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Death & Dying Ch 11

"The Last Dance - Encountering Death and Dying" Chapter 11

QuestionAnswer
According to Erickson's model, the last 3 stages of psychosocial development occur when? During adulthood
What ages does the young adulthood cover? 20 - 40 years old
What represents the young adulthood stage of Erickson's model? Tension between intimacy and isolation.
What ages does the middle adulthood psychosocial stage cover? 40 - 60 or 65 years old
What is the middle adulthood psychosocial stage characterized by? The crisis of generativity versus stagnation and self-absorption.
What signals a lack of generativity according to Ken Doka? Self-indulgence, boredom, lack of psychological growth.
Why does Michele Paludi say middle adulthood appears to be a prime period for experiencing fear of death? It is during this stage that death of one's parents typically occurs.
What is the crisis of late adulthood? Integrity versus despair
Patricia Miller says that "acceptance of the limitations of life, a sense of being part of a larger history that includes previous generations, a sense of owning the wisdom of the ages, and a final integration of all the previous stages" is what? Integrity
Why is the crisis of the late adulthood period especially powerful? Physical decline, outward signs of aging, vulnerability to chronic diseases, and the approaching certainty of death.
How does Erickson describe wisdom? Informed and detached concern with life itself in the face of death itself.
In earlier times, and in parts of the world today, an infant is not really viewed as a "person" until he/she has what? Lived long enough to exhibit the likelihood of ongoing viability.
Symbolically and actually, a child's death is opposed to what task of adulthood? The nurturant psychosocial task.
What word is defined as protecting and nurturing a child until he or she can act independently in the world? Parenting
A study by Paul Rosenblatt showed that parents do what with their other children after the death of a child? Become more protective, exhibit greater vigilance and more rapid response to signs of trouble, and greater awareness of child vulnerability.
What did the Cree of North America do to protect their infants? Cut holes in the bottom of the moccasins so that if an ancestral spirit beckoned, the infant could refuse to go because the moccasins needed mending.
Why can the death of a child worsen a marital relationship? The energy expended by each partner in coping with his/her own grief can deplete the emotional resources needed for mutual support.
What may reduce the sense of commonality in a couple's grief experience? Differences in values, beliefs, and expectations causing conflicts in coping styles.
While parents may not grieve in an asynchronous or "roller-coaster" pattern, what may be true of their grieving in relation to each other? Their grieving may be out of synch with each other.
Conflict can arise between parents mourning a child's death because of what about the other's behavior? Interpretation
What ability enhances coming to terms with a partner's behavior in grieving the death of a child? The ability to reframe each other's behavior in a positive way.
Define stillbirth. Sudden intrauterine death - fetal death occurring between the 20th week of pregnancy and the time of birth, resulting in the delivery of a dead child.
Define neonatal death. Death occurring within the first 28 days following birth.
Define postneonatal death. Death occurring after the first 4 weeks and up to 11 months following birth.
What is another term for miscarriage? Spontaneous abortion
Define miscarriage. The loss of the products of conception before the fetus is viable.
The distinction between a miscarriage and a late period, or between a miscarriage and a stillbirth, can be seen as what? Socially negotiated.
In addition to the deaths in or directly after pregnancy, what are other forms of reproductive loss? Infertility and sterility, giving up a child for adoption, and the birth of a child with severe impairments.
What can complicate the loss from a miscarriage? Having no remains to bury.
What can cause the grief for an unborn baby to recur? The birth of a subsequent child or the onset of menopause.
Induced abortion is also termed what? Elective abortion
What perceptions of oneself can affect whether one grieves after an abortion? Viewing oneself as simply pregnant versus as a potential mother.
After an abortion, subsequent pregnancy loss can be seen as what? Retribution
When tests during pregnancy identify genetic diseases, couples face not only the choice of losing this baby, but also what? The possibility of a childless future since biological considerations or genetic risk may preclude the choice to conceive again.
In Japan, mizuko represent what? Children conceived but never born.
The mizuko in Japan are erected as what? Repositories for the souls of unborn babies.
What watches over the mizuko in Japan at Hase Temple? A 30-foot-tall wooden statue of the Japanese Goddess of Mercy.
In what way can conflicting views about abortion place the bereaved in a dilemma? Those who believe a loss occurred may not sanction the act, but those who sanction the act may not validate the grief in response.
