Transcript Psychology 203 Human Development

Psychology 203
Human Development
The End of Life
Chapter 19
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Dealing With Death
and Bereavement
Many Faces of Death
• Death is a biological fact but other aspects
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Social
Cultural
Historical
Religious
Legal
Psychological
Developmental
Medical
Ethical
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Dealing With Death
and Bereavement
• * Death and loss are universal experiences that
have a cultural context
• Cultural Context – customs concerning
– Disposal of dead
• Care of and behavior toward the dying and dead
• Setting where death usually takes place
– Remembrance of the dead
– Transfer of possessions
– Expression of grief
• Mourning customs and rituals
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Dealing With Death
and Bereavement
• Remembrance and Expression of grief
– All-night Irish wake – toast the memory
– Week-long Shiva – vent feeling, share memories
– Flying a flag at half-mast – show respect
• Malayan society
– Death seen as a gradual transition
• Romania
– Warriors went laughing to their graves
• Greece
– * Cremation, the art of burning the bodies of the dead
was seen as a sign of honor
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Dealing With Death
and Bereavement
• Mortality Revolution – advances in
– Medicine
– Sanitation
– Treatments of many once-fatal illnesses
– Better educated
– Health-conscious populations
• * Mortality rates have decreased sharply
for men in the United States, mainly due to
the declining rates of heart disease
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Care of the Dying
• Hospice Care – warm personal patient and
family centered care for a person with a
terminal illness
• Palliative Care – care aimed at relieving
pain and suffering and allowing terminally
ill to die in peace, comfort, and dignity
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Confronting One’s Own Death
• Kubler-Ross five stages in coming to
terms with death
– Denial (refusal to accept the reality of what is
happening)
– Anger
– Bargaining for extra time
– Depression
– Acceptance
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Patterns of Grieving
• * Bereavement
– The loss due to death of someone to whom one feels close to
and the process of adjustment to the loss
– Can affect all aspects of a survivor’s life
• Change in status or role
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Wife to widow
Son or daughter to orphan
Loss of friend
Loss of income
• Grief is first emotional response in early phases of
bereavement
– Example: * The emotional loss that Anna felt when her son died
kept her from eating, going to work, or caring for the children that
she still had. This emotional response is known as grief
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Grief Work
• Shock and disbelief
– Survivors often feel lost and confused which may last
for several weeks
• Overwhelming feeling of sadness and frequent crying
• Preoccupation with the memory of the dead
person
– Survivor tries to come to terms with death but cannot
yet accept it
• lasts six months or longer
– Diminish with time but may recur for years on
anniversary or marriage or of death
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Grief Work
• Resolution
– Final stage when the bereaved person
renews interest in everyday activities
– Memories of the dead person mingle with
sadness rather then pain and longing
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Grief Work
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Kubler-Ross five stages are controversial
1. Depression is far from universal
2. Failure to show distress may not lead to
problems latter
3. Not everyone needs to work through the
loss
4. Not everyone returns to normal quickly
5. People cannot always resolve their grief and
accept their loss
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Death and Bereavement
Across the Life Span
• Childhood and Adolescence
– Before the age of 5 or 7 years
• Certain groups of people do not die (teachers, parents,
children)
• Smart or lucky people can avoid death
• They themselves will live forever
• Dead person can still think and feel
– Children between the ages of 5 to 7 years
• Death is irreversible
• Death is universal – all things must die
• Dead persons are nonfunctional – all life functions end at
death
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Childhood and Adolescence
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Death and
Childhood and Adolescence
• Adolescents take heedless risks
– Hitchhike
– Drive recklessly
– Experiment with drugs
– Experiment with sex
– More concerned with how they live rather than
with how long they will live
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Death
Adulthood
• Young adults
– May be extremely frustrated which turns into
rage
• Older adults who feel their lives have been
meaningful and adjusted to their losses
better able to face death
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Special Losses
• Surviving a Spouse
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Women tend to live longer then man
Women tend to widow younger than men
On-third of women lose their husbands by age 65
Hard for women who have structured their life and
their identity around caring for their husband
– Strong likelihood that widowed person (especially a
man) will soon follow a spouse to the grave
• Men who lost their wife are 21% more likely to die within the
same period, only 10% for women
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Special Losses
• Surviving a Spouse
– Available women greatly outnumber available
men but widowers are four times as likely to
remarry as elderly widows
– * One of the major reasons men may remarry
more often than women is of the need for
intimacy is greater because men usually have
fewer close friendships
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Special Losses
Surviving a Spouse
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Special Losses
Losing a Child
• Parent is rarely prepared emotionally for the death of a
child
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Cruel
Unnatural shock
Untimely event
Should not have happened
Feel that they have failed
Hard to let go
• If marriage is strong will draw closer together for support
• If marriage is not strong marriage will weaken and
destroys the marriage
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The “Right to Die”
• Suicide
– In modern societies is no longer a crime but still a
stigma
– US rate of 10.7 per 100,000 is lower then that in other
industrialized countries
– Highest rate among elderly white men, particularly
those 85 and older
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Withdrawing from family or friends
Talking about death
Giving away prized possessions
Abusing drugs or alcohol
Unusual anger, boredom or apathy
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The “Right to Die”
• Aid in Dying
– Euthanasia
• Active – deliberate action taken to shorten the life
of a terminally ill person in order to end suffering or
to allow death with dignity (mercy killing)
• Passive – deliberate withholding or discontinuation
of life-prolonging treatment of a terminally ill
person
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The “Right to Die”
• The United States Supreme Court has held that
a person is clearly within his/her constitutional
rights if he/she requests passive euthanasia
(1997)
• Advance Directives
– Living will – document specifying the type of care
wanted by the maker in the event of terminal illness
– Durable power of attorney – appiints another person
to make decisions if the maker becomes incompetent
to do so
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The “Right to Die”
• Efforts to legalize physicians aid in dying
– US Supreme Court left regulation of physician aid in
dying up to the states
• Only Oregon has passed such a law
• * Loss of autonomy and bodily functions were the biggest
fears that the Oregon patients had about the end of life
experience
• Finding meaning
– Those who saw the most purpose in life had the least
fear of death
– Life review is reminiscence about one’s life in order to
see its significance
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The “Right to Die”
• Life-review therapy
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Writing or taping one’s autobiography
Construction a family tree
Talking about scrapbooks, photo albums
Reading old letters
Making a trip back to scenes of childhood and young
adulthood
– Reunions with former classmates or colleagues
– Describing ethnic traditions
– Summing up one’s life’s work
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The “Right to Die”
• Weingberger
– “Even dying can be a developmental
experience”
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