1. Dying And Death Chapter 20

2. 2 Why Is There Death?  Life span is long enough to allow reproduction and the linage of our species.  Challenges our emotions and intellectual security.  We know that everything alive eventually dies.

3. 3 Understanding Death and Dying  Defining death.  Defined as cessation of the flow of bodily fluids.  Life-support systems.  Brain death. 1. Lack of receptivity and response to external stimuli. 2. Absence of spontaneous muscular movement and breathing. 3. Absence of observable reflexes. 4. Absence of brain activity. 1. Electroencephalogram (EEG).

4. 4 Learning About Death  Understanding of death changes as we age.  Mature understanding of death.  Four components (Mark Speece). 1. Universality. 2. Irreversibility. 3. Nonfunctionality. 4. Causality.

5. 5 Denying Versus Welcoming Death  Anxiety associated with death.  Many seek to avoid any thought or mention of death.  United states attitude is to “death denying”.

6. 6 Planning For Death  Making a will.  Estate.  Testator.  Interstate.

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8. 8 Considering Options for End-of Life Care  Spending your last days at home, cared for by relatives and friends? -OR-  Access to the sophisticated medical technologies in the hospitals.  Home care.  Hospital-based palliative care.  Hospice programs.

9. 9 Deciding to Prolong Life or Hasten Death  Modern medicine.  Persistent vegetative state.  Ethical questions about the “right to die”.  U.S. Supreme Court in 1990.  The right to refuse life sustaining treatment is constitutionally protected.

10. 10 Deciding to Prolong Life or Hasten Death  Withholding or Withdrawing Treatment.  Passive euthanasia.  Assisted Suicide and Active Euthanasia.  Physician-assisted suicide (PAS).  Active euthanasia.

11. 11 Completing an Advance Directive  Living will.  Health care proxy.  Surrogate.

12. 12 Becoming an Organ Donor  Human body is a valuable resource.  Each day 60 people receive an organ transplant.  Each day 18 people on the waiting list die because not enough organs to assist.  Uniform Donor Card.

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14. 14 Planning a Funeral or Memorial Service  Disposition of the body.  Arranging a Service.  Non-profit memorial society.

15. 15 Coping With Dying  No one right way to live or die of a life-threatening illness.  Doctors treat diseases; people suffer from illness.  Concerns with:  Costly medical care.  Loss of income.  Repeated and lengthy hospitalization.  Physical pain.

16. 16 Awareness of Dying  “Living-dying” experience.  Middle knowledge – patients and family seek a balance between hope and reality.

17. 17 The Tasks of Coping  On Death and Dying (Elisabeth Kubler-Ross).  5 Psychological stages: 1. Denial. 2. Anger. 3. Bargaining. 4. Depression. 5. Acceptance.

18. 18 The Tasks of Coping  Charles Corr’s primary dimensions in coping with dying. 1. Physical. 2. Psychological. 3. Social. 4. Spiritual.

19. 19 Patterns of Coping  Defense mechanisms.  Coping Strategies.  Different strategies: 1. Emotion-focused. 2. Problem-focused. 3. Meaning-based.  The Trajectory of dying.  Supporting a dying person.

20. 20 Coping With Loss  Experiencing Grief.  Bereavement.  Mourning.  Tasks of Mourning. 1. Accepting the reality of the loss. 2. Working through the pain and grief. 3. Adjusting to a changed environment. 4. Emotionally relocating the deceased and moving on.  The Course of Grief.

21. 21 Supporting a Grieving Person  Give kind and loving support.  Be a good listener.  Refrain from making judgments about the survivor’s feelings are “good” or “bad”.  Social support is critical.

22. 22 Helping Children Cope With Loss  Children tend to cope with loss healthier fashion.  Adults must share the news with the children.  Natural curiosity.  Sudden changes in the family environment.  Keep the informational lines open for the child’s questions.  Be Honest.

23. 23 Enjoy Your Day!