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Copyright © Allyn & Bacon 2007 Development Through the Lifespan Chapter 18 Death, Dying, and Bereavement This multimedia product and its contents are protected.

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Presentation on theme: "Copyright © Allyn & Bacon 2007 Development Through the Lifespan Chapter 18 Death, Dying, and Bereavement This multimedia product and its contents are protected."— Presentation transcript:

1 Copyright © Allyn & Bacon 2007 Development Through the Lifespan Chapter 18 Death, Dying, and Bereavement This multimedia product and its contents are protected under copyright law. The following are prohibited by law:  Any public performance or display, including transmission of any image over a network;  Preparation of any derivative work, including the extraction, in whole or in part, of any images;  Any rental, lease, or lending of the program.

2 Copyright © Allyn & Bacon 2007 Phases of Dying  Agonal phase  Suffering in first moments body can no longer support life  Clinical death  Heart, breathing, brain stopped, but still can resuscitate  Mortality  Permanent death  Agonal phase  Suffering in first moments body can no longer support life  Clinical death  Heart, breathing, brain stopped, but still can resuscitate  Mortality  Permanent death

3 Copyright © Allyn & Bacon 2007 Defining Death  Brain death  All activity in brain and brain stem stopped  Irreversible  Persistent vegetative state  Activity in cerebral cortex stopped  Brain stem still active  Brain death  All activity in brain and brain stem stopped  Irreversible  Persistent vegetative state  Activity in cerebral cortex stopped  Brain stem still active

4 Copyright © Allyn & Bacon 2007 Death with Dignity  Communication with and care of dying person:  Assurance of support  Humane, compassionate care  Esteem and respect  Candid about certainty of death  Information to make end-of-life choices  Communication with and care of dying person:  Assurance of support  Humane, compassionate care  Esteem and respect  Candid about certainty of death  Information to make end-of-life choices

5 Copyright © Allyn & Bacon 2007 Concept of Death  Permanence  Inevitability  Cessation  Applicability  Causation  Permanence  Inevitability  Cessation  Applicability  Causation

6 Copyright © Allyn & Bacon 2007 Children’s Understanding of Death  Most develop adultlike concept of death by middle childhood  Factors that affect understanding  Experience with death  Religious teachings  Candid, sensitive discussion with adults  Most develop adultlike concept of death by middle childhood  Factors that affect understanding  Experience with death  Religious teachings  Candid, sensitive discussion with adults

7 Copyright © Allyn & Bacon 2007 Adolescents’ Understanding of Death  Logically understand death, but problems applying idea to their real lives  High-risk activities  Conversations with parents promote understanding  Logically understand death, but problems applying idea to their real lives  High-risk activities  Conversations with parents promote understanding

8 Copyright © Allyn & Bacon 2007 Discussing Death with Children and Adolescents  Take the lead  Listen perceptively  Acknowledge feelings  Provide facts  Be culturally sensitive  Joint problem solving  Take the lead  Listen perceptively  Acknowledge feelings  Provide facts  Be culturally sensitive  Joint problem solving

9 Copyright © Allyn & Bacon 2007 Adulthood and Understanding of Death Early Adulthood Avoidance Death anxiety Death considered distant Middle Adulthood Begin to think of death Aware of limited time left to live Focus on tasks to be completed Late Adulthood Think and talk more of death Practical concern about how and when

10 Copyright © Allyn & Bacon 2007 Death Anxiety Cultural Variations  Religious teachings  Westerners - spirituality, meaning of life Cultural Variations  Religious teachings  Westerners - spirituality, meaning of life Individual Variations  Personal philosophy of death  Consistency of religious beliefs and practice  Symbolic immortality  Age  Gender

11 Copyright © Allyn & Bacon 2007 Age, Gender, and Death Anxiety

12 Copyright © Allyn & Bacon 2007 Kübler-Ross’s Theory  Denial  Anger  Bargaining  Depression  Acceptance  Denial  Anger  Bargaining  Depression  Acceptance

13 Copyright © Allyn & Bacon 2007 Appropriate Death  Makes sense with person’s pattern of living, values  Preserves or restores significant relationships  Free of suffering  As much as possible  Makes sense with person’s pattern of living, values  Preserves or restores significant relationships  Free of suffering  As much as possible

14 Copyright © Allyn & Bacon 2007 Communicating with Dying People  Be truthful  Diagnosis  Course of disease  Listen perceptively  Acknowledge feelings  Maintain realistic hope  Assist final transition

