Midterm Review Flashcards
What are some themes in death education?
1) Limitation and Control
2) Individuality and Community
3) Vulnerability and Resilience
What are the reasons for new patterns in death statistics?
1) Industrialization
2) Public Health Measures
3) preventative health care
4) modern cure-oriented medicine
5) nature of contemporary families
What is death?
The cessation of life
What are attitudes towards death?
A reflection of today’s society
How are attitudes towards death disseminated in todays society?
mass media literature music visual arts formal death education AIDS quilt
How are we removed from the concept of death?
euphemisms isolation of process of dying technologies institutions by the media
How are attitudes towards death reflected?
Through humour and language
What are some factors that have affected attitudes towards death?
We have an aging population-more old people than young
The process of dying has been prolonged
The nuclear age is rising
The dying have rights-psychology of entitlement
What are the benefits of death education?
Learning bout death and dying helps to identify attitudes and bahaviours to confront mortality in OUR OWN WAY.
It Allows for people to make choices rather than to conform (hospices and pastoral care)
Make a statement about death attitudes and culture.
No matter what culture, death attitudes represent an effort to RATIONALIZE death
Where do you see belief in afterlife?
In societies that believe in myth
What are some common themes of myths?
Death is out of person’s control
There is a sense that you can fix or change things before death
Mortality is recognized
What sort of services could the dead provide for the living?
Can communicate with dead through shamans
The dead are role models for the living
The dead are the link between the living and the gods
Discuss names and death in different cultures.
Some cultures practice name avoidance where the name of a dead person will never be mentioned or if a living person has the same name as the dead they must change their name
Other cultures practice name admiration and name their children after the dead
What are the domains of death?
Natural
Socioeconomic
Psychosocial
How was death handled until the 6th Century?
People were pagans so everyone was buried together in charnel houses
How was death handled in 12th century?
People started to think about the concept of death and become aware of their own mortality.
Wills were testament to the dead not disposition of wealth.
How as death handled in the 17th century?
Big shift. Survivors started to be allowed to express emotion so ceremonies began to help them, along with tombstones. The state and the church became equal instead of church being more powerful. Death began to be romanticized and lots of art was made surrounding it.
How as death handled in the 19th century?
Others death overshadowed one’s own (?)
How as death handled in the 20th century?
Death became taboo, you weren’t supposed to show your emotions and children were left out of the grieving process.
Death was moved to hospitals instead of at home where a lot of opioids were used to spare dying from any pain as they did not have antibiotics yet and did not know what was really going on.
What are the functions of religion when it comes to death?
It is meant to relieve anxiety of death, this could mean through religious activities and rituals. However, activities and beliefs surrounding death could create some anxiety themselves because they are to unite the group through a common concern. This secondary anxiety is removed through group rituals.
What do all religions have in common when it comes to their beliefs surrounding death?
There is always some form of judgement involved in the process of the afterlife.
Discuss Judaism and the afterlife.
Some Jews believe in the afterlife and some don’t. They believe that death is the curse of Adam and Eve and that the body will rise from the dead at the end of time. The decisions you make in life are more about the affect on the survival of the community and Israel than about yourself.
Discuss Christianity and the afterlife.
They believe in dualism which is the existence of the body and the soul. Your soul will be judged at the moment of death and you will either go to heaven, hell, or limbo/purgatory. The foundation of Christianity is life, death, and resurrection.
Discuss Islam and the afterlife.
Muslims are fundamentalists meaning they believe and emphasize religious identity in ALL aspects of life. God will judge you after you die and he is believed to be just and compassionate
Discuss Hinduism and the afterlife.
Hindus believe in multiple gods, reincarnation, and transmigration. After death, the soul is absorbed into the oversoul. If you are being punished after death, your soul will not be absorbed into the oversoul and you will not have the chance to reincarnate. Your past souls determines your present living soul. Hindus believe that you must be free of selfhood.
Discuss Buddhism and the afterlife.
Buddhists do not believe in a soul. The goal for Buddhists is to reach Nirvana which is a state of peace that is free from the miseries of existence. There are two types of death; continuous and regular. Your last thought while dying will determine your next incarnation so they have guides that will read scripture to them while they die so their last thought it a pure and religious one.
Discuss the Greeks and the afterlife.
The afterlife and the afterworld were not pleasant for the Greeks. They were more preoccupied with the survival of the community and the moral responsibility of being a citizen than death. They believed that immortality could be reached through certain religious cults and their practices. Pythagoras believed that life determined the fate of the soul at death. Socrates believed that your soul survives after you die. Plato believed that death is universal and is meant to keep the living good.
