order to achieve “acceptance”
*Stroeb and Schuts Dual-Process Model of Grief
Oscillation between loss-oriented behaviors (direct) and restoration-oriented behaviors (indirect)
*Bolby and Parker’s Four Phases of Grief
Based on research of children’s reactions to being separated from their caregivers
Phases: shock and disbelief, searching and yearning, disorganization and repair, rebuilding and healing
__ in __ Americans who die each year die in a hospital
1 in 3
Hospital staff members’ role in patients’ deaths
Depersonalized, yet full of experience - offers a unique perspective that family members often cannot
Risks of terminal care for hospital staff (4)
- Difficult for staff b/c care is often palliative not curative
- Involves unpleasant custodial work like feeding, changing, and bathing the patient
- Burnout from watching their patients die
- Possible temptation to work in efficient, objective ways and not be warm/supportive to minimize their personal pain
Palliative care
With terminal illness, this kind of care is designed for comfort, not curative measures
Thanatologist
Those who study death and dying
Guidelines for terminal care
Informed consent, safe conduct, significant survival, anticipatory grief, timely and appropriate death
Hospice Care
May be residential or home-based. Aimed at providing warmth and emotional support to terminally ill patients
Home Care
Run by family members. Similar goals to hospice care (warmth and emotional support), but more cost effective. Con: can be a large emotional burden for family members
