MODULE 2

Question 1

Describe the trends in death and dying in Canada

Answer 1

Increased life expectancy means people expect to live into old age

Increased life expectancy, smaller family sizes, and changes in family living arrangements means family is not always available/able/willing to care for people who are dying

Medical advancements are available to treat many conditions- but with what quality of life?
Do we have dignity, quality, and empowerment in death?

Question 2

2) What are the two leading causes of death in Canada?

Answer 2

1. CANCER
2. HEART DISEASE

Question 3

3) What are the four end-of-life trajectories?

Answer 3

Sudden death
Terminal illness
Organ failure
Frailty

Question 4

Causes may include: accidents, crimes, toxins, heart failure, brain aneurysm

Answer 4

Sudden Death Trajectory

Question 5

Little or no health care resources needed, little or no time spent with health care providers (only 1% spent time in hospital)

Answer 5

Sudden Death Trajectory

Question 6

Sudden decline to the point of death; little or no warning or preparation; more independent at time of death

Answer 6

Sudden Death Trajectory

Question 7

Typical profile: younger (<75 years), often male

Answer 7

Sudden Death Trajectory

Question 8

Tend to have more interaction with health care workers, particularly in the last year and a half of life; more inpatient care

Answer 8

Terminal Illness Death Trajectory

Question 9

Person may live at a baseline, and then experience a rapid and/or steady progression towards the end of life

Answer 9

Terminal Illness Death Trajectory

Question 10

Drastic declines typical in last 3 months of life, including increased fatigue, functional dependence, mood changes, weight loss, loneliness, perceptions of poor social support

Answer 10

Terminal Illness

Question 11

Typical profile: younger (age 65-75)
Causes may include: Cancer

Answer 11

Terminal Illness

Question 12

Decline with some variability over time; gradual over time, but includes some acute episodic losses of function as the person declines

Answer 12

Organ Failure

Question 13

Often have many interactions with health care workers; health care costs are greater than any other group

Answer 13

Organ Failure

Question 14

Expect to see some rapid declines in the last three months of life

Answer 14

Organ Failure

Question 15

Terminal phase can be unpredictable, can still show fluctuations, may require more support to the individual and care partners

Answer 15

Organ Failure

Question 16

Causes may include: COPD, heart failure, liver failure

Answer 16

Organ Failure

Question 17

Typical profile: tend to be older population (>80 years)

Answer 17

Frailty

Question 18

Tend to have fewer health care interactions compared to other death trajectories; may have interactions for other reasons, but not for palliative reasons

Answer 18

Frailty

Question 19

Slow cognitive, functional, health decline

Answer 19

Frailty

Question 20

Causes may include: Dementia, Parkinson’s Disease

Answer 20

Frailty

Question 21

What is Death- Denying Culture?

Answer 21

Death and dying have largely become invisible

Death, which used to be normalized, is now a social taboo.

Conversations are discouraged; euphemisms often used; death segregated to institutions; caregiving handed to “professionals”
“passed on”; “a better place”; “the other side”

Question 22

Death is regularly used within media to advance plots or for entertainment value

Answer 22

Death Fascination

Question 23

For many, the primary exposure to death is now on mass media; by age 16, the average American has seen 18,000 murders on television (Durkin, 2003)

Cartoons feature 20-25 violent acts per hour, some with the death of characters (Durkin, 2003)

Coverage of wars, terrorist attacks, and deaths of popular celebrities are often television on round-the-clock news channels

Answer 23

Death Fascination

Question 24

Touring places which involve/involved death, accidents, or tragedy

Answer 24

Dark Tourism

Question 25

Current or former warzones; locations of mass murder; past prison locations; graveyards; wax museums; ghost tours; memorials

Answer 25

Dark Tourism

Question 26

Makes light of topics which are typically taboo to address

Answer 26

Dark Humour

Question 27

May include humour about death and dying, but might also include humour about topics which are stigmatized or painful to talk about

Answer 27

Dark Humour

Question 28

Can be used by front-line health care providers and first responders as a coping mechanism to deal with the degree of distressing content they are exposed to; can also be used by groups who are oppressed to take power over these topics

Answer 28

Dark Humour