Psychology - Death Flashcards

1
Q

Compared to the non-bereaved, bereaved people have

A

Higher mortality after the loss of a spouse (elderly)
Higher levels of morbidity and mortality (elderly)
Increased risk of accidents
Increased physical and emotional problems - aches and pains, disturbed sleep, panic attacks, depression
Higher suicide rates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Loss

A

We experience loss when a person we are attached to becomes permanently unavailable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Grief

A

The human reaction to loss. Acute – integrated – complicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Bereavement

A

The psychological processes through which people adapt to loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Normal grief reactions can be …

A

Physical
Emotional
Behavioural
Cognitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do 85% of bereaved people do

A

Adapt to a new reality without the deceased by the 2nd year of bereavement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Physical grief response - normal

A
Fatigue 
Sleep disturbances 
Appetite changes 
Aches and pains 
SOB
Palpitations 
Restlessness 
Illness vulnerability 
Digestive problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Emotional grief responses - normal

A
Depression 
Anxiety 
Anger 
Guilt 
Priming/ yearning 
Lineliness 
Sense of detachment 
Helplessness 
Numbness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Behavioural grief responses - normal

A
Crying 
Irritability 
Restlessness 
Searching 
Social withdrawal 
Difficulty in fulfilling normal roles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cognitive repsones in normal grief

A
Poor conc
Short attention span 
Memory loss 
Confusion 
Preoccupation 
Search for meaning 
Hallucinations 
Disturbances of identity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does the duration and severity of someones grief depend on

A

1) How attached they were to the diseased person
2) The circumstances of the death (for example was it a sudden, traumatic or unexplained death; was it the death of child)
3) The amount of time to work through anticipatory mourning
4) Previous unresolved losses that the bereaved person might have experienced that can interfere with the process of normal grief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anticipatory mourning

A

That is the grief some people go through when they expect the death of someone such as a person with a terminal illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Theoretical approaches to grief

A

Phase model
Grief work
Dual-process model

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Phases of Grief (Bowlby, 1980)

A

Initial period of shock, disbelief and denial
Acute grief
Integrated grief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acute grief

A

Intermediate acute mourning period of physical and emotional discomfort, yearning and mourning, social withdrawal.
Impact of loss is registered cognitively and emotionally.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Integrated grief

A

Gradual shift to the ‘restitution’ phase when attention shifts back to reengaging with the world.
Adaptation and recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Basis for Phases of grief model

A

Grief is not a linear process with concrete stages but a fluid process with phases that are overlapping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Grief work model (Worden, 1991)

A

Describes the cognitive process of confronting the reality of a loss and adjusting to life with this loss
This process involves tasks of grief rather than stages. People who engage with these tasks, adapt better than those who don’t

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Tasks of grief

A

To accept reality of the loss
Experience the pain of loss
Adjust to new environment without the lost person
Reinvest in the new reality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does the Dual-Process model describe

A

How people cope with loss and to predict good versus poor adaptation to such a stressful life event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What was the Dual-Process model developed as

A

Direct response to the idea that we should do ‘grief work’ and go through grief stages before we are able to reengage with the world.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Loss orientated vs restoration orientated

A

Loss-orientated focuses on confrontation of loss and restoration-orientated focuses on avoidance of loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Key element of Dual Process model

A

Oscillation
Coping with bereavement according to this model is a complex process that combines confrontation and avoidance, and oscillation is vital for adaptive coping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What may pathological grief result from

