1. The End of Life

2. I. EXIT LIFE IN LATE ADULTHOOD AND ENTER DEATH Schaie: 7 Stage Life-Span Model of Cognitive Development Reintegrative stage: Sixth of Schaie’s seven cognitive stages, in which older adults choose to focus limited energy on tasks that have meaning to them. Legacy-creating stage: Seventh of Schaie’s seven cognitive stages, in which very old people prepare for death by recording their life stories, distributing possessions, and the like. Thanatology: Study of death and dying.

3. II. FACING DEATH AND LOSS: PSYCHOLOGICAL ISSUES Confronting One’s Own Death Terminal drop: A frequently observed decline in cognitive abilities near the end of life. Related to depression A decline in verbal ability Kűbler-Ross’s Five Stages of Coming to Terms with Death 1. Denial - This can’t be happening to me! 2. Anger - Why me? 3. Bargaining for extra time If only I can…….I won’t ask for anything else. 4. Depression 5. Acceptance

4. Bereavement: Loss, due to death of someone to whom one feels close and the process of adjustment to the loss. Grief: Emotional response experienced in the early phases of bereavement. The Classic Grief Work Model Grief work: Common pattern of working out of psychological issues connected with grief, in which the bereaved person accepts the loss, releases the bond with the deceased, and rebuilds a life without that person. The Three Stages of Grief Work: 1. Shock and disbelief 2. Preoccupation with the memory of the dead person 3. Resolution

5. 3. Chronic grief: Grief pattern in which the mourner remains distressed for a long time. 4. Resilience: Grief pattern in which there is a low and gradually diminishing level of distress, with the mourner accepting death as a natural process. 5. Chronically depressed: Grief pattern in which mourners had been depressed before their loss and became more so afterward. 6. Improved during bereavement: Grief pattern in which mourners are depressed before their loss and tend to improve during the bereavement. Grief therapy: Treatment to help the bereaved cope with loss. Therapists help survivors express: Sorrow, Guilt, Hostility, Anger Patterns of Grieving 1. Commonly expected pattern: Grief pattern in which the mourner goes from high to low distress. 2. Absent grief: Grief pattern in which the mourner does not experience intense distress immediately or later.

6. III. DEATH AND BEREAVEMENT ACROSS THE LIFE SPAN Childhood Irreversible: Child understands that death is permanent (cannot be undone). Universal and inevitable: Child understands that all living things die. Nonfunctional: Child understands that all life functions end at death. Adolescence Many adolescents take heedless risks Driving recklessly Experimenting with drugs More concerned with ‘how’ they live than ‘how long’ they live Adulthood Young adults…Mortality at this stage can lead to frustration and rage Middle age… More acceptance of mortality Older adults have mixed feelings… Fear, Denial, Acceptance

7. IV. SPECIAL LOSSES Losing a Child A parent is rarely prepared for this loss Generally feels like a cruel and unnatural shock Parents often feel they have failed the child If marriage is strong, the loss may draw a couple closer If marriage is weak, the loss may tear the couple apart Surviving a Spouse Because they live longer, women are more likely to be widowed Especially difficult for a woman whose identity was built around husband Elderly widowed men 4 times more likely to remarry than elderly widowed women Sudden Infant Death Syndrome (SIDS): a seemingly healthy baby stops breathing and dies of unexplained causes. Typically occurs between the ages of 2 – 4 months while sleeping

8. V. THE “RIGHT TO DIE” Aid in Dying Active euthanasia: Deliberate action taken to shorten the life of a terminally ill person in order to end suffering or to allow the death with dignity; also called mercy killing. Assisted Suicide: Suicide in which a physician or someone else helps a person take his or her own life. Passive euthanasia: Deliberate withholding or discontinuation of life-prolonging treatment of a terminally ill person in order to end suffering or allow death with dignity.

9. VI. FINDING MEANING AND PURPOSE IN LIFE AND DEATH Life Review: Remembering process that enables a person to see the significance of their life. In older age, this can foster a sense of integrity. Methods of the Life Review Writing or taping an autobiography Constructing a family tree Looking over scrapbooks and old letters Trips to childhood locations Reunions with friends and family Autobiographical Memory: memories of information about one’s own life.