1. Slide 1 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. LIFE-SPAN DEVELOPMENT 17 A Topical Approach to John W. Santrock Death and Grieving

2. Slide 2 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Issues in Determining Death Brain death—neurological definition of death –All electrical activity of brain has ceased for a specified period of time –Flat EEG recording –Some medical experts argue criteria for death should include only higher cortical functioning Defining Death and Life/Death Issues

3. Slide 3 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Decisions Regarding Life, Death, and Health Care Natural Death Act and Advance Directive –Expresses person’s desires regarding extraordinary medical procedures that might be used to sustain life when medical situation becomes hopeless Defining Death and Life/Death Issues

4. Slide 4 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Euthanasia Painlessly ending lives of persons suffering from incurable diseases or severe disabilities –Passive euthanasia—withholding of available treatments, allowing the person to die –Active euthanasia—death induced deliberately, as by injecting a lethal dose of drug Defining Death and Life/Death Issues

5. Slide 5 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Needed: Better Care for Dying Individuals Hospice—humanized program committed to making the end of life as free from pain, anxiety, and depression as possible Palliative care—reducing pain and suffering and helping individuals die with dignity Defining Death and Life/Death Issues

6. Slide 6 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Death in Different Cultures Perceptions of death vary; reflect diverse values and philosophies Individuals more conscious of death in times and places of war, poverty, disease. Most societies have: –Philosophical or religious beliefs about death –Rituals that deal with death –View that death does not end existence Death and Cultural Contexts

7. Slide 7 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. U.S. Denial of Death Funeral industry emphasis on lifelike qualities of the dead Euphemisms for death Rejection and isolation of aged Concept of pleasant and rewarding afterlife Medical emphasis on prolonging life rather than diminishing suffering Death and Cultural Contexts

8. Slide 8 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Causes of Death Death can occur at any point in human life span –Childhood - accidents or illness –Adolescence - motor vehicle accidents, suicide, and homicide –Older adults - chronic diseases A Developmental Perspective of Death

9. Slide 9 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Attitudes Toward Death at Different Points in the Life Span Childhood Adolescence Adulthood Infants have no concept of death; perceptions of death develop in middle and late childhood; even very young children are concerned about separation and loss Develop more abstract conceptions of death; not unusual to think they are immune to death Middle-aged adults fear death more than young adults or older adults; older adults think about death more A Developmental Perspective of Death

10. Slide 10 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Suicide Adolescence –3 rd leading cause of death in 10 to 19 year olds in U.S. –19% of U.S. high school students seriously considered or attempted suicide in the last 12 months Adulthood and Aging –U.S. suicide rates increase in adulthood –Reach highest level in the 85 and over age group A Developmental Perspective of Death

11. Slide 11 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Facing One’s Own Death Most dying individuals want to make decisions regarding their life and death –Complete unfinished business –Resolve problems and conflicts –Put their affairs in order Facing One’s Own Death

12. Slide 12 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Kubler-Ross’ Stages of Dying Denial and isolation Anger Bargaining Denies she/he is going to die Denial gives way to anger, resentment, rage, and envy Develops hope that death can somehow be postponed Depression Acceptance Comes to accept the certainty of her or his death Develops sense of peace and may desire to be left alone Facing One’s Own Death

13. Slide 13 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Perceived Control and Denial When individuals believe they can influence and control events, they may become more alert and cheerful Denial can be adaptive or maladaptive Facing One’s Own Death

14. Slide 14 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. The Contexts in Which People Die Most individuals say they would rather die at home –Many worry Burden at home Limited space May alter relationships Competency and availability of emergency medical treatment Facing One’s Own Death

15. Slide 15 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Communicating with the Dying Person Establish your presence Eliminate distraction Limit visit time Don’t insist the person feel acceptance Allow person to express guilt or anger Discuss alternatives, unfinished business Ask if there is anyone he or she would like to see Encourage the dying individual to reminisce Talk with the individual when she or he wishes to talk Express your regard Coping with the Death of Someone Else

16. Slide 16 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Grieving Emotional numbness Disbelief separation anxiety Despair Sadness Loneliness that accompany the loss of someone we love Coping with the Death of Someone Else

17. Slide 17 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Cultural Diversity in Healthy Grieving Contemporary western orientation –Breaking bonds with the dead –Return of survivors to autonomous lifestyle Non-Western cultures –Maintenance of ties with deceased varies Healthy coping involves –Growth –Flexibility –Appropriateness within the cultural context

18. Slide 18 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Making Sense of Grief Grieving stimulates many to try to make sense of their world Effort to make sense of it pursued more vigorously when caused by an accident or disaster Coping with the Death of Someone Else

19. Slide 19 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Losing a Life Partner Those left behind after the death of an intimate partner suffer profound grief and often endure: –Financial loss –Loneliness –Increased physical illness –Psychological disorders, including depression Coping with the Death of Someone Else

20. Slide 20 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Marital Quality and Adjustment to Widowhood Widowhood associated with increased anxiety among those highly dependent on their spouses Lower anxiety for those who did not depend on their spouse very much Coping with the Death of Someone Else

21. Slide 21 © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Forms of Mourning Approximately 80 percent of corpses are disposed of by burial, the remaining 20 percent by cremation Funeral is important aspect of mourning in many cultures Cultures vary in how they practice mourning Coping with the Death of Someone Else