1. Death is the final stage of growth!
Dying & Death

2. What is Terminal Illness?
A disease that cannot be cured and will result in death.
How might a patient feel when they find out this news?

3. Stages of Dying and Death
Denial
Anger
Bargaining
Depression
Acceptance

4. Denial * “no, not me!” * cannot accept reality
* “the doctor doesn’t know what he is talking about”
* May get a second opinion
What are some things you can say?

5. Anger * “why me?” * “it’s your fault”
What are some things you can say?

6. Bargaining * turn to religion or beliefs * will to live is strong
* want to see marriages, etc so make deals with God
What are some things you can say?

7. Depression * may express regrets * sadness, despair *allow them to cry
What are some things you can say?

8. Acceptance * Final stage * may complete unfinished business
*separate from the world and people
What are some things you can say?

9. Hospice Care * can play an important role in meeting a patients’ needs
* offers palliative care: support and comfort
* usually starts around 6 months to live
* services they provide?

10. Right to Die
The Bill of Rights pg 254

11. Changes the body goes through during the dying process
Physiology of Dying
Changes the body goes through during the dying process
Somatic death: the death of the body

12. Physiology of Dying Irreversible events of all vital systems
Respiratory, Cardiovascular, Urinary, Nervous

13. Cardiovascular System
Physiology of Dying
Respiratory System
Lungs: unable to oxygenate the body
Death Rattle: Cheyne – Stokes breathing
Cardiovascular System
\Blood starts backing up bc heart stops pumping
Skin becomes cool, pale
Cyanotic
Pulse changes

14. Physiology of Dying Urinary System Nervous System
Might retain feces or become incontinent
Urinary output decreases
Nervous System
Motion lost in legs first, then arms
Turns toward light
Eyes might be open even if unconscious

15. Physiology of Dying
Criteria for death is determined by hospital policy; therefore one can be pronounced dead in one hospital and alive in another
Heart, Lungs & Brain: Trinity of death standards; if these aren’t working-- Death

16. Clinical Death vs. Biological Death
Physiology of Dying
Clinical Death vs. Biological Death
Clinical Death: Heart, Lungs, Brain activity
Biological Death: Hair still grows for several hours, liver converts glycogen, muscles contract
RIGOR MORTIS: begins 2 hours after death, muscles remain contracted for ~30 hours: calcium remains in muscles causing stiffness

17. Biological Death
Somatic Death
Rigor Mortis
Hospice
Death Rattle
Acceptance
Brain Failure
Terminal Illness
Cyanotic
Respiratory System
Right to Die

18. Alzheimer’s Disease
Clinical Death
Puberty
Cardiovascular System
Bulimia
Cheyne Stokes
Incontinence
Denial
Anger
Bargaining
Development
Moro Reflex