Exam 2

Question 0

In American funeral customs, there are several basic areas considered to be accepted practices. What are these areas?

(8)

Answer 0

1. Funeral home
2. Embalming
3. Viewing
4. Visitation
5. Funeral director
6. Credit
7. Disposition of remains
8. Format of major american religious and organizational funeral rites and ceremonies.

Question 1

List the basic cultural information about the national character of the United States.

(7)

Answer 1

1. Religion - doctrine of atonement
2. Family structure- modified extended family system, more families not marrying
3. Government - democratic, free to choose any funeral service
4. Economics - capitalistic, free enterprise
5. Age - youth oriented
6. Educational level - high degree of educational status
7. Mobility - nation on the go, neo-localism

Question 2

List the Determinants of Grief

14

Answer 2

1. Normal coping behavior
2. Number of previous losses and deaths.
3. Grief overload
4. Concurrent stressors
5. Expectations of local, cultural, and religious groups
6. Available support network
7. Gender conditioning
8. Physical and mental health
9. Pre-death adjustment time
10. Unfinished business with the deceased
11. Secondary losses
12. Importance of the relationship
13. Age of deceased
14. Fulfillment of dreams

Question 3

Normal Coping Behaviour

as a Determinate of Grief

Answer 3

A person will normally respond the same way to different stressors. That is why it is important for those counseling the grieving to know about past coping behaviors.

Question 4

Number of previous losses and deaths

As a determinate of grief

Answer 4

Grief can be cumulative. Experiencing one loss does not necessarily make adjustment to the next loss easier.

Question 5

Grief overload

As a determinant of grief

Answer 5

A person can experience too many losses in a given period of time. This overload often manifests itself in what others consider an exaggerated response to the most recent loss. (Losses need not be the same type; death, divorce, moving to a new home, etc.)

Question 6

Concurrent stressors

as a determinant of grief

Answer 6

Similar to grief overload, a person experiencing multiple stressors at once may not react with their usual “together” response.

Question 7

Expectations of local, cultural, and religious groups

as a determinant of grief

Answer 7

Grief is an individual response – everyone responds differently. However, part of our response is determined by what is expected of us by members of important groups in our lives.

Question 8

Available support network

As a determinate of grief

Answer 8

The more positive support a grieved has, the more positive his adjustment to the death will be.

Question 9

Gender conditioning

as a determinate of grief

Answer 9

Males expected to be strong. Females are taught sadness and crying are more acceptable than anger.

Question 10

Physical and mental health

As a determinate if grief

Answer 10

The fact that you can contribute to ill health, both physically and mentally, makes the state of health of an individual at the time of a death an important factor in determining the outcome of the experience.

Question 11

Pre-death adjustment time

As a determinate of grief

Answer 11

Having time to prepare for a death has both positive and negative outcomes for an individual.

Positive: ability and opportunity to tell the dying person things you want him to know.

Negative: watching the person suffer and waste away

Question 12

Unfinished business with the deceased

As a determinate of grief

Answer 12

Arguments or ill-feelings left unattended with the intention of working them out later will remain unfinished after a death, making the adjustment more difficult.

Question 13

Secondary losses

As a determinate of grief

Answer 13

Secondary losses come along with primary loss (the death of the person). They include things like the loss of a breadwinner leading to a loss of tuition, transfer to a different school, or moving all together.

Question 14

Importance of the relationship

As a determinate of grief

Answer 14

The psychological intensity if the pre-death relationship between the deceased an the mourner will influence the mourner’s response.
The “family tree” may not be the determining factor. The most important factor is the quality of the relationship in emotional terms.

Question 15

Age of the deceased

As a determinate of grief

Answer 15

Generally people feel the death of a child or adolescent is the most tragic type of death. The old are expected to die and the death of an infant of a stillborn deserve less grief because of the misconception there was too short a time for bonding to take place.

Question 16

Fulfillment of dreams

As a determinate of grief

Answer 16

The reason we feel the death of young people is so tragic is because they have not lived long enough to fulfill their dreams and experience life. Can also be felt with adults who have not accomplished their goals.

Question 17

Accidents - Facts

Answer 17

• Fourth leading cause of death in US for ages 15-24.
• Most common cause worldwide is motor vehicle accident.
• Accidents may require inquiry and court cases that prolong mourning process
• Repeat trauma may occur when survivors hear of or see other accidents.

Question 18

Homicide - Facts

Answer 18

• Possibly most difficult unexpected death to cope with.
• Guilt for not preventing the death or protecting the victim is common.
• Anger associated with the loss often becomes rage at the legal system.
• Survivors tend to focus on the terror, suffering, and helplessness endured by the victim.
• Many survivors consider retribution or revenge.
• Media coverage may complicate grief process.

Question 19

Recovery from a homicide doesn’t seem to even start until a number of events take place. List them.

