1. Feb 20 Key Points from Quiz

2. Elisabeth Kübler-Ross Pioneer because she was the FIRST to bring death and dying into the mainstream by talking about it. NOT because she is old and traveled by covered wagon! She introduced the 5 Stages – a process by which people deal with a terminal illness

3. 5 stages can also apply to: 1. Catastrophic loss. (job, income, freedom). 2. Significant life events a) The death of a loved one b) Divorce c) Drug addiction d) Infertility diagnosis, e) As well as many tragedies & disasters.

4. Characteristics of the “Stages” 1. Stages not necessarily in the order given 2. All stages not experienced by all patients usually a person will always experience at least two. 3. Often, people will experience several stages in a "roller coaster" effect switching between two or more stages, returning to one or more several times before working through it.

5. Stages of Dying Stage 1 Denial a.Denial is usually only a temporary defense for the individual. b.Person may need this for a time to transition to later acceptance. c.Cushion may be needed because this is so traumatic.

6. Stage 2 Anger a. The individual recognizes that denial cannot continue. b. The person is very difficult to care for due to misplaced feelings of rage and envy. They take their anger out on us! Healthy people are resented!

7. Stage 3 Bargaining – "Just let me live to see my children graduate."; "I'll do anything for a few more years."; – "I will give my life savings if..." Person hopes that they can somehow postpone or delay death. –Deal with God: “I’ll live a better life if you just give me more life.”

8. Stage 4 DEPRESSIONDEPRESSION – "I'm so sad, why bother with anything?"; "I'm going to die... What's the point?“ a. The dying person begins to understand the certainty of death. b. The individual may become silent, refuse visitors and spend much of the time crying and grieving. (Allows person to disconnect). It is not recommended to attempt to cheer up an individual who is in this stage. It is an important time for grieving that must be processed.

9. Stage 5 ACCEPTANCE a. This final stage comes with peace and understanding of the death that is approaching. The living can't possibly understand this “transitional stage” b. Person will want to be left alone.

10. Dealing With the Dying 1.We need to be willing to talk 2.Don’t be afraid of upsetting them – they are already upset! 3.Never say: “I know what you’re going through.” YOU DON’T! 4.Allow the dying to give you a clue (They may be afraid to upset YOU). 5.Remember: Not everyone wants to discuss it. (Some still in denial and you can’t “break through it.”) 6.Those not in denial may not talk because: a.They are considering your feelings b.They are afraid they will have no visitors c.They may talk better with certain people.

11. 7. Don’t be afraid to show your feelings. (doctors may be an exception). 8. Children may visit – but use judgment –Which will “frighten” them more? 9. Families often suffer from a misguided compassion: –They don’t want to face it so they assume the patient doesn’t want to face it! 10. Patients often “know” even if they haven’t been told. 11, “Active Listening” – Respond to patients hints and don’t be afraid to address their concerns. 12. Dying are often considered “untouchables” so don’t be afraid of a hug, hold their hand, etc. 13. Regulate visits: “A visit is a ‘medication’, regulate the dose, don’t become ‘toxic!’” 14. REMEMBER: They are still LIVING – they are the same person, the difference is often in us!

12. DISCUSSION Strange Stories  Better off dead?  Declining vulture population leads to disease. A world without death: DISCUSSION (p. 75) General Consequences Personal Consequences

13. Death System We face death alone in one sense, but in another sense we face death as part of society whose expectations, rules, motives and symbols influence our individual encounters with death.

14. Components of the Death System People – Funeral director, life insurance agent, florist, cemetery worker, health-care professionals, clergy, etc. Places – Cemeteries, funeral homes, hospitals, nursing homes, NYC (WTC), Oklahoma City, Dallas TX, Memphis (Lorraine Motel), Ford Theater, etc. Times – Memorial Day, All Souls Day, Halloween, 911, etc. Objects – hearse, death certificate, cross, etc. Symbols & Images

17. Class Presentations