In the past, how did medical professionals respond to stillbirths? They whisked away the baby without letting the parents see the baby, and tranquilized the mother if she became too upset.
A recent large study of mothers who experienced stillbirth found that what percentage saw and what percentage held their stillborn babies? 95% saw, 90% held
What has been described as the antidote to powerlessness? Rituals such as holding, caressing, and caring for the dead body of a loved one.
In one study, what kind of support was the only form of support associated with reduced maternal anxiety and depression after a stillbirth? Family support
A certificate of stillbirth acknowledges what? The birth as well as the death.
What percentage of parents in a study by John DeFrain named their stillborn babies? 90%
If a baby dies after weeks of a life-or-death struggle in a hospital, how might the parents feel toward the medical institution? Resentment at surviving a painful and futile ordeal only to be billed later for the experience.
What was one of the most difficult and important things for one young neonatologist to learn? To hand over the baby to the parents so it could die in their arms.
Define SIDS Sudden infant death syndrome - death of an apparently healthy infant usually before 1 year of age of unknown or no definitive cause.
What are risk factors for SIDS? Low birth weight, prematurity, mother's age less than 20 years, maternal drug use, smoking during pregnancy, overly cold/hot environment, soft bedding.
Why might parents who experience SIDS be experiencing intimate death for the first time? They are generally young.
Because the cause of death is not certain and because of generalized concerns about child abuse, what might parents who have suffered a death due to SIDS also suffer? Misdirected accusations by law enforcement personnel.
Researchers at the Children's Hospital in Boston found what about children who died from SIDS? Defects in the brain stem undermining the action of serotonin, which is critical to breathing and arousal.
Judith Savage says, "Childbearing losses are mourned not only for what was, but also for what?" "What might have been."
What two distinct yet related realities is it important to be aware of in childbearing loss? The actual relationship and the symbolic nature of the parent-child bond.
What might the symbolic nature of the parent-child bond refer to? Meaning and purpose, as when a parent becomes a nurturing, supportive guide.
What deceptions might emotional responses to childbearing loss be accompanied by? Auditory or kinesthetic
Well-intentioned family members and friends may attempt to do what in an effort to console the bereaved parent? Minimize the death.
What tops the list of major causes of death among children between the ages of 5 and 14? Accidents
As the most prominent cause of death during the first half of the human life span, injury is characterized as what? The last major plague of the young.
The book states that which is especially poignant in children deaths - death from accident or from illness? Illness
With the death of an only child who was a young or middle-aged adult, the consequent loss of parenthood may become a kind of what? Perpetual bereavement
The older parent who survives the death of an adult child may have also lost what? A caregiver
There may be a sense of competing with whom for most bereaved in the loss of an adult child? The dead child's spouse or children.
The death of a parent can result in what kind of push that leads to what kind of stance? A developmental push that may lead to a more mature stance in parentally bereaved adults who no longer think of themselves as children.
With the death of both parents, a sense of what is gone? Security - the bereaved child may feel that there is no longer anyone who would be willing to answer his/her call for help unconditionally.
The way a person adjusts to spousal bereavement depends on what factors? Sociocultural, personal, and circumstantial.
In same-sex relationships, grief following the death of a partner may be exacerbated by what conflict? That of a mate's parents who never made peace with their child's sexual orientation or lifestyle.
Grief over the loss of a mate is independent of what? Legal or social sanctions about the nature of the relationship.
The patterns of what are important in determining how the loss of a partner will be experienced by a survivor? Intimacy and interaction between spouses.
Spousal bereavement elicits distinct behaviors related to culturally sanctioned what? Gender roles
Why might individuals who have lived out traditional gender roles find the transition to widowhood especially hard? They must learn to manage unfamiliar role responsibilities in the midst of grief.
How do widowed persons whose lifestyles include multiple roles compare in terms of adjustment to those with fewer role involvements? They appear to make an easier adjustment.
For how long after the death of a mate are there higher rates of illness and death among the widowed? The first year
What partly explains the higher rates in illness and death among the recently widowed? Individuals tend to neglect health problems while care for an ailing spouse, making them more prone to disease. Ties to the outside world may have diminished while caring for spouse, increasing feelings of loneliness and.
A study found that women widowed less than a year reported substantially higher rates of what? Depression, poorer social functioning, overall mental health, and general health.
