Death, Dying, and Grieving Chapter 20

Death, Dying, and Grieving Defining death has become more complex Brain death A neurological definition of death. A person is brain dead when all electrical activity of the brain has ceased for specified period of time.

Death, Dying, and Grieving Advance Care Planning The process of patients thinking about and communicating their preferences about end-of-life care Decreases life-sustaining treatment, increased hospice use, and decreased hospital use Associated improved quality of care at the end of life .... Including Less in-hospital death and greater use of hospice care

Death, Dying, and Grieving Living Will A legal document that reflects the patient's advance care planning Laws in all 50 states now accept an advance directive, such as a living will

Death, Dying, and Grieving Euthanasia The act of painlessly ending the lives of persons who are suffering from incurable diseases or severe disabilities ..... sometimes called "mercy killing."

Death, Dying, and Grieving Passive euthanasia The withholding of available treatments, such as life-sustaining devices, in order to allow a person to die Active Euthanasia Death induced deliberately, as by injecting a lethal dose of a drug

Death, Dying, and Grieving In US - there is no official government policy on assisted suicide and leaves the decimation up to each of the states Currently, three states allow assisted suicide Oregon, Washington, and Montana Typically a physician giving the patient an overdose of muscle relaxants or sedatives, which causes a coma and then death

Death, Dying, and Grieving Care of Dying Individuals Death in America is often lonely, prolonged and painful Many health care professionals have not been trained to provide adequate end-of-life care or to understand its importance

Death, Dying, and Grieving Good Death for some: Physical comfort, support from loved ones, acceptance, and appropriate medical care For others: Accepting one's impending death and not feeling like a burden to others

Death, Dying, and Grieving Hospice A program committed to making the end of life as free from pain, anxiety, and depression as possible. The goals of hospice contrast with those of a hospital.... ... Which are to cure disease and prolong life.

Death, Dying, and Grieving Palliative Care The type of care emphasized in a hospice, which involves reducing pain and suffering and ......helping individuals die with dignity Hospice goal is to bring pain under control and to help patients face death in a psychologically healthy way Also makes every effort to include the dying individual's family (assisting with diminishing guilt)

Death, Dying, and Grieving Kubler-Ross Stages of Dying Elisabeth Kubler-Ross divided the behavior and thinking of dying persons into five stage. Not all individuals go through the same sequence

Death, Dying, and Grieving Denial and isolation- the dying person denies that she or he is really going to die. Anger- the dying person's denial gives way to anger, resentment, rage, and envy Bargaining- the dying person develops the hope that death can somehow be postponed Depression- the dying person comes to accept the certainty of her or his death. A period of depression or preparatory grief may appear. Acceptance- The dying person develops a sense of peace, an acceptance of her or his fate, and in many cases, a desire to be left alone

Death, Dying, and Grieving Communicating with a Dying Person Most psychologists argue that it is best for dying individuals to know that they are dying ... And that significant others know that they are dying so .... they can interact and communicate with each other on the basis of this mutual knowledge

Death, Dying, and Grieving Advantages: Dying individuals can close their lives in accord with their own ideas about proper dying They may be able to complete some plans and projects, can make arrangements for survivors, and can participate in decisions about a funeral and burial Dying individuals have the opportunity to reminisce and to converse with people who have been important to them Individuals who know they are dying have more understanding of what is happening within their bodies and what the medical staff is doing for them

Death, Dying, and Grieving Communicating with the dying person Some experts reason that a conversation should not focus on mental pathology ... Or preparation for death... But should focus on strengths of the individual and preparation for the remainder of life

Death, Dying, and Grieving Grief The emotional numbness, disbelief, separation anxiety, despair, sadness, and loneliness ........that accompany the loss of someone we love

Death, Dying, and Grieving Grief is not a simple emotional state.... But rather a complex, evolving process with multiple dimensions: Pining for the lost person Separation anxiety.... Including preoccupation with thoughts of the deceased person Focuses on places and things associated with the deceased Crying or sighing Sense of hopelessness and defeat Depressive symptoms Apathy, loss of meaning for activities Growing desolation

Death, Dying, and Grieving Even six months after: Some still have difficulty moving on Feeling numb or detached Believing their life is empty without the deceased Feeling that the future has no meaning ...... Often referred to as Prolonged or complicated grief.

Death, Dying, and Grieving Prolonged grief disorder: Grief that involves enduring despair and remains unresolved over an extended period of time Disenfranchised grief Individual's grief over a deceased person that is a socially ambiguous loss that can't be openly mourned or supported Loss of an ex-spouse, a hidden loss like an abortion, or a stigmatized death because of AIDS May intensify an individuals grief because the feelings cannot be publicly acknowledged May be hidden or repressed for many years, only to be reawakened by later deaths

Death, Dying, and Grieving Losing a Life Partner Those left behind after the death of an intimate partner often suffer profound grief. And often endure financial loss, loneliness, increased physical illness and psychological disorders, including depression

Death, Dying, and Grieving Both widow and widowers Need social support to adjust to the death of a spouse Support groups often beneficial organized social activities Religiosity and coping skills needed

Death, Dying, and Grieving Mourning In the US 42% of deaths were followed by cremation.... Expected to be 60 percent soon Trend is away from public funerals and displaying the dead body

Death, Dying, and Grieving Funeral directors Argue that the funeral provides a form of closure to the relationship, especially when there is an open casket Others claim that funeral directors are just trying to make money and that embalming is grotesque One way to avoid being exploited during bereavement is to purchase funeral arrangements in advance But only 24% of individuals 60 years of age and over had made any funeral arrangements