1. Death as part of life Inevitable

2. Death as part of life Loss – Something removed

3. Death as part of life Coping – process

4. Death as part of life Grief – Expression of loss

5. Death as part of life Mourning – Process following loss

6. Elisabeth Kubler-Ross’s stages 1.Denial 2.Anger 3.Bargaining 4.Depression 5.Acceptance

7. John Bowlby’s stages of separation 1.Protest 2.Despair 3.Detachment

8. Bowlby’s Phases of Mourning 1.Numb stage 2.Painful stage 3.Disorganized & despair 4.Reorganization stage

9. Types of lose Physical – Death of spouse – Death of parent – Death of child – Death of friend Symbolic losses – Loss of work – Loss of status – Loss of mobility – Loss of independence

10. Loss of a Spouse Great magnitude Risk of death – >2yrs Men – Feel alone Women – Feel abandoned Widows younger than widowers

11. Loss of a parent Age?

12. Loss of a child One of most difficult Blame

13. Loss of unborn child Hold child

14. Loss of sibling Blame self

15. Facing one’s own death Terminal illness

16. Signs of approaching death Withdraw  senses Cheyne-Stokes Respirations BP –  Pulse –  Temp – 

17. Development of concept of death Infant –N–No concept Toddler –S–Separation anxiety Preschool –P–Pain avoidance 5-6 –P–Punishment School-age –H–Have capacity to understand!

18. Advanced directive Legal document Wishes for medical treatment is they cant make these decisions

19. Living Will Form of advanced directive States wishes regarding life-sustaining treatment

20. Durable power of attorney for health care Appoint someone to make their wished known in the event they can’t any longer

21. Do not Resuscitate (DNR)

22. Euthanasia Assisted suicide “Mercy killing” Oregon

23. Right to die Can refuse medical treatment

24. Palliative care Relieve suffering

25. Hospice Care Part of Medicare/medicaid Emphasizes comfort