Module 10 - Psychosocial Factors in Dying & Aging Flashcards
1
Q
What is death?
A
- Irreversible loss of circulation/respiration or irreversible loss of brain function or brain stem alone
2
Q
When is death considered premature?
A
- Before the age of 75
3
Q
Why is the dying process quite variable?
A
- The course and length of illness vary greatly from one disease to another
4
Q
What is futile care?
A
- Continuued provision of care or treatment to a paitent when there is a no reasonable hope of a cure or benefit
5
Q
What has a positive correlation with moral distress among ICU nurses?
A
- Futile medical care
6
Q
What is palliative care?
A
Intended to:
- Reduce pain & Discomfort
- Improve quality of life
of patient with chronic illness
7
Q
What is the standard form of care in nursing home?
A
- Palliative Care
8
Q
What is hospice palliative care?
A
- Relief of suffering from terminal illness
9
Q
What is palliative care desinged to provide?
A
- Warm, personal comfort at the end of life
10
Q
When does palliative care begin?
A
- When treatment of the disease is stopped
11
Q
What is discountinued during palliative care?
A
- Invasive treatments
12
Q
What are some key goals of palliative care?
A
- Psychological comfort
- Increase social support
13
Q
Why might palliative care extend beyond a person’s death?
A
- To assist in bereavement
14
Q
Where might hospice care occur?
A
- palliative care units of hospitals
- Freestanding hospices
- Homes
15
Q
What is home care accompanied by?
A
- Improved personal control and availability of support
16
Q
Why might home care be problematic?
A
- For family members
17
Q
What often goes unaccommodated in Canadian Hospitals?
A
- Indigenous culture and specific traditions related to death and dying
18
Q
What has palliative care been associated with?
A
- Lower Pain
- Improved Quality of Life
- Lower Anxiety and Depression
- Reduction in Disease Symptomology
- PRolonged Survival
19
Q
What are Avery Weisman’s goals for medical staff working with dying patients?
A
- Informed Consent
- Safe Conduct
- Significant Survival
- Anticipatory Grief
- Timely and “appropriate death”
20
Q
Why is terminal care often more difficult for medical staff and formal care providers?
A
- Emotionally draining
- Unpleasant custodial work
- Not curative care
- Less interesting / stimulating
21
Q
What is physician assisted suicide?
A
- Physician knowingly and intentionally provides person with knowledge and/or means required to end their life
22
Q
What does physician assisted suicide include?
A
- Counselling about lethal doses
- Prescribing lethal drugs
- Supplying lethal drugs
23
Q
What did the supreme court of Canada rule in 2015?
A
- Canadians have right to assisted suicide
24
Q
What did Bill C-14 restrict in 2016?
A
- Medical assistance in dying to mentally competent adults who have incurable disease
25
What happened in Quebec in 2019 about assisted dying?
- Ruled restrincting MAiD to people with foreseable death is unconstinutional
26
What happened in 2020 regarding assisted suicide?
- Online survey seeking feedback from Canadians about it
27
What happened after the 2020 survey on assisted suicide in Canada?
- Bill C-7 was introduced
28
What did Bill C-7 do?
- Expanded MAiD access
- Removing the requirement that death is foreseable
29
What are the 2 safeguards for non-foreseeable deaths to get MAiD?
- 90-day waiting period in most cases
- Consultation with one physician who has expertise in the person's condition
30
Can mental illness be the sole underlying condition for MAiD?
- Only after two years
31
What are some of the concerns and criticism of physician-assisted suicide?
- Incompatibility with care provider's ethics
- Errors in diagnosis or prognoses
- Coercion by family members or physicians
- Suicide contagion effect
- Impact on disabled people
- Disproportionate impacts on vulnerable groups
32
What was the biggest cause of people requesting physician assisted suicide in Canada?
- Decreased ability to participate in activities that made life enjoyable
- Loss of Autonomy
33
What were the highest risks of suicide?
- Traumatic Brain Injuries
- Sleep Disorders
- HIV/AIDS
34
What is the Stages of Dying?
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
35
Explain the Denial Stage of Dying
- Lack of belief or acceptance
36
Explain the Anger Stage of Dying
- Expressed toward those who are closest
37
Explain the Bargaining Stage of Dying
- Negotiation for more time or longer life
38
Explain the Depression Stage of Dying
- Despair over the recognition of mortality
39
Explain the Acceptance Stage of Dying
- Mortality and future embraced
40
What is the principal coping mechanism people use during the terminal phase of dying?
