1. Dying & Death Death is the final stage of growth!

2. What is Terminal Illness? A disease that cannot be cured and will result in death. How might a patient feel when they find out this news?

3. Stages of Dying and Death Denial Anger Bargaining Depression Acceptance

4. Denial * “no, not me!” * cannot accept reality * “the doctor doesn’t know what he is talking about” * May get a second opinion What are some things you can say?

5. Anger * “why me?” * “it’s your fault” What are some things you can say?

6. Bargaining * turn to religion or beliefs * will to live is strong * want to see marriages, etc so make deals with God What are some things you can say?

7. Depression * may express regrets * sadness, despair *allow them to cry What are some things you can say?

8. Acceptance * Final stage * may complete unfinished business *separate from the world and people What are some things you can say?

9. Hospice Care * can play an important role in meeting a patients’ needs * offers palliative care: support and comfort * usually starts around 6 months to live * services they provide?

10. Right to Die The Bill of Rights pg 242

11. Physiology of Dying Changes the body goes through during the dying process Somatic death: the death of the body

12. Physiology of Dying ★ Irreversible events of all vital systems ★ Respiratory, Cardiovascular, Urinary, Nervous

13. Physiology of Dying Respiratory System ★ Lungs: unable to oxygenate the body ★ Death Rattle: Cheyne - Stokes Cardiovascular System ★ Skin becomes cool, pale ★ Cyanotic ★ Pulse changes

14. Physiology of Dying Urinary System ★ Might retain feces or become incontinent ★ Urinary output decreases Nervous System ★ Motion lost in legs first, then arms ★ Turns toward light ★ Eyes might be open even if unconscious

15. Physiology of Dying Criteria for death is determined by hospital policy; therefore one can be pronounced dead in one hospital and alive in another Heart, Lungs & Brain: Trinity of death standards; if these aren’t working-- Death

16. Physiology of Dying Clinical Death vs. Biological Death ★ Clinical Death: Heart, Lungs, Brain activity ★ Biological Death: Hair still grows for several hours, liver converts glycogen, muscles contract ★ RIGOR MORTIS: begins 2 hours after death, muscles remain contracted for ~30 hours: calcium remains in muscles causing stiffness

17. Biological Death Somatic Death Acceptance Rigor Mortis Respiratory System Cyanotic Brain Failure Right to Die Terminal Illness Hospice Death Rattle

18. Clinical Death Cardiovascular System Cheyne Stokes Incontinence Denial Bargaining Puberty Alzheimer’s Disease Anger Bulimia Moro ReflexDevelopment