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Psychology of Death > Final > Flashcards

Final Flashcards

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1
Q

modern dying is…

A

degenerative

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2
Q

modern dying - trajectory

A

slower, gradual (you can live for many years), death is a medical failure

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3
Q

modern dying - % dying in institutions

A

70-80%

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4
Q

cancer survival

A

for females, more preventative if caught early, only 5 (out of 25) types of cancer that dont survive for 5 years

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5
Q

Survival after first heart attack

A

24 hrs - 61%
28 days - 48%
5 years - 36% (lower than cancer)
10 years - 30%

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6
Q

Modern dying - treatment choices

A

hospital stressors, pain from treatment, body esteem threatened, medical compliance, patient role, anxious, chronic stress, lifestyle changes and losses

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7
Q

Psychological coping tasks (6)

A

seek treatment, integrate treatment with life, body changes, maintain self-esteem, coping with pain, prepare for death

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8
Q

Is there evidence that fighting helps?

A

No

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9
Q

Role of optimism and hope (3)

A

Optimism draws social support, hope correlates with self-esteem, but neither seems to prolong life

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10
Q

Additional coping factors (5)

A

concurrent stressors, coping resources, social network, emotional expressiveness, disclosure

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11
Q

Seeing what in death? Coping

A

Meaning, spirituality and illusions

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12
Q

Coping - What is ego transcendence?

A

Focus on post self or symbolic immortality

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13
Q

What are the 3 psychological states in reaction to death?

A

Bereavement, grief, mourning

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14
Q

What is bereavement?

A

Outer behavior. defined by society, acted out as a role

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15
Q

What is grief?

A

Inner behavior, sadness, pain, shock, confusion, guilt, anger, most intense in the first 30 days, death rate rises for 6 months, 1-2 years to be normal

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16
Q

What is mourning?

A

Behaviors used to adapt to loss, highly individualized, mourning with others may help

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17
Q

What does Freud say about mourning?

A

It does not equal depression. Mourning is normal, other-directed, and grief-work

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18
Q

Kubler-Ross: Stages of Dying

A

5 steps: denial, anger, bargaining, depressions, acceptance

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19
Q

Yale Bereavement Study (YBS) Stages

A

Disbelief (denial), anger, yearning (bargaining), depression, acceptance

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20
Q

YBS Key findings

A

All reactions occur simultaneously, regular but complex pattern

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21
Q

YBS - first 3 months

A

acceptance, yearning and disbelief

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22
Q

YBS - 4-8 months

A

worst period, less disbelief, rising anger and depression

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23
Q

YBS - 1 year

A

yearning and disbelief less, rise in anger and depression

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24
Q

YBS - 2 years

A

Depression still lingers, acceptance dominates

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25
Q

Grief Work (3): Freud& Bowlby

A

Emotion-oriented view of grief, love energies blocked, reworking of attachments

26
Q

Maggie

A

Movie: child is dead, but mom still visits the grave with her ghost

27
Q

Task-based grieving: Worden

A

popular. Emhasize coping, accept loss, experience pain of loss, adjust roles and adapt to changes, withdraw and reinvest love in the living

28
Q

Due-Process Model: Stroebe

A

2 stressors: grieving the loss, restoring one’s life. Strong ambivilance. Approach-avoidance conflicts. Imbalance and conflict

29
Q

Narrative Model: Walter

A

Grief is not just emotion, shift in thoughts and memories (my wedding will miss my dad), storytelling

30
Q

Pennebaker writing experiments

A

Physical health better over next year with higher positive emotion, higher causes, reasons

31
Q

Aspect of Complicated Grief - Idealization

A

Unusually positive distortion of memories

32
Q

Aspect of Complicated Grief - mummification

A

attempts to preserving dea person’s life

33
Q

Aspect of complicated grief - memorialization

A

excessive effort at public recognition of loss

34
Q

Aspect of complicated grief - chronic grieving

A

Lifestyle built around mourning behaviors

35
Q

Aspect of complicated grief - Repression via busyness

A

Avoidance or normal grieving

36
Q

Aspect of complicated grief - substance abuse

A

Repression via drug dependance

37
Q

Aspect of complicated - Disenfranchised grief

A

Social stigmas block normal mourning

38
Q

How is end-of-life care?

A

Far from ideal

39
Q

Ideas to fix problems with end-of-care? (4)

A

Training for nurses, monitoring of patient needs, daily updates for doctor, care for family concerns

40
Q

Problems with end-of-care? (3)

A

Doctors did not know patient wishes, patient choices are not implemented, families and patients are frustrated by pain

41
Q

Reasons for problem with care?

A

Medicine is focused on treatment, avoidance and denial, legal concerns

42
Q

AMA standard for medical futility?

A

When intervention to prolong life become futile, physicians are obligated to shift to intent of care for comfort and closure

43
Q

Is futility scientifically objective?

A

No, values are involved

44
Q

AMA - fair review process

A

5 steps for communication, alternatives and conflict resolution

45
Q

Advanced directives

A

Incase you become crazy, your wishes can still be heard

46
Q

Healthcare power of attorney

A

Living will, natural death declaration

47
Q

California: Health Care Decisions Law

A

Designates a health care agent if incapable of making decisions

48
Q

Palliative care

A

Alternative. Emphasis on comfort, social emotional and spiritual support, and pain management.

49
Q

De-institutionalization of care (5)

A

Alien settings, legal constraints, under-medication of pain, family stress, expensive

50
Q

Hospice

A

Good death is natural, comfortable

51
Q

Hospice - requirements

A

6-month diagnosis, stopped curative

52
Q

Reasons for late referral to Hospice

A

Lack of awareness, communication hurdles, physician reluctance, patient denial, fear of assisted death

53
Q

CA - Right to know Act

A

Disclosure of all options, hospice info, right to refuse care, stop eating or drinking,

54
Q

What does VSED stand for?

A

Voluntary stop eat and drink

55
Q

Euthanasia - arguments for (4)

A

dying is lingering, suffering has no purpose, choice helps patients, we do it to animals

56
Q

Passive Euthanasia

A

withdrawal of ususal treatment, DNR, removal of respiration, may take 2-3 weeks to die. Legal in US

57
Q

Active Euthanasia

A

Action taken by some other person that causes death, voluntary or involuntary, injection of lethal drugs, only legal in Netherlands.

58
Q

Who is Dr. Jack Kevorkian

A

Performed 130 assisted suicides, convicted of murder in 1998

59
Q

Physician-assisted death (PAD)

A

Voluntray, patient takes acion, injection. Legal in Oregon, Washington, and Montana. 72% approval vote

60
Q

Oregon Death with Dignity Act

A

15 days waiting period, first request to death=42 days, oral barbiturate, 25 minutes to die, 40-50 deaths per year

Psychology of Death (3 decks)

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