Exam 2 Flashcards
In American funeral customs, there are several basic areas considered to be accepted practices. What are these areas?
(8)
- Funeral home
- Embalming
- Viewing
- Visitation
- Funeral director
- Credit
- Disposition of remains
- Format of major american religious and organizational funeral rites and ceremonies.
List the basic cultural information about the national character of the United States.
(7)
- Religion - doctrine of atonement
- Family structure- modified extended family system, more families not marrying
- Government - democratic, free to choose any funeral service
- Economics - capitalistic, free enterprise
- Age - youth oriented
- Educational level - high degree of educational status
- Mobility - nation on the go, neo-localism
List the Determinants of Grief
14
- Normal coping behavior
- Number of previous losses and deaths.
- Grief overload
- Concurrent stressors
- Expectations of local, cultural, and religious groups
- Available support network
- Gender conditioning
- Physical and mental health
- Pre-death adjustment time
- Unfinished business with the deceased
- Secondary losses
- Importance of the relationship
- Age of deceased
- Fulfillment of dreams
Normal Coping Behaviour
as a Determinate of Grief
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.
Number of previous losses and deaths
As a determinate of grief
Grief can be cumulative. Experiencing one loss does not necessarily make adjustment to the next loss easier.
Grief overload
As a determinant of grief
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.)
Concurrent stressors
as a determinant of grief
Similar to grief overload, a person experiencing multiple stressors at once may not react with their usual “together” response.
Expectations of local, cultural, and religious groups
as a determinant of grief
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.
Available support network
As a determinate of grief
The more positive support a grieved has, the more positive his adjustment to the death will be.
Gender conditioning
as a determinate of grief
Males expected to be strong. Females are taught sadness and crying are more acceptable than anger.
Physical and mental health
As a determinate if grief
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.
Pre-death adjustment time
As a determinate of grief
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
Unfinished business with the deceased
As a determinate of grief
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.
Secondary losses
As a determinate of grief
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.
Importance of the relationship
As a determinate of grief
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.
Age of the deceased
As a determinate of grief
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.
Fulfillment of dreams
As a determinate of grief
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.
Accidents - Facts
- 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.
Homicide - Facts
- 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.
Recovery from a homicide doesn’t seem to even start until a number of events take place. List them.
(7)
- The murderer must be caught.
- 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.
- 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.
- If the murderer is found not guilty, the survivors may never get the justice they’re seeking.
- 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.
- When the murderer is eligible for parole, some survivors make it their mission to get the parol denied.
- 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.
Grief response after suicide.
10
- Shock
- Bewilderment
- Denial
- Guilt
- Powerlessness
- Obsessive review
- Blame
- Shame
- Anger
- Fear
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.
Sudden Infant Death Syndrome (SIDS) / Crib Death
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.
Disaster
An act or practice of allowing the death of a person suffering from a life limiting condition.
Euthanasia
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.
Voluntary active euthanasia
Often card “mercy killing”.
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.
Involuntary active euthanasia
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.
Passive euthanasia
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.
Physician – assisted suicide
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)
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.
A reaction that is prolonged, excessive in duration, and never comes to a satisfactory conclusion.
Chronic grief
A reaction that does not occur in a normal time frame but occurs at a later time.
Delayed grief / inhibited, suppressed, or postponed grief
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.
Masked grief
Occurs when the reactions to the loss are excessive and disabling.
Excessive grief
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.
Disenfranchised grief
List Doka’s four types of death that lead to disenfranchisement.
- Relationship to the deceased is not socially recognized. This would include relationship such as homosexual relationships, extramarital affairs, or heterosexual cohabitation.
- Loss is not acknowledged by others as being a genuine loss. Examples include abortion, miscarriage, pet loss, and death of a former spouse.
- Grievers are unrecognized. Examples include the death of a friend, schoolmate, coworker, or someone mentally disabled.
- Death is not socially sanctioned. Examples include suicide, autoerotic asphyxia, or legal execution.
Factors that may complicate grief / lead to complicated grief
(5)
- Relationship - factors such as ambivalence
- Circumstantial - factors such as uncertainty and multiple losses or when the death is sudden.
- Personality – factors such as the inability to tolerate extreme emotional issues, negative self-concept.
- Social – factor such a shame embarrassment or social stigma when the death is not approved by society, or no strong support group.
- Historical – factors such as previous complicated grief reactions or the influence of early parental loss.
What is the new counseling treatment for complicated grief?
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.
