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Chapter 19
Human Development
| Question | Answer |
|---|---|
| Chapter 19 | Dealing with Death and Bereavement |
| What are examples of cross-cultural differences in customs and attitudes related to death? | Some cultures do not do cremation but some cremate as a sign of honor, some showed deep sadness but some try to be joyful |
| study of death and dying | thanatology |
| warm, personal, patient and family centered care for a person with a terminal illness | hospice care |
| care aimed at relieving pain and suffering and allowing the terminally ill to die in peace, comfort and dignity | palliative care or comfort care |
| What is the mortality revolution in developed countries? | Advances in medicine and sanitation, new treatments for once fatal illnesses, better educated/more health-conscious population, no longer see dying as part of living, has become invisible and abstract, avoidance and denial of death |
| What are the chief goals of hospice care? | Warm, personal, patient and family centered care, relieve pain and suffering, allow terminally ill to die in peace, comfort and dignity |
| How do attitudes and customs concerning death differ cross cultures? | Some cultures do not do cremation but some cremate as a sign of honor, some showed deep sadness but some try to be joyful |
| What are the implications of the “mortality revolution” in developed countries? | No longer see dying as part of living, has become invisible and abstract, avoidance and denial of death |
| a frequently observed decline in cognitive abilities near the end of life | terminal drop or terminal decline |
| experience often involving a sense of being out of the body or sucked into a tunnel and visions of bright lights or mystical encounters | near-death experiences |
| loss, due to death, of someone to whom one feels close and the process of adjustment to the loss | bereavement |
| emotional response experienced in the early phases of bereavement | grief |
| working out of psychological issues connected with grief | grief work |
| when a loved one is missing and presumed dead | ambiguous death |
| grieving pattern where a mourner goes from high to low distress | common expected pattern |
| grieving pattern where a mourner does not experience distress immediately or later | absent grief |
| grieving pattern where a mourner remains distressed for a long time | chronic grief |
| grieving pattern where a mourner has a low and gradually diminishing level of distress | resilience |
| What are changes that may occur in a person close to death? | Functional declines, lose interest in eating and drinking, terminal drop or decline, decline in verbal ability and spatial reasoning |
| What are possible explanations of near-death experiences? | Physiological changes that accompany process of dying, biological events in brain that reflect, and bodily structures affected by the process of dying, images arise due to alteration in visual cortex, effective oxygen deprivation, biologically predisposed |
| What are Kubler-Ross’s 5 stages of confronting death? | 1) denial, 2) anger, 3) bargaining for extra time, 4) depression, 5) acceptance |
| Why is Kubler-Ross’s work controversial? | Not everyone goes through all 5 stages, do not occur in same sequence for everyone, not everyone reaches final stage, individual experience |
| What are the classic 3 stages of grief? | 1) shock and disbelief, 2) preoccupation with the memory of the dead person, 3) resolution |
| What are the newer findings of variations in the grieving process? | Commonly expected pattern, absent grief, chronic grief, ambiguous, resilience |
| At ages 5 to 7, what 3 important concepts to children come to realize about death? | Irreversible (can’t come back), inevitable (universal/happens to all things), nonfunctional (all life functions end at death) |
| How do people of different ages understand and cope with death and bereavement? | Children do not understand, start to understand the 3 concepts; adolescence don't think about it, focus on how they live not how long, adults think of how to make the most of their life |
| How do people deal with dying? | Kubler-Ross’s 5 steps (denial, anger, bargaining, depression, acceptance) or a variation of them |
| How do people grieve for a loss? | Classic grief model (shock and disbelief, preoccupation with memory of dead person, resolution) or variation (absent grief, chronic grief) |
| What are specific challenges in losing a spouse? | Affects physical health, affects mental health, drug use, hospitalization, heightened risk of anxiety/depression/insomnia/social dysfunction, can forget to take medicines, economic hardship |
| How can an adult's loss of a spouse or a parent be a maturing experience? | Can be catalyst for introspection and growth, learn to stand on own feet, resolved developmental issues, achieve stronger sense of self, awareness of own mortality, more responsibility/commitment, attachment to others |
| Why are parents rarely prepared emotionally for the death of a child? | Comes as a cruel, unnatural shock, untimely event, feel they have failed |
| What are ways to help expectant mothers cope with the loss of a pregnancy? | Poor partner, provide support, support group |
| What are special challenges involved in surviving a spouse, parent or a child or in mourning a miscarriage? | Not ready for it, have to mature, awareness of own mortality, introspection and growth, stronger sense of self, mourning, have to let person go |
| deliberate withholding or discontinuation of a life prolonging treatment of the terminally ill patient in order to end suffering or allow death with dignity | passive euthanasia |
| deliberate action taken to shorten the life of a terminally ill person in order to end suffering or to allow death with dignity | active euthanasia or mercy killing |
| document specifying the type of care wanted by the maker in the event of an incapacitating or terminal illness | advanced directive (living will) |
| legal instrument that appoints an individual to make decisions in the event of another person’s incapacitation | durable power of attorney |
| suicide in which a physician or someone else helps a person to take his or her own life | assisted suicide |
| Why is the intent to commit suicide sometimes not recognized? | People concealed plans, people don't know what to look for |
| What are warning signs of suicide? | Depression, hopelessness, worthlessness, no purpose, preoccupation with death, seeking access to medicine/weapon, wide mood swings, uncontrolled anger, changes in eating/sleeping/behavior, risky, sudden calmness, trauma or crisis, putting affair in order |
| What are the ethical, practical and legal issues involved in advanced directives, euthanasia and assisted suicide? | Ethnic-right to choose but high value on life; practical-Dr. obligated to relieve suffering but misdiagnosis or future treatment, not healing; legal-regulation of practices that occur anyway but lawsuits from family members |
| How are attitudes towards hastening death changing? | People are starting to consider it for others relief and dignity |
| What concerns do hastening death raise? | Ethical, medical and legal concerns, from preserving life to preserving dignity, from regulation to lawsuits, from relieving suffering to misdiagnosis or future treatment |
| reminiscence about one's life in order to see its significance | life review |
| Why is life review especially helpful in old age? | It enables a person to see the significance in their life |
| How can life review help overcome fear of death? | Foster ego integrity |
| What types of memories are most conductive to a life review? What kind are least conductive? | Self understanding memories; only pleasurable memories are less; only recalling negative events causes of session with regret and fear of death |
| What are several activities used in life review therapy? | Record autobiography, construct family tree, spend time with scrapbooks, old photo albums, letters, memorabilia, recall childhood and young adult memories, reunite with former classmates/colleagues/family members, describ traditions, sum up life work |
| How can dying be developmental experience? | Appreciate time with those we are close to, achieve enduring sense of self-worth, readiness to let go |
| How can people overcome the fear of dying and come to terms with death? | Use a life review and remember the good times and bad |
| What are aspects of death? | Biological, social, cultural, historical, religious, legal, psychological, developmental, medical, ethical |
| What are the customs surrounding death? | Customs regarding death and mourning very greatly from own culture to another, depend on society's view of nature and consequences of death, some have evolved from ancient beliefs and practices |
| What have happened to death rates in the 20th century? | Dropped drastically, especially in developed countries |
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