Parts taken from Human Development 1 Psychology 203 Human Development The End of Life Chapter 19

Parts taken from Human Development 2 Dealing With Death and Bereavement Many Faces of Death Death is a biological fact but other aspects –Social –Cultural –Historical –Religious –Legal –Psychological –Developmental –Medical –Ethical

Parts taken from Human Development 3 Dealing With Death and Bereavement * Death and loss are universal experiences that have a cultural context Cultural Context – customs concerning –Disposal of dead Care of and behavior toward the dying and dead Setting where death usually takes place –Remembrance of the dead –Transfer of possessions –Expression of grief Mourning customs and rituals

Parts taken from Human Development 4 Dealing With Death and Bereavement Remembrance and Expression of grief –All-night Irish wake – toast the memory –Week-long Shiva – vent feeling, share memories –Flying a flag at half-mast – show respect Malayan society –Death seen as a gradual transition Romania –Warriors went laughing to their graves Greece –* Cremation, the art of burning the bodies of the dead was seen as a sign of honor

Parts taken from Human Development 5 Dealing With Death and Bereavement Mortality Revolution – advances in –Medicine –Sanitation –Treatments of many once-fatal illnesses –Better educated –Health-conscious populations * Mortality rates have decreased sharply for men in the United States, mainly due to the declining rates of heart disease

Parts taken from Human Development 6 Care of the Dying Hospice Care – warm personal patient and family centered care for a person with a terminal illness Palliative Care – care aimed at relieving pain and suffering and allowing terminally ill to die in peace, comfort, and dignity

Parts taken from Human Development 7 Confronting One’s Own Death Kubler-Ross five stages in coming to terms with death –Denial (refusal to accept the reality of what is happening) –Anger –Bargaining for extra time –Depression –Acceptance

Parts taken from Human Development 8 Patterns of Grieving * Bereavement – The loss due to death of someone to whom one feels close to and the process of adjustment to the loss –Can affect all aspects of a survivor’s life Change in status or role –Wife to widow –Son or daughter to orphan –Loss of friend –Loss of income Grief is first emotional response in early phases of bereavement –Example: * The emotional loss that Anna felt when her son died kept her from eating, going to work, or caring for the children that she still had. This emotional response is known as grief

Parts taken from Human Development 9 Grief Work Shock and disbelief –Survivors often feel lost and confused which may last for several weeks Overwhelming feeling of sadness and frequent crying Preoccupation with the memory of the dead person –Survivor tries to come to terms with death but cannot yet accept it lasts six months or longer –Diminish with time but may recur for years on anniversary or marriage or of death

Parts taken from Human Development 10 Grief Work Resolution –Final stage when the bereaved person renews interest in everyday activities –Memories of the dead person mingle with sadness rather then pain and longing

Parts taken from Human Development 11 Grief Work Kubler-Ross five stages are controversial 1.Depression is far from universal 2.Failure to show distress may not lead to problems latter 3.Not everyone needs to work through the loss 4.Not everyone returns to normal quickly 5.People cannot always resolve their grief and accept their loss

Parts taken from Human Development 12 Death and Bereavement Across the Life Span Childhood and Adolescence –Before the age of 5 or 7 years Certain groups of people do not die (teachers, parents, children) Smart or lucky people can avoid death They themselves will live forever Dead person can still think and feel –Children between the ages of 5 to 7 years Death is irreversible Death is universal – all things must die Dead persons are nonfunctional – all life functions end at death

Parts taken from Human Development 13 Childhood and Adolescence

Parts taken from Human Development 14 Death and Childhood and Adolescence Adolescents take heedless risks –Hitchhike –Drive recklessly –Experiment with drugs –Experiment with sex –More concerned with how they live rather than with how long they will live

Parts taken from Human Development 15 Death Adulthood Young adults –May be extremely frustrated which turns into rage Older adults who feel their lives have been meaningful and adjusted to their losses better able to face death

Parts taken from Human Development 16 Special Losses Surviving a Spouse –Women tend to live longer then man –Women tend to widow younger than men –On-third of women lose their husbands by age 65 –Hard for women who have structured their life and their identity around caring for their husband –Strong likelihood that widowed person (especially a man) will soon follow a spouse to the grave Men who lost their wife are 21% more likely to die within the same period, only 10% for women

Parts taken from Human Development 17 Special Losses Surviving a Spouse –Available women greatly outnumber available men but widowers are four times as likely to remarry as elderly widows –* One of the major reasons men may remarry more often than women is of the need for intimacy is greater because men usually have fewer close friendships

Parts taken from Human Development 18 Special Losses Surviving a Spouse

Parts taken from Human Development 19 Special Losses Losing a Child Parent is rarely prepared emotionally for the death of a child –Cruel –Unnatural shock –Untimely event –Should not have happened –Feel that they have failed –Hard to let go If marriage is strong will draw closer together for support If marriage is not strong marriage will weaken and destroys the marriage

Parts taken from Human Development 20 The “Right to Die” Suicide –In modern societies is no longer a crime but still a stigma –US rate of 10.7 per 100,000 is lower then that in other industrialized countries –Highest rate among elderly white men, particularly those 85 and older Withdrawing from family or friends Talking about death Giving away prized possessions Abusing drugs or alcohol Unusual anger, boredom or apathy

Parts taken from Human Development 21 The “Right to Die” Aid in Dying –Euthanasia Active – deliberate action taken to shorten the life of a terminally ill person in order to end suffering or to allow death with dignity (mercy killing) Passive – deliberate withholding or discontinuation of life-prolonging treatment of a terminally ill person

Parts taken from Human Development 22 The “Right to Die” The United States Supreme Court has held that a person is clearly within his/her constitutional rights if he/she requests passive euthanasia (1997) Advance Directives –Living will – document specifying the type of care wanted by the maker in the event of terminal illness –Durable power of attorney – appiints another person to make decisions if the maker becomes incompetent to do so

Parts taken from Human Development 23 The “Right to Die” Efforts to legalize physicians aid in dying –US Supreme Court left regulation of physician aid in dying up to the states Only Oregon has passed such a law * Loss of autonomy and bodily functions were the biggest fears that the Oregon patients had about the end of life experience Finding meaning –Those who saw the most purpose in life had the least fear of death –Life review is reminiscence about one’s life in order to see its significance

Parts taken from Human Development 24 The “Right to Die” Life-review therapy –Writing or taping one’s autobiography –Construction a family tree –Talking about scrapbooks, photo albums –Reading old letters –Making a trip back to scenes of childhood and young adulthood –Reunions with former classmates or colleagues –Describing ethnic traditions –Summing up one’s life’s work

Parts taken from Human Development 25 The “Right to Die” Weingberger –“Even dying can be a developmental experience”