- Denial
41
What is death acceptance?
- Giving in and realizing of the inevitability of death
42
Is death acceptance happy or sad?
- Neither, sometimes void of feelings
43
What happens after death acceptance?
- No longer in denial
- Neither depressed nor angry
44
What does death denial often involve?
- Denying death and minimizing prognosis
- Simultaneously making plans for death
45
What does death denial do?
- Prevents us from being overwhelmed by the terror of death
46
What did Weisman propose as 4 requirements for the dying patients?
- Reduced conflcits
- Compatibility with ego ideal
- Continuity of relationships preserved/restored
- Fulfillment of prevailing wish(es)
47
What psychological factors and goals become more salient as an individual approaches death?
- Regrets
- Wishes and Goals
- Reminiscence
- Generativity
- Symbolic Immortality
- One's LEgacy
- Existential Reflection
- Spirituality / Religiosity
48
What is reminiscnence?
- Process of recollecting one's past experience & life events
- Spontaneous
49
What is a Life Review?
- Return of memories/past conflicts at end of life
- Spontaneous or structured evaluation/reconciliation of one's life
50
What is a Guided Autobiography?
- Reconstructing the past and integrating it with the present
- Systematic
51
What is Symbolic Immortality?
- Sense of leaving behind a legacy
- Passing along wisdom to next generation
52
What might symbolic immortality involve?
- raising a child
- Starting an organization
- Volunteering
- Sharing Wisdom
53
What is Generativity?
- Concern for establishing and guiding next generation
54
What is Religiosity?
- Personal involvement in and commitment to organized religion
55
What is spirituality?
- Personal quest for understanding answers to ultimate quesitons about life, meaning, and relationship to sacred or transcendent
56
Explain Finding Acceptance
- Sources of meaning and purpose at end of life can help dying individuals reach death acceptance
57
What is death acceptance related to?
- Well-being and quality of life
58
What is death anxiety?
- Worry
- Dread
- Terror over the prospect and process of dying
59
Why might older adults think more about death than middle-aged adults yet fear death less?
- More experience with loss/death
- Lived long life and accepting death is natural
60
Who is more likely to fear death: young or old adults?
- Young
61
Who is more likely to fear the dying process: Young or old adults?
- Old adults
62
What is bereavement?
- Period of suffering a loss through death
63
What is Grief?
- Intense sadness and emotional pain caused by the death of a loved one
64
What is mourning?
- Refers to public display of grief
65
What is the Survivor's Acceptance?
- Accepting relaity that our loved one is physically gone and this new reality is permanent
66
What does survivor acceptance involve? what does it not involve?
Involve
- Learning to live with new reality and pain
Not Involve
- Being Okay with what has happened
67
What is integrated grief?
- Lasting form of grief
- Loss-related feelings, behaviours are integrated into persons ongoing function
68
What is complicated grief?
- Griving process does not progress as expected
69
What are the typical symptoms of complicated grief?
- Prolonged acute grief w/ intense sorrow
- Frequent troubling thoughts about death
- Excessive avoidance of reminders of loss
70
What is prolonged grief disorder (DSM-5-TR)?
- Peristent grief following death of loved one
71
What happens in Prolonged grief disorder?
- Longing for deceased
- Preoccupation with deceased for 12 months following the loss
72
What is Prolonged Grief Disorder accompanied by?
- Distress
- Additional emotional/social challenges
73
What is grieving for each person?
- Personal and unique
74
What are some emotions that are experienced in loss?
- Sorrow
- Anguish
- Depression
- Bitterness
- Anger
- Rage
- Regret
- Self-blame
- Guilt
- Loneliness
- Pessimism
- Hopelessness
- Despair
- Confusion
- Emptiness
- Numbness
- Fatigue
- Lack of Motivation
- Low Self-esteem
- Alienation
- Loss of meaning
- Loss of purpose
75
What is the most common experience following a trauma or loss?
- Resilience
76
what are some trajectories based on depressive symptoms following spousal grieving?
- Common Grief
- Chronic Grief
- Chronic Depression
- Depression-improved
- Resilient
77
What is the predominant risk factor for most diseases and illnesses that significantly compromise health, reduce life expectacny, most leading causes of death?