(7)

Answer 19

1. The murderer must be caught.
2. If the murderer is apprehended and is let out on bail, survivors usually do not feel it is justified. May also fear for their own safety.
3. At trial (which may be months or years away) the family can become even more hurt as defense lawyers try to smear the reputation of the deceased or partake in character assassination.
4. If the murderer is found not guilty, the survivors may never get the justice they’re seeking.
5. If the murderer is found guilty, survivors seldom feel the sentence is severe enough. Their lives are changed forever and the murderer may be eligible for parole in 5 to 8 years.
6. When the murderer is eligible for parole, some survivors make it their mission to get the parol denied.
7. Even when the murderer is sentenced to death and the execution is carried out, often there is not the closure that the people are hoping for.

Question 20

Grief response after suicide.

10

Answer 20

1. Shock
2. Bewilderment
3. Denial
4. Guilt
5. Powerlessness
6. Obsessive review
7. Blame
8. Shame
9. Anger
10. Fear

Question 21

Sudden unexpected death of a seemingly healthy infant between four months and one year age for which no other cause of death has been found after thorough examination of the death scene, review of medical history, and a complete autopsy.

Answer 21

Sudden Infant Death Syndrome (SIDS) / Crib Death

Question 22

An occurrence of a severity and magnitude that normally results in death, injuries, property damage, cannot be managed through the routine procedures and resources of the government.

Answer 22

Disaster

Question 23

An act or practice of allowing the death of a person suffering from a life limiting condition.

Answer 23

Euthanasia

Question 24

A deliberate intervention by someone other than the person whose life is at stake intended to end the life of a competent, terminale ill person who makes a fully voluntary and persistent request for aid in dying.

Answer 24

Voluntary active euthanasia

Often card “mercy killing”.

Question 25

An intervention intended to kill a person who is incapable of making a request to die: an infant or young child, a mentally incompetent patient, or someone, who because event impaired consciousness, is unable to give voice to his opinion.

Answer 25

Involuntary active euthanasia

Question 26

The foregoing or withdrawal of medical treatment that offers no hope of benefit to the total well-being of the patient with the intent of causing death.

Answer 26

Passive euthanasia

Question 27

When a physician provides medications or other means for a patient to use on himself to end life. The physician does not control the act, the patient does.

Answer 27

Physician – assisted suicide

Question 28

An abnormal grief response that is more intense than normal grief, yet different than clinical depression. Must last for an excess of several months.

(15-20% of all mourners)

Answer 28

Complicated grief

The book lists the following as AKAs for complicated grief: pathologic, chronic, delayed, masked, or exaggerated grief. However, it should be noted, that these terms have separate definitions in that same book. Ergo, these terms would be more accurately described as types or subsets of complicated grief.

Question 29

A reaction that is prolonged, excessive in duration, and never comes to a satisfactory conclusion.

Answer 29

Chronic grief

Question 30

A reaction that does not occur in a normal time frame but occurs at a later time.

Answer 30

Delayed grief / inhibited, suppressed, or postponed grief

Question 31

Occurs when a person experiences symptoms and behavior which causes them difficulty but they do not recognize the fact that these are related to the loss.

Answer 31

Masked grief

Question 32

Occurs when the reactions to the loss are excessive and disabling.

Answer 32

Excessive grief

Question 33

Kenneth Doka introduced this term to describe a loss that society believes does not deserve morning. The loss is not openly acknowledged, socially sanctioned, or publicly shared.

Answer 33

Disenfranchised grief

Question 34

List Doka’s four types of death that lead to disenfranchisement.

Answer 34

1. Relationship to the deceased is not socially recognized. This would include relationship such as homosexual relationships, extramarital affairs, or heterosexual cohabitation.
2. Loss is not acknowledged by others as being a genuine loss. Examples include abortion, miscarriage, pet loss, and death of a former spouse.
3. Grievers are unrecognized. Examples include the death of a friend, schoolmate, coworker, or someone mentally disabled.
4. Death is not socially sanctioned. Examples include suicide, autoerotic asphyxia, or legal execution.

Question 35

Factors that may complicate grief / lead to complicated grief

(5)

Answer 35

1. Relationship - factors such as ambivalence
2. Circumstantial - factors such as uncertainty and multiple losses or when the death is sudden.
3. Personality – factors such as the inability to tolerate extreme emotional issues, negative self-concept.
4. Social – factor such a shame embarrassment or social stigma when the death is not approved by society, or no strong support group.
5. Historical – factors such as previous complicated grief reactions or the influence of early parental loss.

Question 36

What is the new counseling treatment for complicated grief?

Answer 36

It is a two-pronged therapy which involves the patient both “revisiting” the death and resuming pleasurable activities and social contacts.
Patients are urged to make an audio recording of their story and listen to it repeatedly to reduce their version to talking or thinking about it. They also participate in an imagined conversation with the person they have lost, speaking openly about their shared experiences. Doctors also urge patients to resume activities that satisfy them, we engaging with the world.