L14 - Death and bereavement Flashcards
How have the views towards death and bereavement changed?
- Huge impact of social media
- Informed about deaths 24/7 in news
- Able to immediately respond
- Social media memorial pages - Inc wish for openness and candour
- Death cafes and discussion groups
- Many recent books by health practitioners
How has death been medicalised?
- Death moved from home to hospital
- Dec importance of religious rituals
- Increasing taboo
- Society values youth and health; carries on by marginalising the dying and bereaved
- Doctors making decisions (‘power grab’)
- Hospice movement/ palliative care concept as a response
What is biological death?
The end of the biological organism
What is social death?
The end of the person’s social identity (as seen by others)
Give examples of when social death occurs
- Ceasing full membership in active society (e.g. on retirement)
- Loss of autonomy (e.g. moving into institutional care)
- Chosen by the dying person - saying goodbye
- When the body cannot be controlled - the dying person is avoided or avoids others
What are the 3 types of deaths?
- Traditional
- Modern
- Postmodern
What are the different ways of awareness of dying?
- Closed awareness (only staff is aware)
- Suspicion (patient suspects but has not been told)
- Mutual deception (both know but do not talk about it, ‘pretend’ the other does not know)
- Open awareness (both know that the patient is dying and discuss this openly)
When/ why might awareness of dying patient occur?
Different dynamics around awareness between hospital staff, patients and their relatives
- Relatives may ‘shield’ family members
What does a gradual slant death mean?
Long, slow decline
What does a downward slant death mean>
Rapid decline
What does peaks and valleys mean when describing the pace of death?
Remission and relapse
What does descending plateaus mean when describing the pace of death?
Periods of decline and stabilisation
What are the typical 5 stages that people who know they are going to die pass through?
- Denial
- Anger
- Bargaining with God or Drs
- Depression - feeling defeated
- Acceptance
- Not necessarily linear/ unidirectional
- Similar dynamics with carers and bereaved
What are the pros of seeing death as ‘stage’ models?
- Helps those in a supportive role to understand how the person is feeling
- Why they might respond differently e.g. wanting support/ pushing people away
What are the cons of seeing death as ‘stage’ models?
- When used prescriptively
- Rushing towards acceptance/ moving on
What does the hospice movement (1960) involve?
- Specialised places for palliative care including care in last days of life
- Care focused on comfort, personhood, family and dignity
- Like a hospital and home
- Reliant on charitable funding - based in more affluent areas
What is the concept of palliative care?
- Dying acknowledged as part of life
- Dying people can/ should be enabled to live as well as possible even while dying
- Autonomy of the dying person
- Support for family/ bereaved
- Main focus is improving the QOL; sometimes may be more important than QUANTITY of life
- Enabling good deahts: right place, comfort, with fight/ acceptance
What are the different aspects of experiencing loss?
- Bereavement
- Grief
- Mourning
What happens during bereavement (aspect of experiencing loss)?
Situation of those who have experience significant loss
What happens during grief (aspect of experiencing loss)?
Range of emotions felt by the bereaved
- Numbness
- Pining for the lost person
- Despair
What happens during mourning (aspect of experiencing loss)?
Visible signs of grief or the period of time in which this happens
What are the bereaved at a greater risk of?
- Depression
- Social isolation
- Alcohol misuse
- use of prescribed and OTC drugs
- Self harm
