1. Copyright © 2010 Pearson Education, Inc. All rights reserved. Death and Dying Chapter 18 18

2. Copyright © 2010 Pearson Education, Inc. All rights reserved. Death and Dying Thoughts and Fears of Death Confronting One’s Own Death The Search for a Humane Death Grief and Bereavement Completing the Life Cycle

3. Copyright © 2010 Pearson Education, Inc. All rights reserved. Thoughts and Fears of Death Denial of Death Reactions to Death Managing the Anxiety Associated with One’s Own Death

4. Copyright © 2010 Pearson Education, Inc. All rights reserved. Thoughts and Fears of Death Denial of Death –Death is an integral part of life –Death is embedded in cultural tradition –Historically, developmental psychologists have largely ignored the subject of death

5. Copyright © 2010 Pearson Education, Inc. All rights reserved. Thoughts and Fears of Death Reactions to Death –Emotional impact to death is very different from birth –Some theories believe we live in an era of “invisible death”: we cope with death through denial –Western cultural taboo about discussing death is weakening, however

6. Copyright © 2010 Pearson Education, Inc. All rights reserved. Thoughts and Fears of Death People vary widely in how they view death Terror management theory argues that the anxiety we feel about our own death leads us to cope by developing our self-esteem Other theories view self-esteem more as the result of positive desire for competence and autonomy, not as to reaction to fears about death Anxiety about death is greater in individualist cultures than in collectivist cultures

7. Copyright © 2010 Pearson Education, Inc. All rights reserved. Confronting One’s Own Death Death as the Final Developmental Task –a time to look back and review life Stages of Adjustment –Kübler-Ross’s Five Stages

8. Copyright © 2010 Pearson Education, Inc. All rights reserved. Video Clip Carnegie Mellon professor Randy Pausch: The Last Lecture: http://www.youtube.com/watch?v=mIysXLiA5s0&NR=1

9. Copyright © 2010 Pearson Education, Inc. All rights reserved. Kübler-Ross’s Five Stages of Death and Dying

10. Copyright © 2010 Pearson Education, Inc. All rights reserved. Video Clip A little girl experiences the 5 stages of grief after her goldfish dies: http://www.youtube.com/watch?v=bcNQGNUncd4

11. Copyright © 2010 Pearson Education, Inc. All rights reserved. Video Clip Elisabeth Kubler-Ross talks about children and death and the meaning of spirituality: http://www.youtube.com/watch?v=-ry4iIegZrU

12. Copyright © 2010 Pearson Education, Inc. All rights reserved. Confronting One’s Own Death Coping with Terminal Illness –Caring for someone with terminal illness may lead to physical and emotional drain Alternative Trajectories –Submissive death –Suicide –Suicidal erosion

13. Copyright © 2010 Pearson Education, Inc. All rights reserved. Suicide Rates for U.S. Adult Men and Women in 2005 SOURCE: From Health, United States, 2008, with chartbook on trends in the health of Americans, by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and National Center for Health Statistics, 2009. Washington, DC: Government Printing Office. Available online from Centers for Disease Control and Prevention: http://www.ccd.gov/nchs/data/hus/hus08.pdf

14. Copyright © 2010 Pearson Education, Inc. All rights reserved. The Search for a Humane Death Hospice –a philosophy designed to help people with terminal illness live out days as independently as possible –Comprehensive services, including medical and psychological consultation, and nursing services

15. Copyright © 2010 Pearson Education, Inc. All rights reserved. Video Clip Hospice care described by staff from the Mayo Clinic: http://www.youtube.com/watch?v=_dhQ_VxyhQ

16. Copyright © 2010 Pearson Education, Inc. All rights reserved. The Search for a Humane Death The “Right” to Die –“assisted suicide” involves providing those with a terminal illness the means to end their own life –Passive euthanasia: withholding or disconnecting life- sustenance so as to die naturally –Active euthanasia: Taking steps to bring about another person’s death The question of how far a physician should go in easing a person’s death is a hotly- debated question

17. Copyright © 2010 Pearson Education, Inc. All rights reserved. The Search for a Humane Death Legal documents can be used to state end-of-life issues –Living will: specifically states you do not want extraordinary measures to keep you alive, if you are terminally ill –Medical power of attorney: designates someone to make medical decisions when you are incapacitated

18. Copyright © 2010 Pearson Education, Inc. All rights reserved. Palliative vs. End-of-Life Care Palliative Care: care that attempts to prevent or relieve emotional stress and physical difficulties associated with life- threatening illness End-of-Life Care: Specifically addresses concerns associated with impending death

19. Copyright © 2010 Pearson Education, Inc. All rights reserved. Grief and Bereavement Grief work – coping with emotional reactions occurring after loss Anticipatory grief – when death is preceded by a long illness Bereavement overload – stress reaction when someone experiences multiple losses over a short period of time Chronic grief – pathological mourning, grief continues Grief response is culturally defined

20. Copyright © 2010 Pearson Education, Inc. All rights reserved. Video Clip A woman describes her grieving process after the death of her grandmother: http://www.youtube.com/watch?v=KytKn9sorJ8

21. Copyright © 2010 Pearson Education, Inc. All rights reserved. Coping with Loss

22. Copyright © 2010 Pearson Education, Inc. All rights reserved. Death of a Child In 1999, about 55,000 U.S. children between ages of 0 and 19 died There is often confusion, guilt, and attempts to assign blame for the loss When child dies of a terminal illness, there are other issues to deal with A crisis of values is common among survivors after the death of a child

23. Copyright © 2010 Pearson Education, Inc. All rights reserved. Percentage of Total Childhood Deaths by Age Group, 1999 SOURCE: From Figure S.1, When children die: Improving palliative and end-of-life care for children and their families (p. 4). Copyright © 2003, by National Academy of Sciences. Reprinted by permission from the National Academies Press.

24. Copyright © 2010 Pearson Education, Inc. All rights reserved. Completing the Life Cycle Life is a cycle that begins at conception and ends at death Death of an individual an inspire and transform the lives of others left to grieve Death – regardless of the circumstances – is a part of nature