- Aging
78
What are the most frequently reported health issues for those over the age of 65?
- Arthritis
- Hypertension
- Cataracts
- Back Pain
- Heart Disease
79
What is the most common cause of death for older Canadians?
- Cancer
80
After the age of 85, what is the most common cause of death?
- heart disease
81
Despite living longer than men, what do women experience more than men?
- Higher rates of disability
- Poor health
82
What is Frailty?
- Disease that only occurs in old age
83
What is frailty often characterized by?
- Decline in ability to respond and adapt to stress.
- Loss in physical reserves
- Greater impact of illness or disease
- Increased likelihood of fall/serious injury
- Mobility issues
- Greater chance of being hospitalized
84
What are the key factors found to prevent physical and cognitive decline?
- Increasing physical activity and exercise
- Increasing cognitive activity
- Stress reduction
- Social activity
- Healthy diet
85
What was found to improve brain health among older adults with mild cognitive impairments?
- Aerobic training
86
What did a study find about combining exercise and cognitive training?
- Amplify the benefits of both for the brain
87
What kind of stressors are older adults less likely to report?
- Work
- Finances
- Family
88
What stressors are older adults more likely to report?
- Illness
89
What are common sources of stress in old age?
- Illness
- Problems with sexual health/performance
- Increasing social loss
- Retirement
90
What appears to decrease with age?
- Perceived control
91
Why do older adults appear to do better than younger ones?
- Cope more effectively with stress
- Regulate their emotions better
- Use more complex problem-solving strategies
92
What is well-being in old age largely dependent on?
- Healthy social network
- Meaningful social connection
93
What can loneliness do in older age?
- Increase
94
Why does loneliness increase in older age?
- Social losses
- Physical/cognitive decline
95
What is successful aging?
- Positive perspective on aging
96
What does successful aging entail?
- Prosperous achievment of something attempted
- Attainment of object according to one's desire
97
How do adults define succesful aging?
- Physical activity
- Income
- Health
- Social Interactions
- Sense of Purpose
- Self-Acceptance
- Personal Growth
- Autonomy
- Environmental Mastery
98
How do adults define life satisfaction?
- Phyiscal Activity
- Income
- Health
- Social Interactions
99
What is a precursor to successful aging?
- Social Interaction
100
How does the medical perspective describe successful aging?
- Optimizing life expectancy
- Minimizing physical / psych. / social morbidity
101
What is compression of morbidity into a shorter, later time period mean?
- Experiencing illness and disease for the shortest period of time possible
102
What does the Biopsychosocial Perspective of Aging Well describe as 3 fundamental factors?
- Avoiding Disease & Disability
- Active Engagement with Life
- High Cognitive & Physical Function
103
How does lifespan perspective explain successful aging?
- Maximizing positive outcomes and minimizing negative ones
104
What is selective optimization with compensation?
- Compensating for loss of abilities by engaging in new strategies
- Optimizing existing abilities through practice and technology
105
How can disengaging from unattainable goals be positive?
In old age:
- adaptive
- avoid goal failure
106
What can buffer the difficulties with goal disengagement?
- Goal Reengagement
107
What might be a flexible indicator of success in old age?
- Wisdom
108
What is Wisdom?
- Coordination of knowledge and experience to improve well-being
109
Based on the socio-emotional selectivity theory what is successful aging?
- Redirected focus on what matters most in life
110
What are some predictors of successful aging?
- Physical functioning
- Social support/social resources
- Happiness/satisfaction with life
- Emotional security
- Financial Status
- Purpose in life/personal meaning
- Spirituality/inner peace
- Participation in religious activities
111
What are telomeres?
- Regions of repetitive nucleotide sequences at the end of chromosomes
112
What do Telomeres do?
- Protect the end of chromosomes from deterioration/fusion with neighbouring chromosomes
113
What happens to telomeres as cells divide?
- They get shorter
114
What happens indexed by shorter telomeres at the end of chromosomes?
- Accelerated cell aging
115
What do shorter telomeres contribute to?
- Manifestation of aging
- Limit human lifespan
116
How are stress and aging related?
- Increased stress leads to decrease in telomere length
117
What has been found to mitigate the effects of stress on aging?
- Consistent exercise
118
