1. Dying

2. Number of deaths for leading causes of death: 1. Heart disease: 616,067 2. Cancer: 562,875 3. Stroke (cerebrovascular diseases): 135,952 4. Chronic lower respiratory diseases: 127,924 5. Accidents (unintentional injuries): 123,706 6. Alzheimer's disease: 74,632 7. Diabetes: 71,382 8. Influenza and Pneumonia: 52,717 9. Nephritis, nephrotic syndrome, and nephrosis: 46,448 10. Septicemia: 34,828 CDC 2007 CAUSES OF DEATH Do you notice anything?

3. The five leading causes of death among teenagers are 1.Accidents (unintentional injuries) Accidents account for nearly one-half of all teenage deaths 2. Homicide 3. Suicide 4. Cancer 5. Heart disease Homicide is the leading cause of death for non-Hispanic black male teenagers. For all other groups, accident is the leading cause. TEEN AGE DEATH

4. ttp://gosset.wharton.upenn.edu/mortality/perl/CalcForm.html http://calculator.livingto100.com/calculator LIFE EXPECTANCY: 77.9 YEARS

5. Up to 6 months, a loss brings no response due to undeveloped memory capacity for specific personal relationships Up to 6months, there is not ability to conceptualize death From 6 months to 1 year, a loss like separation, may be felt, if at all as a vague absence or experimental sense of something different DEATH BIRTH TO 1 YEAR

6. Main concern is separation fear (less alive) Death of the primary caregiver will usually result in displeasure and depression Do not really understand or attribute meaning to it Influenced by the parent's tense and emotional response to a death in the immediate family DEATH 1 TO 2 YEARS

7. Pre-school, children are concerned with getting hurt and the pain associated with it. Are concerned about punishment or wrong doings They have seen death portrayed on TV or movies; they have a vivid imagination and can dream or become frightened of what they believe May see death as temporary and happens to other people 4-6 year olds may want to talk about it DEATH 2-6 YEARS

8. 6-8 years an understanding of death is developing. There is an interest in the physical and biological aspects of death. Magical thinking – thoughts can make things happen By 9 the concept of death is similar to an adult, but only happens to other people. Ghost figures 9-12 see death as final. Awareness of personal death, but a distant possibility for adolescents because they think they are invincible DEATH 6-12 YEARS

9. Teens struggle with finding the meaning of life. Death is now viewed abstractly. They think of themselves as immortal. (Still happens to others) Death is romanticized as beautiful and tragic; paradoxically a gesture that will endure. DEATH 12 - ADOLESCENCE

10. View death according to their perspective on life They are building their life. May think of death if someone their age dies. Middle age focus on their changing body. They think about their own mortality. Their parents are dying, evaluation of their values and priorities. The older adult they will die and talk about death and their final wishes. Culture and religion influence it. DEATH ADULTS

11. Denial Anger Bargaining Depression Acceptance http://www.youtube.com/user/kenrossaz FEELINGS OF DEATH AND DYING DR. ELIZABETH KUBLER-ROSS

12. By studying the child’s reaction to separation from the mother compared this to patterns of adult grief. Child’s initial reaction is to Stage I protest (angry, crying) Stage II is despair (quiet, sad and subdued) Stage III is detachment (the child is not interested when the mother returns) With an adult (4 stages) 1.Numbing stage (protective mechanism) 2. Painful stage (magnitude of the loss) 3. Disorganization and despair (anger) 4. Reorganize and adapt (requires support and encouragement from friends) JOHN BOWLBY’S STAGES OF SEPARATION

13. Grief Anticipatory Grief Maladaptive Grief Mourning (natural process) Bereavement (having the loss) GRIEF VS MALADAPTIVE GRIEF

14. Live Promise www.stelizabeth.com/Hospice www.hospicebg.org/ www.hospicenet.org RIGHT TO DIE HOSPICE - PAGE 249

15. The longer I live, the more I realize the impact of attitude on life. Attitude, to me, is more important than facts. It is more important than the past, than education, than money, than circumstances, than failures, than successes, than what other people think or say or do. It is more important than appearance, giftedness or skill. It will make or break a company... a church... a home. The remarkable thing is we have a choice every day regarding the attitude we will embrace for that day. We cannot change our past... we cannot change the fact that people will act in a certain way. We cannot change the inevitable. The only thing we can do is play on the one string we have, and that is our attitude... I am convinced that life is 10% what happens to me and 90% how I react to it. And so it is with you... we are in charge of our Attitudes ATTITUDE BY CHARLES SWINDOLL