Topic 14: death + dying Flashcards
5 Stages of dying
1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance
Describe denial
- Shock to learn they’re dying
- Then cannot conceive own death
- Denial + isolation = common responses
Describe anger
- Denial is substituted by rage/envy/resentment
- ‘Why me?’
- Healthcare professionals = target of anger
Describe bargaining
- Not experienced by all dying people
- Dying people negotiate
- Postponed = reward of good behavior
Describe depression
- Develop sense of great loss = depression
- Identity crisis e.g. woman + uterus cancer = no longer a woman
- Depressed due to loss of family
Describe acceptance
- Find peace
- Pain over = struggle over
- Family needs more support than patient this stage
Describe home deaths
- Traditional place to die
- Lots of people feel more comfortable
- Great pressure on informal carers = emotional strain + life restricted
Describe hospital death
- Majority of deaths
- Medicalized death
- Death becomes pathologies = try save patient even when dying
Describe hospice death
- Holistic care + interdisciplinary teams
Describe bereavement
- Sudden death is more difficult
- Terminal illness = more mourning time
Stages of mourning
- Short period of shock
- A period of intense mourning
- Re-established socially + physiologically
What is the role of funerals?
- Contexts of expressing intense feelings
- Offer the living a framework to understand death
- Complete a cycle = nothing pending
- Linked to place of burial = place of reference with dead
Define biological + social death
- Biological = end of life
- Social = person no longer capable of mastering own life = rely on others to act on their behalf = brain injured + coma + brain death
Describe the changes in perception of death
- Michael bury 1997 = death feared
- Death privatized
- Death exposure declined = death not observed in public = people afraid of death
- Scientific understanding of death in modern societies
- Decline in importance of sacred death experience
Describe medicalization
- Leads to cultural iatrogenesis
- Biomedicine undermines peoples ability to manage own health + ability to cope with pain + suffering + death
- Dying is presented as a disease = curable = over-treatment + heroic medicine
Glaser + Strauss 4 forms of awareness contexts
1) Closed = staff knows but patient doesn’t
2) Suspicion awareness = staff acts in ways where they don’t address it but patient recognizes
3) Mutual pretense = both pretend nothing is wrong
4) Open awareness = patient informed = emotional commitment by staff = associated with good death
Kellehear’s idea of good death
- Open awareness
- Dying person closes pending issues
5 FEATURES:
1) Awareness of dying = patient + family + staff know
2) Personal preparations + social adjustments = Settle emotional accounts + family disputes
3) Public preparations = settle practical accounts = wills
4) Relinquishing formal work roles = withdrawal from jobs
5) Formal/informal farewells
