Death and Grieving - Gordon State College
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Transcript Death and Grieving - Gordon State College
Death and Grieving
Chapter 17
Issues in Determining Death
Brain death — neurological definition of
death
All electrical activity of brain has ceased for a
specified period of time
Flat EEG recording
Some medical experts argue criteria for death
should include only higher cortical functioning
Death becoming increasingly complex
1. When to determine death has
occurred?
2. Life expectancy has increased
3. Care for dying shifted away from family
4. Minimized exposure to death and its
pain
Death in Different Cultures
Most societies have
Philosophical or religious beliefs about
death
Rituals that deal with death
View that death does not end existence
U.S. Denial and Avoidance of Death ?
Funeral industry emphasizes lifelike
qualities
Euphemisms — softening language for
death
Persistent search for “fountain of youth”
Rejection and isolation of aged
Hope that everyone goes to heaven
Medical emphasis — prolonging life, not
easing suffering
Attitudes Toward Death at Different
Points in the Life Span
Childhood
Infant has no concept of death; perceptions
of death develop in middle/late childhood;
even very young children concerned about
separation and loss
Adolescence
Develop more abstract concepts of death;
common to think they are immune to death
Adulthood
Middle-aged adults fear death more than
young adults or older adults; older adults
think about death more
A Developmental Perspective of Death
Suicide
Risk factors
Serious physical illness
Feelings of disparity,
isolation, failure, loss
Serious financial
problems
Drug use or prior
suicide attempts
Antidepressant links
– Cultural and gender
differences exist
– Rare in childhood, risk
increase in adolescence
– Most adolescent
attempts fail
– Linked to genetic and
situational factors
– Gay or lesbian links not
clear
Facing One’s Own Death
Most dying individuals want to make
decisions regarding their life and
death
Complete unfinished business
Resolve problems and conflicts
Put their affairs in order
Kubler-Ross’ Stages of Dying
Denial and isolation
Denies s/he is going to die
Anger
Denial gives way to anger,
resentment, rage, and envy
Bargaining
Develops hope that death can
somehow be postponed
Depression
Comes to accept the certainty
of her or his death
Acceptance
Develops sense of peace and
may desire to be left alone
Perceived Control and Denial
When individuals believe they can influence and
control events, they may become more alert and
cheerful
Denial can be adaptive or maladaptive
Care for Dying Individuals
?
Death in U.S.: often lonely, prolonged, painful
Plan for your death
Make a living will
Give someone power of attorney
Give your doctor specific instructions
Discuss desires with family and doctor
Check insurance plan coverage
The Contexts in Which People Die
Most would rather die at home but worry
over
Burden at home
Limited space
May alter relationships
Competency and availability of emergency
medical treatment
Communicating with the Dying Person
Establish your presence
Eliminate distraction
Ask if there is anyone s/he
would like to see
Encourage the dying individual
to reminisce
Limit visit time
Don’t insist on acceptance
Talk with the individual when
s/he wishes to talk
Allow expressions of guilt or
anger
Express your regard
Discuss alternatives,
unfinished business
Decisions Regarding Life, Death,
and Health Care
Natural Death Act and Advance Directive
Expresses
person’s desires regarding
extraordinary medical procedures that might
be used to sustain life when medical situation
becomes hopeless
Euthanasia
Painlessly ending lives of persons suffering from incurable
diseases or severe disabilities
Passive euthanasia — withholding of
available treatments, allowing the person to
die
Active euthanasia — death induced
deliberately, as by injecting a lethal dose of
drug
Publicized controversy: assisted suicide
Care for Dying Individuals
Hospice — humanized program
committed to making the end of life as
free from pain, anxiety, and depression
as possible
Palliative care — reducing pain and
suffering and helping individuals die
with dignity
When Others Decide
Remember Terry Schaivo
What is a persistent vegetative state?
Who decides?
What are their motives?
Should the government decide?
Social security bankruptcy – workerpensioner imbalance
Medicare/Medicaid bankruptcy
Generational inequity – rationing of care
Grieving
Grief: emotional numbness; a complex
emotional state of…
Disbelief
Separation anxiety
Despair
Sadness
Loneliness
…that accompanies loss of someone we
love
Cultural Diversity in Healthy Grieving
Contemporary western orientation
Breaking bonds with the dead
Returning survivors to autonomous lifestyle
Non-Western cultures
Maintaining ties with deceased
Influenced by religious beliefs and lifestyle
Making Sense of Grief
Grieving stimulates many to try to make
sense of their world — positive themes
linked to hopeful future and better
adjustment
Effort to make sense of it pursued more
vigorously when caused by an accident or
disaster
Losing a Life Partner
Those left behind after the death of an
intimate partner suffer profound grief and
often endure
Financial loss
Loneliness linked to poverty and education
Increased physical illness
Psychological disorders, including depression
Marital Quality and
Adjustment to Widowhood
Widowhood associated with increased
anxiety among those highly dependent
on their spouses
Lower anxiety for those who did not
depend on their spouse very much
Forms of Mourning
Approximately 80 percent of corpses are disposed of by
burial, the remaining 20 percent by cremation
Funeral industry is source of controversy
Funeral is important aspect of mourning in many cultures
Cultures vary in how they practice mourning
Amish Mourning
Conservative group; family-oriented society
Live same unhurried pace as ancestors
Time of death met with calm acceptance
Neighbors notify community; funeral at home
High level of support to family for one year
Traditional Judaism and Mourning
Mourning in graduated time periods; each
with appropriate practices
1st period: Aninut — between death and
burial
2nd period: Avelut period — mourning proper
Shivah
period — 7-day begins at burial
Sheloshim period — 30-day period after burial
Mourning over for all but parents who mourn
another 11 months