Discuss Secularism and the afterlife.
Secularists don’t believe in an afterlife. They believe in positivism which is a faith in science and empiricism. They are also humanitarians which means they value human being not the supernatural or gods. They also believe that immortality is in the brotherhood of man and children are a continuation and this such life.
Discuss Temporalism and the afterlife.
There is no afterlife, death is the end. They are present-oriented meaning they focus on the survivors. Immortality can be seen through offspring and social relationships.
What are some purposes of funerals?
They provide the survivors with a forum for expression
It causes the survivors to confront the death and move on
There is a need to respond to a death, this solves that need
It serves as a notification of death to elicit support for survivors
It emphasizes segregation and integration
It involves mental processes of what has to be done and physical processes of carrying out the funeral which can help with the process of grief
What are some critiques of funerals?
commercial conspicuous dignity is lost funeral directors are tradesmen euphemistic they are not optional
When did embalming start?
It began during the civil war
How did funeral parlours start?
With smaller houses and urbanization
How much does a funeral cost and how much could it cost?
5000-6000 for very basic Canadian funeral. Could cost as little as 800
What are some beliefs surrounding NDEs
Human personalities exist after death and that they are response to the stress of facing death
How do people describe NDEs?
Voice telling you your'e going to die Acute and heightened senses Out of body experiences Sense of calm Tunnel with light at the end that is drawing you in Flashbacks/life review Greeted by loved ones Realization of return Pain on return Conversion
What are the core elements of NDEs?
Being told about your death
Sense of body departure
Seeing loved ones
Realization of return
What are some theories to explain NDEs?
Endorphin release Massive cortical disinhibition Drugs Sensory Deprivation Archetypes
How was research done on NDEs in the past and how is it done now?
Earlier research was psychoanalytical now it is parapsychological.
What are the different types of theories?
Task-based theories
Stage (Phase) Theories
Intervention Theories
Who are task based theories for?
They emphasize with the people who are dying
What are the 4 sections of tasks?
Physical, Psychological, Social, Spiritual
List what must be done for each task.
Physical
satisfy dying body’s needs
minimize distress following your values
Psychological
Maximize psychological security, autonomy, and richness
Social
sustain/enhance interpersonal relationships
address social implication of death
Spiritual
identify, develop, reaffirm spiritual energy
foster hope
What type of theory is Doka’s? What are her phases?
This is a task-based theory
Prediagnostic (just living your regular life and what you do to prevent death)
Acute (when you get diagnosed)
Chronic (what you’re doing when you’re living with disease)
Recovery (what happens when you recover)
Terminal (when you find out that you will definitely die)
What are stage/phase theories? Who are they for?
They are for both those who survive and those who are dying. Stages blend together, they are NOT successive. Not all of them have to occur. The intensity and the duration of the stage varies from person to person. There is no empirical data, only anecdotal.
What are Kubler-Ross’ phases?
Denial and Isolation Anger Bargaining Depression Acceptance
What happens in the Denial phase?
Initial reaction is numbness then denial. Denial/partial denial is used by almost all patients at different stages. KR believe is a healthy response to pain. It gives them time for collection and mobilization of defence mechanisms. Anxious denial is experienced by those who are notified prematurely by someone they do not know, where their readiness was not taken into account. It is easier to deal with if the death is far away. Usually they will briefly discuss then change the subject. They will eventually talk. Maintained denial until the end is very rare.
What happens in the Anger phase?
This is when denial can no longer be maintained. It is righteous anger and can be displaced in all directions and projected onto all things. It will reduce if the patient is respected, understood, and given attention. You need to have tolerance and not take it personally.
What happens in the Bargaining phase?
Bargaining occurs if there is denial in the first stage and anger towards everyone (including god) in the second stage. It is an attempt to postpone. Includes a prize, deadline, and a promise to never ask for anything more. They wish for life, then life without pain. This is done with some quiet guilt especially if they were angry at god before. You should ask about their sources of guilt and their comments should not be pushed aside.
What happens in the Depression phase?
It is a physical condition. The patient will become very weak. The discrepancy between their wishes and the expectation of those around them causes the greatest grief and turmoil. It is a preparatory grief. Let them feel what they want to feel, trying to cheer up is an expression of what you want and not what the patient wants. You should encourage a state of acceptance.
What happens in the Acceptance phase?
If other stages are worked through, acceptance will occur. It should not be mistaken for happiness. It is usually void of feels. At this point their communication is nonverbal and might just want to sit in silence with a loved one while receiving confirmation that they will be there when they die and they will not die alone. Family may need support at this stage.
