2Learning ObjectivesHow is death defined?Why is the definition of death controversial?How does the social meaning of death vary across groups?What factors influence life expectancy?Is it possible to extend life expectancy?What is the difference between programmed theories of aging and damage theories of aging? Give an example of each.
3Biological Definitions of Death Harvard Definition: Total Brain DeathUnresponsive to stimuliNo movement or breathingNo reflexesFlat EEGEuthanasia: “Happy” or “good” deathHastening death of someone suffering incurable illness or injury
4Social Meanings of Death Modern American: Medical failureMore traditional societiesNatural part of life cycleGrieving Practices VaryBy culture: Weeping/partyingBy ethnicity: Wake/Shiva
5Life ExpectancyExpected Age at DeathU.S.: 76.5 yearsWhite females: 80 yearsWhite males: 75 yearsBlack females: 75 yearsBlack males: 68 yearsAncient Rome: 30 years
7Male and female life expectancies at birth in selected countries Male and female life expectancies at birth in selected countries. Life expectancies vary widely from country to country but are generally higher for females than for males.
8Theories of Aging and Death Programmed TheoriesMaximum life span (species specific)Hayflick LimitDamage TheoriesFree radicalsInteraction of the two – or more
9Learning ObjectivesWhat are Kübler-Ross’ stages of dying?How valid and useful is the theory?What is the Parkes/Bowlby attachment model of bereavement?Is there evidence to support this model?
10Kübler-Ross’ Stages of Dying Common set of stage-like emotionsDenial, anger, bargaining, depression, acceptanceCriticismsDeath is not a stage-like processCourse of illness not consideredIndividual differences
11Attachment Model of Bereavement Bereavement: The state of lossGrieving: Emotional expressionsAnticipatory griefMourning: Culturally approved reactionsParks/Bowlby ModelReaction to separation from a loved oneNumbness, yearning, despair, reorganization
12Patterns of Bereavement Dual Process ModelLoss oriented coping: Coping with emotional blow of lossRestoration coping: Coping with the practical challenges of living, and re-energizing
13Patterns of grief differ greatly from person to person Patterns of grief differ greatly from person to person. Some people show little grief; many experience disrupted functioning for about a year and then minimal grief in the second year; and about 15% experience chronic and significant psychological problems.
14Learning ObjectivesWhat is the infant’s understanding of separation and death?
15The InfantObject permanenceAttachment by 6-8 monthsSeparation anxiety at lossProtest, yearning, searching, despairBehavioral: eating, sleeping, regressionLess distress if attached to other parentEventual new attachments and recovery
16Learning ObjectivesHow do children’s conception of death compare to a “mature” understanding of death?What factors might influence a child’s understanding of death?What is a dying child’s understanding of death?How do dying children cope with the prospect of their own death? How do children grieve?
17The ChildThe Mature Concept of DeathFinality, irreversibility, universality, biological causalityAge 3-5: UniversalityDead live under altered circumstancesReversible – like sleepAge 5-7: Finality, irreversibilityLevel of cognitive development, experience
19The Dying ChildYoung child aware of impending deathAdults often secretiveSame range of emotions as dying adultsAnxiety revealed in behaviorParental control is helpfulNeed support of important others
20The Bereaved ChildChildren do grieveExpress grief differently than adults doMisbehavior, strike out, rageLack adult coping skillsWill use denial, avoidanceMost adjust successfully
21Learning ObjectivesWhat is the adolescent’s understanding of death?Is an adolescent’s reaction to death different from the reactions of a child or adult?
22The AdolescentHigher levels of understandingConcerns of adolescenceBody image, identity, independenceMay carry on internal dialogue with deadDevastated at death of close friendAdult-like grieving
23Learning ObjectivesHow do family members react and cope with the loss of a spouse, a child, and a parent?What factors contribute to effective and ineffective coping with grief?What can be done for those who are dying and for those who are bereaved to better understand and face the reality of death?
24The AdultDeath of family member difficultDeath of spouse more expected with ageMore difficult when young (non-normative)Elevated levels of stressRisk increases for illness and deathSigns of recovery after 2 years
25Loss of a ChildNo loss more difficultExperienced as untimely, unjustBroken attachmentsGuilt at failure to protect childMay continue relationship w/dead childMarital problems often increase afterward
26The Loss of a ParentLasting problems may occur if youngLess tragic than unexpected deathAdjustment not as difficultGuilt: Not doing enough for parentBroken attachment
27Grief Work Perspective Emotions must be confronted: DetachmentPsychoanalytic, also popular viewMay be a culturally biased beliefGrief work may actually cause more distressDelayed grief reaction predicted w/out itNot supported by researchDetachment not necessary
28Who Copes and Who Succumbs Secure infant attachment related to copingLow self-esteem related to more difficultyCause of death influences bereavementSupport system essentialAdditional life stressors detrimentalPositive outcomes often found
29HospiceDying person decides what is neededDe-emphasize prolonging lifePain control emphasizedNormal setting (home if possible)Bereavement counseling for entire familyResearch shows positive outcomes
30Learning ObjectivesWhat are the major themes of lifespan development that have been covered throughout the text?
31Major Developmental Themes of Text Nature and nurture truly interactWe are whole people throughout the life spanDevelopmental domains relatedDevelopment proceeds in multiple direction with both continuity and discontinuityThere is much plasticity in developmentWe are diverse individuals and are active in our own developmentDevelopment is a lifelong process