1. D EATH AND G RIEVING Lesson 8 November 15 th, 2010

2. U NIT T EST T OMORROW

3. W HAT IS DEATH ? Harvard Medical School has 4 criteria that must be met for a person to be considered dead 1. Unreceptive and unresponsive The patient is totally unresponsive to applied painful stimulus. 2. Unresponsive in breathing For over an hour, the patient shows no spontaneous muscular contraction or breathing

4. 3. Lack of Reflexes Knee jerk is absent, Pupils do not dilate when light is exposed to them. 4. Flat EEG For 20 minutes, the patient’s brain does not generate an electrical impulse or brain wave

5. MythFact Suicide occurs without warning While some suicides may be impulsive, usually the person has thought about suicide for a long time People who talk about killing themselves rarely commit suicide Most people who commit suicide have talked about it before

6. MythFact If you ask a person if he or she is considering suicide, you will encourage that person to commit suicide You will not cause a suicide by asking if someone’s thinking about it. People who are not suicidal will not be influenced by the question. People who are considering will feel relieved that someone cares enough to ask and to listen to their problems.

7. MythFact All suicidal people want to die A suicide attempt is often a cry for help. The person may be asking for help to live. When a suicidal person suddenly seams calm and serene, there is no longer any danger of suicide A suicidal person suddenly seams calm and serene may have decided to commit suicide and therefore feels relief that a decision has been made

8. MythFact If some makes a suicidal comment while drunk or high it is not serious People under the influence of alcohol or other drugs may be at greater risk of acting on suicidal thoughts because their judgment is impaired and they may be more impulsive All people who commit suicide are mentally ill Many people who feel suicidal are not mentally ill. They may be in a period of intense emotional crisis

9. MythFact Once a person is suicidal, he or she will always be suicidal Many people consider suicide for only a brief period in their lives. A person who attempts suicide and survives may never attempt again if proper support and treatment is found The tendency toward suicide is inherited and passed from parent to child Suicide is a behaviour and cannot be inherited. However, depression may have a genetic basis. Severely depressed people may harbour more thoughts of suicide than those who do not suffer from depression.

10. T EENAGE S UICIDE Suicide – The act of intentionally taking one’s own life Stats from the Canadian mental health association

11. T EENAGE S UICIDE Canadian rates 15 in 100 000 Aboriginal communities are 3- 6 times higher Among Aboriginal males, the rate for the 15-24 year age group is 90.0 The rate of suicide among Native youth is five to six times higher than the Canadian average

12. T EENAGE S UICIDE suicide accounts for 24 percent of all deaths among 15-24 year olds and 16 percent among 16-44 year olds Suicide is the second leading cause of death for Canadians between the ages of 10 and 24

13. T EENAGE S UICIDE Seventy-three percent of hospital admissions for attempted suicide are for people between the ages of 15 and 44. Native communities which have retained some of their historical traditions have lower suicide rates.

14. W ARNING S IGNS OF S UICIDE 80 percent of people who commit suicide give warning signs or cry for help. Below is a list of possible warning signs. Change in eating and sleeping habits Withdrawal from friends, family, and regular activities Violent actions, rebellious behaviour, or running away

15. W ARNING S IGNS OF S UICIDE Use of alcohol or other drugs Unusual neglect of personal appearance Marked personality change Persistent boredom, difficulty concentrating, or a decline in the quality of school work.

16. W ARNING S IGNS OF S UICIDE such as stomach-aches, headaches, or fatigue, which are often related to emotions. Giving away favourite possessions Loss of interest in pleasurable activities Not tolerating praise or rewards

17. I NTERVENTION STRATEGIES – Canadian mental health Association If you are suspecting someone of committing suicide, here are a few tips that you can use. If possible, talk with the person directly. The single-most important thing you can do is listen attentively without judgement.

18. I NTERVENTION STRATEGIES Talking about suicide can only decrease the likelihood that someone will act on suicidal feelings. There is very little risk that talking about it will push someone over the edge. Find a safe place to talk, allow for as much time as necessary

19. I NTERVENTION STRATEGIES Ask the person about what has been happening and their emotions. Ask the person if they are considering suicide, ask if they have a plan. Do not tell them that their thoughts are bad. Ask if there is anything you can do to help Talk about possible resources (family, friends, crisis centers, etc.)

20. I NTERVENTION STRATEGIES Make a plan with the person for the next few hours or days. Check up on the person If possible go with them to get help Try to arrange someone to be with them at all times so that you do not burn out.

21. I NTERVENTION STRATEGIES Ask who else knows about the suicidal feelings. Are there other people who should know? Is the person willing to tell them? Confidentiality is important, but do not keep the situation secret if a life is clearly in danger.

22. I NTERVENTION STRATEGIES Praise the person for having the courage to trust you and for continuing to live and struggle. Remember, if the person is serious, get extra help. The person may hate you for saving them but in the end you may have saved a life.

23. S TAGES OF G RIEF In 1969, psychiatrist Elisabeth Kübler- Ross introduced what became known as the “five stages of grief.” These stages of grief were based on her studies of the feelings of patients facing terminal illness, but many people have generalized them to other types of negative life changes and losses, such as the death of a loved one or a break-up.

24. S TAGES OF G RIEF 1. Denial “this cannot be happening to me” No acceptance or acknowledgement of loss 2. Anger "why me?" Anger at the diseased for leaving or angry with self for not preventing it

25. S TAGES OF G RIEF 3. Bargaining Begging, wishing, praying for them to come back 4. Depression Overwhelming feelings of hopelessness, frustration, bitterness, self pity, and mourning Lack of control, feeling numb, possibly suicidal 5. Acceptance There is a difference between resignation and acceptance. You have to accept the loss, not just try to bear it quietly

26. No two people ever experience grief in the same way, or with the same intensity, but there are strategies that can help you cope with your loss.

27. Acknowledge that the death is a suicide Recognize your feelings and loss Talk openly with your family so that everyone’s grief is acknowledged and can be expressed

28. Reach out to your friends and guide them if they don’t know what to say or do Find support groups where you can share your stories, memories and methods of coping

29. Be aware that anniversaries (e.g. birthdays) can be especially difficult and consider whether to continue old traditions or begin new ones Develop rituals to honour your loved one’s life