After what period of time do widows show a marked improvement in their functioning? 3 years
Are adverse effects of spousal death more common among widows or widowers? Widowers
What conventional gender roles create adverse effects after spousal death? Difficulty managing domestic matters, self-reliance - making it less likely that widowers will seek help from others.
Less socially accepted or acknowledged is relief experienced when a mate's death is what? The welcome end to an unsatisfactory relationship.
What is the estimate of how many women will be widowed at one time or another? 3/4
Widows who want to remarry face what challenges? Social pressures and a dearth of eligible men.
Why might a woman's status increase with widowhood? There are many other widows with whom to share leisure time and activities.
A study by Rebecca Utz and colleagues found that widowed persons use what as an active coping strategy to deal with the negative effects of widowhood? Social participation
(A) social participation may not provide the emotional and instrumental support that (B) social participation does. A - Formal B - Informal
Why might family relationships pose a potential psychological threat to the widowed elderly? They contain elements of role reversal between the adult child and the aging parent that suggest or demand dependency from the aged widow/er.
In what way do peers provide a role model to the recently widowed? Exposing the widowed to an accepting attitude so that they learn to live with the painful or difficult feelings of grief and gain perspective on them.
What organization is the parent organization of Widowed Persons Service (WPS)? AARP
Why are friendship ties increasingly important for many people? Changes in family structure, social and geographical mobility, and other psychological or cultural factors.
The 20th century has been called a century of what? Population growth
The 21st century has been characterized as a century of what? Aging
The President's Council on Bioethics reports that we are on the threshold of what? The first-ever mass geriatric society.
The most common trajectory toward death is what? A lengthy period of debility, frailty, and dementia lasting not months, but years.
What are some of the things aged people prefer death to? Inactivity The loss of the ability to be useful Becoming a burden Loss of mental faculties Living with progressively deteriorating physical health and concomitant physical discomfort.
Define senescence. The process of becoming old.
Senescence can be thought of in terms of what? Vulnerability
Nicholas Christakis reports that your chances of dying increase not just when your partner dies, but when what? When your partner becomes seriously ill.
There is a push toward improving the quality of life while doing what? Compressing morbidity/illness and extending active life expectancy.
What age groups does young-old refer to? 60 - 75 years old
What age groups does middle-old refer to? 75 - 85 years old
What age groups does old-old refer to? Over 85 years old
What group uses the terms young-old, middle-old and old-old? National Council on Aging
The old-old population tends not to match what stereotypes? Those of advanced age as a time of fragility and dependency.
What age population tends to be more individually distinct than any other segment of the population? Old people
Mutual respect, faith, communion with others and concern with existential issues of life are essential to what? The well-being of the aged.
In Tova Gamliel's description of residents of an old-age home in Israel, macabre references to the reality of old age were used to what? Both portray the minute and mundane physical details of experience and to transcend their experience.
While we (still) provide for the physical care of older people through programs like Social Security and Medicare, we appear to be less interested in what? Providing a place for the aged in society.
As Daniel Callahan observes, the impulse to rid ourselves of stereotypes about old age may have what effect? Leading us "away from fruitful and valid generalizations about the elderly and fresh efforts to understand the place of old age in the life cycle."
What 4 important questions need to be discussed in seeking what Callahan terms a "public meaning" of aging? How can suffering become a meaningful and significant part of life? What moral virtues should be associated with old age? What are the characteristic moral and social obligations of the elderly? What medical and social entitlements are due to the elder
The attempts to meet ALL the needs of the elderly must inevitably fail, especially if those needs are defined as what? The avoidance of disease and frailty.
Callahan notes an implicit social ideology that apparently seeks to what? Neutralize any inevitability about the process of aging and decline.
A typical story line pictures those who die alone as what? Anti-social, fearful, lonely, even pathetic figures who need help despite themselves or their lifestyles.
Rarely is it thought that those without the attention from social services or the community are doing what? Exercising agency, independence or autonomy.
The positive images and meanings of growing old are eroded when what? We regard old age as a pathological state or as an avoidable affliction.
Elderly women in the African American community occupy what place? A special place as they continue the oral traditions of passing on cultural meanings to succeeding generations.
Who says, "None of us knows whether we have already had the best years of our lives or whether the best are yet to come"? Robert Butler
Created by: silvrwood