Dying and bereavement Flashcards
In what ways does culture affect death definitions?
Variation in definition and in rituals surrounding death as well as bereavement
- Life force leaves the body during sleep or illness, or reaching a certain age
- Malaysian, term, mate; extremely sick, the very old and the dead, toa refers to all living people
What are the 3 medical definitions of death?
Clinical death
- No heartbeat or respiration
- Can change
Whole-brain
- Coma with no known cause
- All brainstem reflexes permanently stopped
- Completely dead
- Breathing stopped
Persistent vegetative state
- No cortical functions
What are some age-related differences in how adults feel about dying?
Young adults
- Feeling cheated
- Hopes and dreams are gone
Middle Adults
- Starting to confront it, how has life been
- Increased awareness, often when in contact with death
Older adults
- Often more accepting of death, not as scared of it
Kubler-Ross’ Stage Theory
- How do we deal with our own upcoming death, as well as loss
- Feelings of; denial, anger, bargaining(higher power), depression and acceptance
Why is Kubler-Ross’ Stage Theory not considered a proper stage theory?
- The stages can overlap with each other
- Doesn’t happen in a specific order, some stages might get skipped
- Individual variation
What is the Contextual Theory?
- Focuses on issues and tasks that people face with dying
- No right way of coping, but some are maladaptive
- Consists of 4 dimensions of issues, from the person’s dying point of view
Bodily needs
Psychological security - retain autonomy
Interpersonal Attachment - alert others
Spiritual Energy and Hope(finding it) - Holistic point of view and focus on individual differences
What is death anxiety and how does it manifest?
- Anxiety or fear over dying, death and what happens after death
- Indirect behaviour
- 3 dimensions (public, private and non-conscious)
How painful will it be
Humiliation or rejection
Punishment after death
Being destroyed
Body malfunction
Terror Management Theory
Focuses on why people engage in behaviors to achieve psychological states based on your concerns about mortality
- Motivation to do what you want
What does experts recommend in order to reduce death anxiety?
- To not let it overcome our daily routines
- Use it as motivation to live with no regrets
- Death education
- Participating in experiential workshops
What are important tasks for those who are either terminally ill or knowing they will die soon?
- End Of Life Issues; after death body disposition, memorial services and assets
- How to live their last time on earth
- Bringing closure to relationships
Anticipatory socialization - Disengage before dying - Still maintaining psychological control, no loss of autonomy
- Making a final scenario; what is important to me
- Living will; states my wishes with medical and end of life services
- Take control over their last time on earth and how to be handled after death
Bereavement
A state or condition which is caused by loss through death
Grief
The negative emotions that comes from loss
- Hurt, anger, frustration, guilt, scared, sadness
Mourning
- Its a form of expression of grief, its manifestation
- Different across cultures
What are the steps that describes the process of grieving?
- Its an active coping respons
1. Acknowledgement of the reality of loss
2. You have to work through its emotional chaos
3. Adjusting the environment where the deceased is no longer present
4. Starting to loosing the ties to the deceased one - Individual process, it can take up to several years
What are some common grief reactions?
- Coping, affect, change, narrative, relationships
- Intense feelings of sadness, denial or anger
- Anniversary grief
- Grief peaks within its first 6 months, may never go away
Four-Component Model of Grief
- A model to help understand grief or how one cope with grief
- Context of loss
Any risk factors, unexpected - A continuation of subjective meaning that is associated with loss
What does this loss mean for me, how to remember their death, keeping traditions - Role of coping and emotion-regulation
Can work as ruminative - Changing representations of lost relationship over time
Your perspective and relationship with the one who is dead
Meaning of death
In Four-Component Model of Grief, what components are seen as normative and non-normative?
- Context of loss
Normative(old) vs non-normative(young) - Dealing with grief
Normative as we all do it - Changing representations of lost relationship over time
Seen as normative, we all need to handle this after loss - Coping and emotion regulation
Both
What is the dual-process of grief?
- Two types of stressor
- Focus on loss vs Getting over the loss
Grief work vs doing new things
Denial of restoration changes vs avoidance of grief - Cycle back and forth
- Long-term balance of effects of bereavement and the need to live
Adaptive Grieving Dynamics
- 2 broad types of stressor
- Go in between them constantly, its dynamic
- Processes and strategies one might use
Integrating - assimilating internal and external changes, integrating the past, present and future
Tempering - To not get overwhelmed by the changes that takes up on individual and community resources as well as capacity to integrate change - Valence
Lamenting - responses that are distressful, disheartening and painful for the person
Heartening - responses that focus on gratifying, uplifting or pleasurable
What are 2 ways in which the grieving process differs across people?
- Sudden vs prolonged death
- Strength of attachment
- Gender differences
- Spousal loss
- How people cope with death
- Cultural differences
Ambigious Grief
- No resolution
Person is physically missing but psychologically there - No closure
Person is physically there but not psychologically
Disenfranchised Grief
- Grief is strong to a person who lost the deceased, but seemingly no grief from others
- Social expectations of loss, needing to move on
- Not being able to see from another perspective
- Loss of an animal
What is complicated or prolonged grief?
- Difficulty with grief
- Caused by sudden death, if the attachment to the deceased one is strong and can differ between gender
- Common in young adults, death of a child or parent
- Difficulty reaching closure
Deaht of one’s child
- Traumatic event, cross-culturally universal
- Miscarriages included
- Some never recover
Death of one’s parent
- A loss of important person in their life
- Reminder of your own mortality
- Letting go is difficult, can lead to acceptance of ones own mortality and that the parent’s suffering is over
What conditions are more likely to be present under prolonged grief and why?
- Separation Distress
Constantly occupied with the death, interferes with the day-to-day life, reminded of the diseased - Traumatic Distress
Feelings of disbelief, isolating from others - Experiencing a physical presence of the deceased, they are are here