A

Complete lack of oscillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Best model for understanding grief process
Dual-process model
26
How do children express grief
Feeling of sadness – on and off – over a long period of time Fear of being alone Anger, boisterous play, nightmares, irritability, bed-wetting Regression to earlier developmental stages – acting younger than their age, needing more attention, unreasonable demands When extreme and long lasting, some of these responses indicate poor coping and may require psychological support
27
Key protective factor for good adjustment in bereaved children
Open and timely communication about death
28
Time period for normal grief
Adaption and integration over time 6 months
29
Physical responses - complicated grief
Digestive issues Fatigue Depressions
30
Cognitive responses - complicated grief
``` Constantly ruminating on death Emptiness Hallucinations of the deceased Suicidal ideation Thinking about the person Self-blame Desire to be with deceased ```
31
Emotional response - complicated grief
Intense sadness Intense distress Loneliness Anger
32
Behavioural responses -complicated grief
``` Withdrawn Not functioning Unable to work Avoid reminders of loss Lack of social engagement ```
33
Diagnosing complicated grief
Unshakeable grief that does not improve over time Experience persistent and intense emotions or moods & usual, severe symptoms that impair major areas of functioning, or that cause extreme distress
34
How many people are affected by complicated grief
4% - translates to about 2.4 million current CG sufferers in the UK
35
CG prevalence in older people
4.8% in 55+ | 7% in 75-85
36
Associated condns with CG
Elevated rates of suicidal ideation and suicide attempts Increased incidence of cancer, htn and cardiac events after several years Immune disorders and dysfunction more frequent Increased adverse heath behaviours Higher health service use and higher sick leave rates
37
Types of complex grief
``` Chronic Delayed Disenfranchsied Compounded Anticipatory ```
38
Chronic grief
Grief that lasts for a prolonged or extended period
39
Delayed grief
Grief that has been postponed
40
Disenfranchised grief
Grief that may be seen as socially difficult to relate to or are negated by others
41
Compounded grief
Grief that occurs following multiple losses
42
Anticipatory grief
Grief that occurs prior to a known future loss
43
Persistent Complex Bereavement Disorders
PCBD Grief disorder for those who are significantly and functionally impaired by prolonged grief symptoms for at least one month after 6 months of bereavements
44
Normal grief as a ddx for PCBD
Persistent complex bereavement disorder usually lasts longer, however, interfering with the sufferer's functioning long after the death.
45
Depressive disorder as a ddx for PCBD
Persistent complex bereavement disorder shares features like sadness with major or persistent depressive disorder but this depressed mood is characterized by a focus on the loss.
46
PTSD as a ddx for PCBD
Individuals with post-traumatic stress disorder may suffer intrusive thoughts about a traumatic event, while those with persistent complex bereavement disorder may suffer thoughts about the deceased or the circumstances of their death.
47
Separation Anxiety Disorder as a ddx for PCBD
Separation anxiety disorder relates to separation from a living individual, whereas sufferers of persistent complex bereavement disorder experience anxiety when separated from the deceased
48
Pre-loss risk factors for CG
Pre-existing mental health problems or few adequate coping mechanisms Children and adolescents, young spouses and older people in long-term relationships Lack of knowledge and info about death Previous experience of trauma and loss or multiple stressors Conflict and difficult relationships between the person and the deceased
49
Risk factors for CG - who loss occurs
The loss is the result of violence, trauma or accident e.g. suicide, accident Others are unable to offer to offer support and comfort for whatever reason The person died from an inherited disease or suffered a long illness The death is associated with stigma, or shame e.g. AIDS
50
Post-loss risk factors for CG
Inadequate family or community supports or physical and emotional care Traumatic reminders, anniversaries, and other significant events Secondary stresses that seriously disrupt family functioning Further losses or bereavements
51
Barriers to seeking bereavement support linked to complicated grief
Seeking bereavement support appears to be difficult for older LGBT people in the UK The complexity of undisclosed relationships and -ve responses from faith communities can result in the bereavement of LGBT people not being acknowledged
52
Culturally sensitive bereavement support
Migrants in the UK may experience increased loneliness and social isolation following a death of a loved one. Loneliness exacerbated by previous experiences of upheavals in their lifetime such as migration, revolution, and unhappy marriages
53
Bereavement for people with Learning Disability
Assessment tool consists of 10 main questions with sub questions with 3 main areas of support - practical issues, social issues, emotional issues
54
Practical issues - bereavement for people with learning difficulties
Has this person’s ability to communicate with others been affected by this loss?
55
Social issues - bereavement for people with learning difficulties
What impact has this death had on the person’s familial network?
56
Emotional issues - bereavement for people with learning difficulties
Does this person recognise their emotions and can they express them?
57
Treating complicated grief
Combi of talking therapy and medications (SSRI) – cognitive restructuring, psychoeducation, CG-CBT, ACT Complicated grief group therapy Self-referrals – better outcomes
58
Organisations resources for grief
Cruse bereavement care
59
"End of Life"
Refers to last year of life
60
"Last days of life"
Usually refers to “active dying” phase and last days to 2 weeks of life
61
Legislation involving terminal illness
Individuals can refuse treatment where they have the capacity to do so, by they cannot compel a dr to provide interventions In England and Wales, it is a criminal offence to assist someone to commit suicide A death can be certified by a dr or may need referral to the coroner under particular circumstances e.g., sudden and unexpected, asbestos, exposure, following surgery
62
Benefits of talking about end of life
Person talking about dying and end of life preferences can help with acceptance
63
Psychosocial needs - terminal illness
Good interaction with hcp’s and the quality of professional Good quality of care systems and procedures (accessibility, rapidity of treatment and other interventions) Active involvement in treatment and healthcare decisions Quality info requirements and opportunities Involvement with social support networks Managing challenges to self-identify
64
Carers psychosocial needs - terminal illness
Carers played a crucial role, undertaking vital care work and emotion management Carer’s success in managing their own psychosocial needs impacts their ability to support the pt Carers often wanted to be alongside the pt in medical settings, and in receipt of info about treatments and care