L10 Flashcards
Death
irreversible loss of circulation and respiration or brain function
When is death premature?
if it occurs before age 70 or 75
Psychological definition of death
the possibility of the impossibility of any existence at all
2 aspects of an illness that vary from one disease to another
course and length
Palliative care
care intended to reduce pain and discomfort and improve quality of life in patients with chronic/terminal illness; standard form of care in nursing homes regardless of prognosis
Hospice palliative care
relief of suffering from terminal illness that begins after treatment stops and may extend beyond a person’s death to assist in bereavement
Goals of hospice palliative care
to provide warmth and personal comfort (e.g. psychological comfort and social support) at the end of life; to manage pain as invasive treatments stop
Where does hospice care occur?
palliative care units of hospitals, freestanding hospices, or in homes
Pro and con of home care
improved personal control and availability of support but can be problematic for family
Benefits of palliative care
lower pain, improved quality of life, lower anxiety and depression, reduction in disease symptomatology, prolonged survival, significantly lower healthcare costs
5 goals for medical staff in providing end-of-life care
informed consent, safe conduct, significant survival, anticipatory grief, timely and appropriate death
Main goal of end-of-life care
help the patient achieve death with dignity
Disparities racialized individuals face in end-of-life care
lower use of palliative care services, worse symptom control, less likely to have end-of-life wishes documented or respected
Difficulties medical staff and formal care providers face
emotionally draining, unpleasant custodial work, not curative care, less interesting/stimulating
Medically assisted dying
a physician knowingly and intentionally provides a person with the knowledge and/or means required to end their life, including counselling about lethal doses of drugs, prescribing, or supplying them
Euthanasia
deliberately ending a person’s life to relieve suffering
Bill C-14 (2016)
restricts MAiD to mentally competent adults who have a serious and incurable illness illness, disease or disability; are in an advanced state of irreversible decline; and face a reasonably foreseeable death
Bill C-7 (2020)
removes the requirement for MAiD that death be reasonably foreseeable
Most common illnesses that lead to MAiD
cancer, neurological disorders, respiratory diseases
Concerns about medically assisted dying
incompatibility with care provider’s ethics; errors in diagnoses or prognoses; coercion by family members or physicians; suicide contagion effect; disproportionate impact on vulnerable groups; impact on the bereaved
What is the only group with a heightened risk in assisted dying?
people with AIDS
Main factor motivating MAiD requests
functional decline or inability to participate in meaningful activities
5 stages of dying
denial, anger, bargaining, depression, acceptance
Death acceptance
a realization of the inevitability of death that is often neither happy nor sad and sometimes void of feelings
What do people do in death acceptance?
detach themselves from events and things they used to value
2 coping strategies used by hospice patients
denial and acceptance (interdependent and fluctuating)
Middle knowledge
denying death and minimizing the bleakness of a prognosis while making plans for one’s death
Psychological factors that become more salient as someone approaches death
sense of integrity, continuity of relationships, reduction of conflicts, wish/goal fulfillment, reminiscence, symbolic immortality, generativity, spirituality/religiosity
What is driving a person approaching death to achieve certain goals?
a desire for meaning and purpose
Personal meaning
a sense of purpose, direction, order, reason for existence, personal identity, and greater social consciousness