15 Copyright © Allyn & Bacon 2007 Factors That Influence Thoughts About Dying  Cause of death  Nature of disease  Personality  Coping style  Family members’ behavior  Health professionals’ behavior  Spirituality and religion  Culture

16 Copyright © Allyn & Bacon 2007 Places of Death  Home  Most preferred  Only 20–25% die at home  Hospital  Emergency room  Intensive care unit  Cancer care unit  Hospice

17 Copyright © Allyn & Bacon 2007 Hospice Approach  Comprehensive support for dying and their families  Family and patient as a unit  Team care  Palliative (comfort) care  Home or homelike  Bereavement help  Comprehensive support for dying and their families  Family and patient as a unit  Team care  Palliative (comfort) care  Home or homelike  Bereavement help

18 Copyright © Allyn & Bacon 2007 Forms of Euthanasia Voluntary Passive Withdraw treatment Advance medical directives Voluntary Active Medical staff or others act to end life at patient’s request Assisted Suicide Medical staff provide means for patient to end own life Controversial Involuntary Active Medical staff end life without patient’s consent

19 Copyright © Allyn & Bacon 2007 Advance Medical Directives  Living Will  Specify unwanted treatments  Durable Power of Attorney for health care  Appoint someone to make health care decisions  Living Will  Specify unwanted treatments  Durable Power of Attorney for health care  Appoint someone to make health care decisions

20 Copyright © Allyn & Bacon 2007 International Public Opinion on Voluntary Active Euthanasia

21 Copyright © Allyn & Bacon 2007 Assisted Suicide  Doctor provides drugs for patient to use  Legal in few nations, only in Oregon in U.S.  Few use .1% in Oregon  Highly controversial  About half disapprove  Some find option comforting  Doctor provides drugs for patient to use  Legal in few nations, only in Oregon in U.S.  Few use .1% in Oregon  Highly controversial  About half disapprove  Some find option comforting

22 Copyright © Allyn & Bacon 2007 Grief Process  Avoidance  “Emotional anesthesia”  Confrontation  Most intense grief  Restoration  Dual-process model of coping with loss Alternate between dealing with emotions and with life changes  Avoidance  “Emotional anesthesia”  Confrontation  Most intense grief  Restoration  Dual-process model of coping with loss Alternate between dealing with emotions and with life changes

23 Copyright © Allyn & Bacon 2007 Grieving Sudden or Prolonged Deaths Sudden, Unexpected  Avoidance from shock and disbelief  May not understand reasons  Suicide especially hard Sudden, Unexpected  Avoidance from shock and disbelief  May not understand reasons  Suicide especially hard Prolonged, Expected  Anticipatory grieving  Allows emotional preparation  Reasons usually known Prolonged, Expected  Anticipatory grieving  Allows emotional preparation  Reasons usually known

24 Copyright © Allyn & Bacon 2007 Difficult Grief Situations  Parents losing a child  Children or adolescents losing a parent  Adults losing an intimate partner  Bereavement overload  Parents losing a child  Children or adolescents losing a parent  Adults losing an intimate partner  Bereavement overload

25 Copyright © Allyn & Bacon 2007 Bereavement Interventions General Support  Sympathy, understanding  Patient listening, “being there” Interventions  Self-help groups  Daily living help Children & Adolescents  After violent death, prevent unnecessary reexposure  Help adults master own distress Difficult situations  Sudden, violent, unexplained, ambiguous deaths  Grief therapy, individual counseling

26 Copyright © Allyn & Bacon 2007 Resolving Grief Give yourself permission to feel the loss Accept social support Be realistic about course of grieving Remember the deceased When ready:  Engage in new activities, relationships  Master tasks of daily living

27 Copyright © Allyn & Bacon 2007 Death Education  Courses in death and dying  Offered at many educational levels  Lecture format  Increases discomfort  Experiential format  Role playing, discussions, guests, field trips  May reduce death anxiety  Courses in death and dying  Offered at many educational levels  Lecture format  Increases discomfort  Experiential format  Role playing, discussions, guests, field trips  May reduce death anxiety

28 Copyright © Allyn & Bacon 2007 Goals of Death Education  Understand physical, psychological changes in dying  Learn to cope with death of loved ones  Inform consumers of medical, funeral services  Understand social, ethical issues  Understand physical, psychological changes in dying  Learn to cope with death of loved ones  Inform consumers of medical, funeral services  Understand social, ethical issues


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