Week 11 Reading

Question 1

True or False: Gerontologists and thanatologists distinguish physical death from social death

Answer 1

True

Question 2

Social death

Answer 2

the perception or behaviour of others when they view or treat a person as if physically dead when the body has not died yet

Question 3

True or false: physical death sometimes precedes social death

Answer 3

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)

Question 4

Mexican Day of the Dead

Answer 4

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

Question 5

What do indigenous people view the process of dying as

Answer 5

preparing the spirit for this journey

Question 6

Cryonics

Answer 6

freezing the body in hope that someday science will bring the dead back to life

Question 7

What are improvements that have led to increased life expectancy

Answer 7

Modern medical treatments
better nutritions

Question 8

Life expectancy at birth in Canada from 2015-2017 for males and females

Answer 8

79.9 years for Males, 84.0 years for females

Question 9

In 2018-2019, seniors accounted for __ percent of all deaths in Canada

Answer 9

80%

Question 10

Trajectory of dying

Answer 10

he pattern or course of dying over time, example (sudden death or slow decline), differs today from the past

Question 11

What percent of deaths in Canada have a sudden-death trajectory

Answer 11

10%

Question 12

Where do long trajectory vs short trajectory deaths take place

Answer 12

long-term care facilities
home or hospital

Question 13

True or False: the percentage of deaths occurring in a hospital in Canada has been declining since the 1990s

Answer 13

True

Question 14

Where do the large majority of deaths take place in Canada (85%)

Answer 14

institutional setting

Question 15

What are the two awareness contexts for dying

Answer 15

a closed or an open awareness context

Question 16

What happens in a closed awareness context

Answer 16

professionals , the patient and the family may all now that death will occur soon, but no one discusses this “secret”

Question 17

What happens in an open awareness context

Answer 17

All these people communicate about the impending death

Question 18

What does todays research and modern medical care support

Answer 18

an open awareness context

Question 19

True or False:

Answer 19

Researchers noted that in an ideal world, physicians and nurses would discuss with the patient and their family members the options available for car

Question 20

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

Answer 20

a dying person looks over their life, seeks a conviction that their life has had meaning and purpose and prepares for death

Question 21

E. Ego integrity

Answer 21

the acceptance of the notion that one’s life cycle is something complete and unique

Question 22

Reasons for delaying the conversation about end-of-life care include

Answer 22

-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

Question 23

What is activity theory

Answer 23

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

Question 24

Disengagement theory:

Answer 24

people want to disengage from social roles as they age
-retirement and withdrawal from social responsibilities

Question 25

Tornstam’s gerontranscenderce suggests seniors may:

Answer 25

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

Question 26

Kubler-Ross (1969) five stages of dying: BAADD

Answer 26

Denial Anger Bargaining Depression Acceptance

Question 27

Bereavement: Grief: Mourning:

Answer 27

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

Question 28

The Changing Lives of Older Couples (2006) study found five responses to the loss of a partner:

Answer 28

-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)

Question 29

Allowing a patient to die

Answer 29

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

Question 30

Advance directions

Answer 30

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

Question 31

Power of attorney

Answer 31

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

Question 32

Do-not-resuscitate (DNR) order:

Answer 32

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

Question 33

Various settings of palliative care

Answer 33

hospice, hospital or patients home

Question 34

Hospice care and Palliative Care

Answer 34

Includes pain management, symptom management, social, psychological, emotional and spiritual support and caregiver support Ensures family receives support

Question 35

Palliative care in indigenous communities

Answer 35

-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

Question 36

Babitz and colleagues suggestions to ease the distress of indigenous patients in a hospital setting

Answer 36

1. Interpreters can assists communication between staff, family and patient 2. Hospitals need rooms large enough for extended family members to visit the dying person 3. Hospitals need to allow family members time to spend with the dying persons 4. Healthcare professionals need to understand the values and cultural preferences of an indigenous elder

Question 37

Families try to care for their dying relative at home

Answer 37

Requires the support of family members, often assisted by healthcare professionals Many older people have no one at home to provide palliative care

Question 38

Importance of caregiver respite care

Answer 38

Temporary institutional care of a sick, elderly, or disabled person, providing relief for their usual caregiver

Question 39

Physician-assisted suicide

Answer 39

-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

Question 40

Active voluntary euthanasia

Answer 40

Intervening actively to end a person's life at the person's request

Question 41

Medical assistance in dying (MAID)

Answer 41

-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

Question 42

What happened in the first 2.5 years of MAID implementation:

Answer 42

-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)