Dying and Death

Question 1

this chapter focuses on…

Answer 1

(1) definitions of dying and death;
(2) the individual senior’s experience of dying, death, and bereavement, including attitudes toward death; and (3) issues in the treatment of the dying.

Question 2

seniors who know they have a terminal illness see themselves as

Answer 2

living while dying

Question 3

Thanatologists

Answer 3

specialists in the studying of dying and death

Question 4

social death

Answer 4

refers to the perception or behavior of others when they view or treat a person as if physically dead when the physical body has not yet died.

Question 5

cryonics

Answer 5

freezing the body in hope that one day science will bring the dead back to life

Question 6

Longer life expectancy today means…

Answer 6

most people die of the diseases of old age—cancer, heart disease, chronic lung disease, stroke, and diabetes

Question 7

what are some of the improvements that have led to increased life expectancy?

Answer 7

Modern medical treatments

Better nutrition

Question 8

Compared with senior women, senior men tend to have

Answer 8

higher rates of death from cancer and heart disease.

Question 9

senior women have higher rates of death by

Answer 9

stroke and Alzheimer’s disease

Question 10

Trajectory of dying

Answer 10

the pattern or course of dying over time, for example, sudden death or slow decline

Question 11

How many deaths in Canada have a sudden-death trajectory?

Answer 11

only 10%

Question 12

Did the proportion of deaths that took place in hospitals between 2007 and 2019 increase or decrease?

Answer 12

The proportion of deaths that took place in hospitals decreased between 2007 and 2019

Question 13

Older people and death

Answer 13

Older people often experience a decline in function and health over time, along with periodic intense crises that may lead to death. Dying can include pain, delirium, swallowing problems, loss of mental function, and other forms of discomfort. Dying in old age makes special demands on healthcare providers, family members, and older people themselves.

Question 14

closed awareness context

Answer 14

professionals, the patient, and the family may all know that death will occur soon. But no one discusses this “secret.”

Question 15

open awareness context

Answer 15

all of these people communicate about the impending death. Today, research and modern medical care supports an open awareness context (Stacey et al., 2019). Still many dying patients today remain unaware of their condition.

Question 16

which awareness context option is encouraged?

Answer 16

open awareness context as it is the most honest for the patient

Question 17

What is palliative care?

Answer 17

specialized medical care that focuses on providing patients relief from pain of a serious illness no matter the diagnosis or stage of disease

can include end of life care, palliative care is much broader and can last for longer.

Question 18

When do conversations about death most often take place in hospitals?

Answer 18

The conversations often took place when nothing more could be done to maintain life. And conversations took place when death seemed inevitable within days or hours.

Question 19

Why do physicians wait to discuss death?

Answer 19

Some patients clearly did not want physicians, nurses, and family members to give up on them. As a result, physicians and nurses waited to discuss death when the patient’s body was failing and could no longer respond to treatment.

Question 20

Why is delaying the conversation about death bad?

Answer 20

This denied the dying person and their family a sense of control. Professionals often failed to provide options such as palliative care and medical assistance in dying.

Question 21

What is the stage of life known as a life review?

Answer 21

A dying person looks over their life, seeks a conviction that their life has had meaning and purpose, and prepares for death

Question 22

What is ego integrity?

Answer 22

the acceptance of the notion that one’s life cycle is something complete and unique

People in this stage often feel a deep concern for others and for the society and culture they will leave when they die.

Question 23

Are seniors more or less afraid of death

Answer 23

Less afraid

typically express more concern about the process of dying than about death itself. For example, a long and difficult process of dying often leads a dying senior to express a welcoming preference for death. When death finally comes, others often speak of that death as a “blessing.”

Question 24

Fears and concerns at end of life

Answer 24

being a burden to their family

Question 25

What describes a good death?

Answer 25

includes a lack of pain during the dying process, a quick death, dying at home surrounded by loved ones, maintaining a sense of dignity, having a sense of control, and being prepared to die.

Question 26

Stages of Dying- Dr. Elizabeth Kubler- Ross

Answer 26

1. denial
2. anger
3. begin to bargain
4. they feel depressed-illness gets worse
5. accept death

Question 27

What role can religion play in helping a person cope with dying?

