1. Death and Dying

2. Objectives Describe dying, the phases of dying, and death.
Explain do-not-resuscitate orders.
Differentiate between medical power of attorney and legal power of attorney.
List who can be an organ donor and what parts of the body can be donated.
Explain various spiritual perspectives on death.
Compare Kubler-Ross’ stages with Temes’ stages of death.
Explain how people cope with death.

3. Death and Dying
In 1980, the National Conference of Commissioners on Uniform State Laws formulated the Uniform Determination of Death Act to help define death.
Dying is the complete and permanent cessation of all vital functions.

4. Do-Not-Resuscitate Order
Instructions written by a doctor telling other health care providers not to try to restart a patient's heart
Usually written after a discussion between a doctor and the patient or family members
Written for people who are very unlikely to have a successful result from CPR—those who are terminally ill or elderly and frail

5. Medical and Legal Powers of Attorney
Medical power of attorney: Gives the person named the authority to make decisions about whether to follow a dying person’s advance directive, or living will.
Legal power of attorney: Gives the person named the control of a person’s financial responsibilities and assets.

6. Phases of Dying Preactive phase Active phase
Patients are more aware they’re dying.
They stop recovering from wounds or infections.
They often want to put affairs in order.
Active phase
Body dies from extremities inward.
Hands and feet become cold and blue.
Patient sleeps a lot.
Patient isn’t hungry or thirsty.

7. Managing End of Life With Hospice Care
Cares for dying person and, often, their families.
Provides palliative care.
Nurses, social workers, and spiritual counselors make up hospice teams.

8. Organ Donors Organs from people of any age can be donated.
Doctors decide which organs are viable for transplantation.
Organs from people who are HIV positive, have active cancer, or have a systemic infection can’t be used for donation.

9. Organs That Can Be Donated
Organs that must be transplanted immediately:
Kidneys
Heart
Liver
Lungs
Pancreas
Intestines
(continued)

10. Organs That Can Be Donated (continued)
Organs that can be stored for later transplantation:
Corneas
Middle ears
Skin
Heart valves
Bone
Veins
Cartilage
Tendons
Ligaments

11. Burial Purposes Places Cremation Dispose of the body.
Commemorate the person’s life.
Places
Varies culturally.
Often churchyards and cemeteries.
Cremation
Costs less than traditional burial.
Remains of cremated person are portable.

12. Spiritual Side of Death
Cultures differ in the way they deal with death.
Cultures differ in their beliefs about the afterlife.
Reincarnation
Heaven and hell

13. Kubler-Ross’ Stages of Grief
Denial (This isn't happening to me!)
Anger (Why is this happening to me?)
Bargaining (I’ll be a better person if . . .)
Depression (I don't care anymore.)
Acceptance (I'm ready for whatever comes.)

14. Five Stages of Grief

15. Temes’ Stages of Grief
Numbness (mechanical functioning and social insulation)
Disorganization (intensely painful feelings of loss)
Reorganization (reentry into a more normal social life)