What is a critique of stage theories?
There is not a model that links determinants with reactions in order to help predict and determine intervention guidelines.
Who are Intervention theories for and what are they?
They are for the survivors to help with their grief.
What type of theory is Bugen’s. What does it have to do with?
It is an intervention theory and has to do with the relationship between centrality (intensity) and preventability (time) and techniques for survivors to cope with death.
What will central and preventable be?
intense and prolonged
central and unpreventable?
intense and brief
peripheral and preventable?
mild and prolonged
peripheral and unpreventable
mild and brief
Discuss centrality
Closeness of relationship is directly linked to the intensity of the grief reaction. etc so if closer feel more.
Discuss preventability
It has to do with whether mourner BELIEVES if it could be preventable or unpreventable, not about reality. It directly relates to the duration of grief. Guilt is felt as they feel like they somehow contributed to the death by not doing anything when it was preventable. They will grieve themselves or parts of their self. When they believe it was unpreventable they usually see the control as being outside of the realm of humans.
Discuss prolonged reactions
Usually beyond 6 month period by persistence of diseases or other physical conditions. They can’t separate themselves from the diseased and might form connections with memorabilia. They cannot find new or re-establish old reward patterns.
What are some techniques involved with centrality
Centrality is intensity. Need to detach mourner, forget the pain, and reconstruct new patterns.
Techniques involved with preventability.
Preventability is length. It is a belief structure that this was preventable so you must recognize and come up with strategies to shift this to a belief structure of the death being unpreventable. Rational Emotive Therapy will rid irrational belief and catastrophic thinking with the right patient but could be destructive for the wrong patient. Must rid negative self talk.
Discuss amount of fear of death throughout life?
Age will change attitudes towards death.
Fear is high when young, peaks at middle age, is lowest when elderly. Death is acceptable in older age except when is in chosen.
What is grief?
A personal’s total emotional response to loss.
What is the typical duration of the most intense grief?
4-6 wks
What is a sign of unresolved grief?
Physical symptoms and depression
What are the tasks of grief?
1) letting go and accepting loss
2) adjusting to new life
3) forming new relationships
What are some symptoms of grief?
1) somatic disturbances
2) disorganized perception (heightened and increased)
3) guilt and anger
4) denial
Discuss Attachment Theory and grief
If the person was a love object, libido will withdraw but eventually it detaches and the ego will become free
There is a psychosocial transition that requires space and attention
Acute grief is a definite syndrome
Kinds of stress
Impact of close person
Acute grief
Mourning
Loss of self-esteem
Techniques for grief
The 3 R’s
Remembering the past
Redefining the present
Recreating the future
What are Bowlby’s Phases of mourning?
1) Shock-Numbness
2) Yearning-Searching
3) Disorganization-Despair
4) Reorganization
What are Rando’s Processes of Mourning?
The 6 R’s (like for Rando)
1) RECOGNIZE loss
2) REACT to Separation-experience the pain
3) RECOLLECT-re-experience deceased person and relationship
4) RELINQUISH-attachments and assumptive world
5) READJUST-to be able to adapt in new world without forgetting the old
6) REINVEST
What do parents feel with the death of a child?
Like they have failed, they feel guilty, or overwhelmed
For an adult child this might mean a lack of support in the future, the possibility of having grandchildren, and survivors guilt
What could a child represent to a parent?
their self past generations genes of the past source of love burden worst parts of self
What they represent to the parent will decide their sense of grief
What are the possible patterns of interactions?
Closed Awareness
Suspected Awareness
Mutual Pretence
Open Awareness
What are the factors that influence the sense of grief of a spouse?
Sexuality-problems with spouse’s family if not accepted, dependent on legal and social sanctions
Patterns of Interaction
Age-relief in long term care, younger more distress more likely for drug us
Gender-traditional roles make it difficult to adjust to the opposite, widowers have more adverse affect and are less likely to seek help
Social Support
Discuss what an adult might feel about death of a parent.
It is the final developmental stage in the life cycle. If parent is estranged a lot might pop up suddenly. Death of primary giver is hardest due to essential nature of role.
What are some types of care and what do they entail?
Domilicary Care-someone come into your home
Nursing Facilities-Grandma’s place now in Cambridge
Day Hospitals-maintenance and counselling
Congregate Housing-grandma’s first place in Cambridge
What is Institutionalization Neurosis?
It is a loss of identity or uniqueness as dependence increases in institutions. Family must know that sometimes institutionalization is necessary and does not mean they failed.
