Week 11 Reading Flashcards
True or False: Gerontologists and thanatologists distinguish physical death from social death
True
Social death
the perception or behaviour of others when they view or treat a person as if physically dead when the body has not died yet
True or false: physical death sometimes precedes social death
True (in some cultures family may define a physically dead elderly family member as alive until they have saved enough $ for the funeral-do not acknowledge death until the funeral takes place)
Mexican Day of the Dead
Celebrate the day of the dead each year
Blend of indigenous and european culture
Commemorates on-going relationships between the living and the dead
Parades, families set up altars in their homes
All welcome spirits of the dead
Festival promotes good relations between the living and the dead
Tends to be costly
What do indigenous people view the process of dying as
preparing the spirit for this journey
Cryonics
freezing the body in hope that someday science will bring the dead back to life
What are improvements that have led to increased life expectancy
Modern medical treatments
better nutritions
Life expectancy at birth in Canada from 2015-2017 for males and females
79.9 years for Males, 84.0 years for females
In 2018-2019, seniors accounted for __ percent of all deaths in Canada
80%
Trajectory of dying
he pattern or course of dying over time, example (sudden death or slow decline), differs today from the past
What percent of deaths in Canada have a sudden-death trajectory
10%
Where do long trajectory vs short trajectory deaths take place
long-term care facilities
home or hospital
True or False: the percentage of deaths occurring in a hospital in Canada has been declining since the 1990s
True
Where do the large majority of deaths take place in Canada (85%)
institutional setting
What are the two awareness contexts for dying
a closed or an open awareness context
What happens in a closed awareness context
professionals , the patient and the family may all now that death will occur soon, but no one discusses this “secret”
What happens in an open awareness context
All these people communicate about the impending death
What does todays research and modern medical care support
an open awareness context
True or False:
Researchers noted that in an ideal world, physicians and nurses would discuss with the patient and their family members the options available for car
E. theory, Life Review: a dying person looks over their life, seeks a conviction that their life has had meaning and purpose and prepares for death
a dying person looks over their life, seeks a conviction that their life has had meaning and purpose and prepares for death
E. Ego integrity
the acceptance of the notion that one’s life cycle is something complete and unique
Reasons for delaying the conversation about end-of-life care include
-Discomfort with the topic of dying and death
-Uncertainty about when death would occur
-Another includes professional ethics that -emphasizes the maintenance of life and patient -family expectations that everything possible be done to extend life
What is activity theory
people waat to stay active throughout their lives and substitute new roles and activities for ones that they lose as they age
When people retire activity theory says: they have the highest life satisfaction if they find new things do do
Theory says nothing about death although it would support living life to the fullest even when dying
Disengagement theory:
people want to disengage from social roles as they age
-retirement and withdrawal from social responsibilities
Tornstam’s gerontranscenderce suggests seniors may:
Become more accepting of life mysteries and uncertainties
Find enjoyment in the little things
Emphasize family connections past, present and future
- Seniors have the potential to redefine themselves in old age
- emphasizes individual choices over conforming to society
Kubler-Ross (1969) five stages of dying: BAADD
Denial
Anger
Bargaining
Depression
Acceptance
Bereavement:
Grief:
Mourning:
Bereavement: the state of having recently experienced the death of a significant other
Grief: sense of profound loss and the experience of deep sorrow
Mourning: public expression of grief, typically following social and cultural rules
The Changing Lives of Older Couples (2006) study found five responses to the loss of a partner:
-Chronic grief (defined as low pre-loss depression, high post-loss depression after 6 to 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-loss depression at 6 and 18 months)
-Chronic depression (high pre-loss depression and high post-loss depression at 6 and 18 months)
Allowing a patient to die
Death often follows the decision of the family and the healthcare provider tob cease treatment and allow the patient to die
Persons lacking the mental competence rely on someone else to decide
Advance directions
can help family members and healthcare workers make difficult medical decisions
-A precise statement of the desired treatment and care, including what medical actions are to be taken under what conditions, and a declaration of who has the right to decide in the situation when the writer of the advance directive can no longer express their wishes
Power of attorney
A legal document that gives someone, usually a lawyer, adult family member, or friend, the right to make decisions on behalf of the ill person if the person losess his or her mental
Do-not-resuscitate (DNR) order:
A person may request that resuscitation not be attempted if the person’s heart stops; the dying persons physician may then place a do-not-reuscitate (DNR) order on the patients medical care
chart
Various settings of palliative care
hospice, hospital or patients home
Hospice care and Palliative Care
Includes pain management, symptom management, social, psychological, emotional and spiritual support and caregiver support
Ensures family receives support
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
-Research calls for more funding: removing federal, provincial and territorial jurisdiction barriers; and culturally appropriate services
Babitz and colleagues suggestions to ease the distress of indigenous patients in a hospital setting
- Interpreters can assists communication between staff, family and patient
- Hospitals need rooms large enough for extended family members to visit the dying person
- Hospitals need to allow family members time to spend with the dying persons
- Healthcare professionals need to understand the values and cultural preferences of an indigenous elder
Families try to care for their dying relative at home
Requires the support of family members, often assisted by healthcare professionals
Many older people have no one at home to provide palliative care
Importance of caregiver respite care
Temporary institutional care of a sick, elderly, or disabled person, providing relief for their usual caregiver
Physician-assisted suicide
-A physician provides a patient with advice about how to die by suicide or with the technical means to die by suicide
-Example: as doctor to prescribe a lethal dose of medicine and you take it yourself
Active voluntary euthanasia
Intervening actively to end a person’s life at the person’s request
Medical assistance in dying (MAID)
-A physician or nurse practitioner helps a person die either by assisting the patients suicide by euthanasia
-In June 2016, the government of Canada legislated guidelines for medical assistance in dying
-Prior to this, a physician in Canada could not legally assist your suicide. Nor could a physician cause your death if you asked
What happened in the first 2.5 years of MAID implementation:
-Just over 1% of all deaths were due to MAID
Average age: 72
-Most deaths took placed in hospital or patients home
-Most common underlying medical issues: cancer (63 percent), circulatory or respiratory diseases (16 percent), and neurodegenerative diseases (12 percent)
