1. © 2007 McGraw-Hill Higher Education. All rights reserved. Chapter Eighteen Accepting Dying and Death

2. © 2007 McGraw-Hill Higher Education. All rights reserved. Definitions Of Death Clinical determinants of death Lack of heartbeat and breathing Lack of heartbeat and breathing Lack of central nervous system function Lack of central nervous system function The presence of rigor mortis The presence of rigor mortis A person is not legally dead until a death certificate has been signed by a physician, coroner, health dept.

3. © 2007 McGraw-Hill Higher Education. All rights reserved. Psychological Stages Of Death Denial Denial Anger Anger Bargaining Bargaining Depression Depression Acceptance Acceptance

4. © 2007 McGraw-Hill Higher Education. All rights reserved. Advance Health Care Directives Living will Living will Durable power of attorney for healthcare Durable power of attorney for healthcare

5. © 2007 McGraw-Hill Higher Education. All rights reserved. Coping with Specific Causes of Death Coping with terminal illness Coping with terminal illness Coping with an accidental death, natural disaster and terrorism Coping with an accidental death, natural disaster and terrorism Coping with death by suicide Coping with death by suicide Coping with death by murder Coping with death by murder

6. © 2007 McGraw-Hill Higher Education. All rights reserved. Definitions Euthanasia Euthanasia 1. Indirect or passive euthanasia 2. Direct or active euthanasia Physician- Assisted Suicide Physician- Assisted Suicide Death with Dignity Act Death with Dignity Act

7. © 2007 McGraw-Hill Higher Education. All rights reserved. Near- Death Experiences A sense of well-being and peace A sense of well-being and peace An out-of-body experience An out-of-body experience A movement into extreme blackness and darkness A movement into extreme blackness and darkness A shaft of intense light A shaft of intense light A decision to enter this light A decision to enter this light

8. © 2007 McGraw-Hill Higher Education. All rights reserved. Interacting with Dying People Display honesty and genuineness Display honesty and genuineness Do not try to avoid crying Do not try to avoid crying Provide emotional support Provide emotional support Resist the temptation to pull someone out of denial, anger or depression Resist the temptation to pull someone out of denial, anger or depression Do not feel obliged to talk constantly Do not feel obliged to talk constantly Use non-verbal communication Use non-verbal communication

9. © 2007 McGraw-Hill Higher Education. All rights reserved. Talking With Children About Death Avoid shielding or misleading children about the reality of death Avoid shielding or misleading children about the reality of death Understand children’s questions before providing an answer Understand children’s questions before providing an answer Give simple, direct answers Give simple, direct answers Answer questions when they arise Answer questions when they arise Respond with openness and honesty Respond with openness and honesty

10. © 2007 McGraw-Hill Higher Education. All rights reserved. Death Of A Child Avoid trying to cope by using alcohol, drugs Avoid trying to cope by using alcohol, drugs Make no important life changes Make no important life changes Share feelings with others Share feelings with others Avoid trying to erase death Avoid trying to erase death Take time and space to grieve Take time and space to grieve Don’t attempt to replace the child Don’t attempt to replace the child

11. © 2007 McGraw-Hill Higher Education. All rights reserved. Hospice Care Pain control Pain control Family involvement Family involvement Multidisciplinary support Multidisciplinary support Patient decisions Patient decisions

12. © 2007 McGraw-Hill Higher Education. All rights reserved. Rituals Of Death Full funeral services Embalming Embalming Calling hours Calling hours Funeral service Funeral service Disposition of the body Ground burial Ground burial Entombment Entombment Cremation Cremation Anatomical donation Anatomical donation

13. © 2007 McGraw-Hill Higher Education. All rights reserved. Personal Preparation For Death Prepare a will Prepare a will Purchase a life insurance policy Purchase a life insurance policy Make funeral prearrangements Make funeral prearrangements Prepare a living will Prepare a living will Consider anatomical or organ donation Consider anatomical or organ donation Discuss plans with family and friends Discuss plans with family and friends Prepare your obituary or eulogy Prepare your obituary or eulogy Write your own epitaph Write your own epitaph

14. © 2007 McGraw-Hill Higher Education. All rights reserved. Chapter Eighteen Accepting Dying and Death