Answer 27

Provides explanations for the meaning of life and afterlife

Question 28

bereavement

Answer 28

the state of having recently experienced the death of a significant other

Question 29

grief

Answer 29

a sense of profound loss and the experience of deep sorrow

Question 30

mourning

Answer 30

the public expression of grief typically following social and cultural rules

Question 31

anticipatory grief

Answer 31

experienced prior to and in anticipation of the death of a loved on

Question 32

disenfranchised grief

Answer 32

defined by society as illegitimate and therefore unacknowledged because society defines the relationship between the deceased as insignificant

Question 33

complicated grief

Answer 33

painful emotions that last so long and are so severe that the person has trouble recovering from the loss and resuming their life

Question 34

five responses to the loss of a partner

Answer 34

1. Chronic grief (defined as low pre-loss depression, high post-loss depression after 6 to 18 months);
2. Common grief or recovery (low pre-loss depression and high post-loss depression at 6 months with improvement at 18 months);
3. Resilience (low pre- and low post-loss depression at 6 and 18 months);
4. Depressed-improved (high pre-loss depression and low post-loss depression at 6 and 18 months); and
5. Chronic depression (high pre-loss depression and high post-loss depression at 6 and 18 months).

Question 35

What are advance directives?

Answer 35

states a person’s healthcare wishes and other preferences for the end of their life. It may designate a decision maker to implement the writer’s wishes. A person writes this directive in advance in case they become incompetent and can no longer make personal decisions.

Question 36

Why are advance directives important?

Answer 36

help family members and healthcare practitioners make timely healthcare decisions, avoid contention, and even avoid court intervention in decision-making.

Question 37

What are some issues that may occur with advance directives?

Answer 37

1. people can change their minds but may not get the chance to change their advance directive
2. subtle forms of coercion may influence decision making of the older person

Question 38

Personal Directives Act

Answer 38

allows a person to create a personal directive. This directive provides instructions about healthcare and other matters to take effect when the person can no longer make their own decisions

Question 39

What is the main purpose of palliative care?

Answer 39

Palliative care does not attempt to extend life in the face of a terminal illness. Instead, palliative care tries to relieve symptoms and help patients enjoy their last days.

Question 40

What does palliative care include?

Answer 40

pain management; symptom management; social, psychological, emotional, and spiritual support; and caregiver support.

Question 41

Pain control in palliative care

Answer 41

1. adjust drug dosage until it relieves a patient’s pain
2. nurses give the next dose before the previous one has worn off

This erases the memory, anticipation, and fear of pain

Question 42

Palliative care main goals

Answer 42

-allows a person to die with a minimum of technological intervention
-Patients also know they have a say in their treatment; they can ask for medication when they feel they need it, and they can ask to die at home.

Question 43

palliative care in indigenous communities

Answer 43

Indigenous seniors may need specialized healthcare in urban settings, far from their home. If a health condition worsens, an Indigenous Elder may die in a hospital. This cuts the person off from their support network of family and friends. Elders would prefer to die in their own community with family and friends nearby

Question 44

Caregiving and dying at home

Answer 44

While the caregiver initially assumed a supportive and then a managing role, the caregiver eventually took over care and decision making completely. Still, the caregivers tried their best to follow the patient’s wishes. Dying at home can place a great deal of stress on the family and on the primary caregiver in particular.

Question 45

assisted suicide

Answer 45

suicide made possible with the help of someone

Question 46

physician-assisted suicide

Answer 46

a physician provides a patient with advice about how to die by suicide or with the technical means (lethal medications) to die by suicide

Question 47

active voluntary euthanasia

Answer 47

intervening actively to end a person’s life at the person’s request

Question 48

medical assistance in dying (MAID)

Answer 48

a physician or nurse practitioner helps a person die either by assisting the patient’s suicide or by euthanasia

Question 49

passive euthanasia

Answer 49

witholding or ceasing treatment of someone who is ill or injured and not expected to recover

Question 50

Who is Gloria Taylor?

Answer 50

first person in Canada to win the right to die with the help of a doctor. And she led the charge to make the right to a peaceful death a reality for the rest of us

Question 51

Canadians today make no single response to dying, death, and bereavement

Answer 51

Canadians display a mix of traditional, religious, medical, scientific, individualistic, and personal responses to the end of life.

Question 52

Few people experience sudden death; most experience a long dying trajectory.

Answer 52

Most people die in the hospital or in a long-term care facility, although dying at home is becoming increasingly common.