End of Life Flashcards
Causes of death
Middle-age: non-accidental (cancer, diabetes, heart disease)
85<: higher disease of heart
12 Principles of Good Health
To have control (what happens/ pain relief/ where death occurs/ who is present)
To be afforded dignity/privacy
To be able to issue advance directives
To be able to leave when it is time/ no pointless prolongation
To know when death is coming/ understand expectations
To have access ( info/expertise/spiritual/emotional support/hospice care at any location)
3 Broad Themes of Good Death
Control
Autonomy
Independence
End-of-life care
Control over individual care passes to medical/family in deteriorating conditions
Hospital deaths problems
Low patient-physician communication/knowledge of wishes
ICU can be traumatic and stressful
End-life-deaths
Homes 19%
Hospitals 66%
Palliative care 4.3% in hospice
Palliative care vs Hospice
Palliative care provides psycho-social support to individuals nearing the end of life with treatments aiding comfort and Hospice specializes in the same support but for more near-death patients
The ‘Will’ to live
A psychological component to death
The role of patient state of mind over timing
The role of significant events for individual
The role of socio-cultural factors
Timing of death is associated with holidays
People are more likely to die during or shortly after holidays, related to gender and involvement
American-Chinese women in the Harvest Moon Festival
Jewish men in Passover
Men and women at Christmas and Easter
Men and women a month after January 1st
Levy: Self Perception and Will to Live of Aging on Dying
Longitudinal 23-year study investigating
IV: self-perception of aging and will to live
DV: mortality
Individuals with more negative views (perception of aging) tend to have earlier deaths.
An average of 7 1/2 year lifespan difference.
The will to live was a mediating factor, an influencing force.
Medical Assisting in Dying (MAID)
Third-party as an active force aiding the death of patients, often through pharmaceuticals.
MAID (before 2015)
Aid to suicide was a criminal offense.
To avoid premature deaths
In fear of the patient being incapable when reaching intolerable suffering.
No one is entitled to consent to die.
Infringed right of a competent adult to make personal decisions as a result of a grievous medical condition causing intolerable suffering.
MAID (Carter V. Canada)
Overboard of ban for non-vulnerable people
MAID regulations
MAID options
Clinician-administered: The physician directly administers the substance causing death.
Self-administered: prescription of drug where patient brings their own death.
Eligibility
Canadian, 18 years old and mentally stable, voluntary decision, and suffering of irremediable and grievous condition
Consent is given (consent can always be withdrawn except with MAID)
Condition criteria
Serious illness, disease, or disability that is irreversible and advancing the state of decline. It excludes mental illness and is not only for fatal/terminal conditions.
Life after death
Belief in life after death relates to better mental health
Anxiety, depression, obsession-compulsion
The belief has to do more with the agency than religious activity