Week 11 Flashcards
- _______ is the one certainty in life
- What did Cicero say?
- T/F: death is viewed as a close event in older people
- death
- to learn to die is the aim of philosophy
- F. it is viewed as a distant event even in old age
- What is biological vs social death?
- T/F: social death begins much earlier than physical death
- bio = how the body will physically decline with age
social = assuming the frail very old person is not part of society anymore. the perception or behaviour of others that indicates they view or treat a person as if physically dead when the physical body has not yet died - T.
- most people who die at old age from the time the disease seems out of control is a (slow or fast) trajectory. What does this indicate?
- What is the most common cause of death for older people?
- slow. means we need a diff type of care to treat them
- malignant neoplasms = a cancerous tumour
- what is a slow trajectory of death?
- What is a short trajectory of death?
- means a long and possibly painful time that people are aware of death in the near future. There must be palliative care for these people
- takes place at a home or hospital
- what is palliative care?
- What is the goal of palliative care?
- What model is this care part of? Why is this a problem
- providing relief from the symptoms, pain, physical, mental and social distress of a terminal diagnosis
- to improve quality of life for both patient and family
- medical model. too much focus on pain and other physical symptoms and signs. A Wholistic approach needs to be adopted
Explain a good death for each below:
What?
How?
Where?
With whom?
When?
Why?
What? = heart attach, natural death
How? = quick, painless
Where? = at home, in bed
With whom? = loved ones
When? = during old age, timely, prepared
Why? = meaningful, expected, accepted
explain a bad death for each below:
What?
How?
Where?
With whom?
When?
Why?
What? = cancer, AIDS, ALS, alzeimers
How? = slow, agonizing, without dignity
Where? = in hospital, intensive care unit
With whom? = alone/strangers
When? = very old age, untimely, unprepared
Why? = meaningless, senseless
- Why are deaths in hospitals or long term care facilities an issue?
- deaths are very ___________
- expensive, focus on keeping the person alive rather than improving quality of life, against aging in place (at home= better quality) philosophy
- medicalized
- The type of disease is a factor for the ________ of death. Explain this.
- T/F: older people have the greatest fear of death than other age groups
- location. Ex: cancer = home, dementia = nursing home/hospital
- F. result is mixed. Older people do not think about death more than young people because they know they will die, but their focus is on living
- What are the 5 stages of psychological reactions to dying?
- T/F: these stages are fixed
- denial
anger
bargaining
depression
acceptance - F. you can skip, go back and forth or overlap stages
define each:
grief =
mourning =
bereavement =
grief = sense of deep sorrow after a loss
mourning = expression of grief in public
bereavement = state of having recently experienced grief; complex and personal can start before death, sometimes never ends but decreases in intensity, become physical
T/F: bereavement only starts after death
T/F: bereavement is strictly a mental decline
F. can start before
F. can become physical
- What is maladaptive grief?
- What are the 3 types?
- a crippling disorder brought on by complicated grief and has to do with your thoughts and actions following a significant loss. Most often, these are disabling, constant thoughts and destructive behaviours that affect your overall wellbeing.
- anticipatory = Grief starts before and in anticipation of the death.Common in partners of older adults with a fatal disease
disenfranchised = grieving for Michael Jackson, but you have never met him- something that society causes. Deemed illegitimate and therefore unacknowledged. insignificant relationship between the grieving person and the deceased
complicated = Long and severe.
Inability of recovering and resuming their life
T/F: some losses can be a relief
T. for women in unpleasant marriages, long and stressful period of caregiving
What are 4 emerging ethical issues involving end of life?
- share of information
- right to die
- cease of care vs. assisting in death = the family, healthcare professionals decide this when the dying patient is not capable
- assisted suicide/euthanasia
Define each:
assisted suicide =
active voluntary euthanasia =
medical assistance in dying =
assisted suicide = asking for a lethal medicine but you take it your self
active voluntary euthanasia = health care professional administrates the medicine
medical assistance in dying = either of above
- about _______ people received MAID as of 2019.
- ___% of older adults (with or without) sex differences
- 5000
- 80%, without
- What issues arise due to the institutionalization of dying?
- How can an ‘active’ and ‘high quality’ social network can help a dying person and their family?
- loss of autonomy
- options for homecare, feel or sense of purpose, material advantages because people get access to resources
T/F: reaction to death is the same across cultures and individuals
F.
Thanatologists
specialists in study of death and dying
- In the past, high _______ mortality rates, _________ diseases and high _________ death rates during _______- ________ years made death in all age groups a common event
- What is the life expectancy for F vs. M?
- infant, childhood, female, child-bearing
- M = 79.9, F = 84
Explain Erikson’s theory of ego development for life review and ego integrity for older people
life review: dying person looks over their life, seeks conviction that their life has had meaning and purpose, prepare for death
ego integrity: accepts that one’s life cycle is something complete and unique
What is Tornstam’s gerotranscendence suggest seniors will do (3)?
What is gerotranscsndence?
- become more accepting of life’s mysteries and uncertainties
- find enjoyment in the little things
- emphasize family connections past, present and future
- it means process of growing old in a healthy and adaptive way where you accept it
What are the 5 responses to a grieving partner?
- chronic grief = low pre-loss depression, high post-loss depression after 6-18 months
- common grief or recovery = low pre-loss depression and high post-loss depression at 6 months with improvement at 18 months
- resilience = low pre and low post-loss depression at 6 and 18 months
- depressed improved = high pre-loss depression and low post-less depression at 6 and 18 months
- chronic depression = high pre-loss depression and high post-loss depression at 6 and 18 months
explain each issue of treatment for dying patients
1. allowing a patient to die
2. power of attorney
3. do not resuscitate (DNR)
4. Hospice care and palliative care
5. palliative care in indigenous communities
- allowing a patient to die = death follows the decision of the family and healthcare provider and persons lacking mental capabilities rely on someone else
- power of attorney = A legal document that gives someone, usually a lawyer, adult family member, or friend to make the decisions on behalf of the ill person if the person loses his or her mental capacities
- do not resuscitate (DNR) = A person may request that resuscitation not be attempted if the persons heart stops. The dying persons physician may then place a do-not-resuscitate (DNR) order on the patients medical care chart
- Hospice care and palliative care = Palliative care tries to relieve symptoms and help patients enjoy their last days.
- palliative care in indigenous communities = Often lack access to palliative care programs. Ending life in a hospital cuts off the patient from support networks. Elders prefer to die in their own community with family and friends. Researchers can for more funding; removal of federal, provincial and territorial jurisdiction barriers; and culturally appropriate services
What are 4 suggestions for relieving the stress of indigenous people in a hospital setting?
- interpreters
- large rooms for full family
- allow family to spend time with patient
- professionals need to understand the values and cultural preferences of indigenous elders
