1. The Psychology of Dying

2. Kubler-Ross Page 44 (PAD&D) 5 stages: –1) Denial: (and Isolation) “the defense mechanism by which a person is unable or refuses to see things as they are because such facts are threatening to the self” –2) Anger: “blame directed toward another person” –3) Bargaining –4) Depression –5) Acceptance

3. Lofland Page 46 (PAD&D) “dying scripts” Elements: –Space –Population –Knowledge –Stance

4. Em. M. Pattison Page 48 (PAD&D) 3 phases of the dying process: –1) acute crisis phase –2) chronic living-dying phase –3) terminal phase

5. A. Weisman 3 degrees of denial: –1) the person denies the facts –2) the person accepts the diagnosis but refuses to believe that it is terminal –3) person vacillates beween open acknowledgement of death and its repudiation

6. Glaser and Strauss Page 49 (PAD&D) 4 contexts of awareness: –1) closed awareness –2) suspicion –3) mutual pretense –4) open awareness

7. Duties of the Dying Page 49 (PAD&D) 1) arrange a variety of affairs 2) adapt to the loss of loved ones and self 3) manage medical needs and balance emotions 4) plan for future loss 5) identify and cope with the death encounter

8. Role of the FD With the Dying Page 50 (PAD&D) Prerequisites for the FD: –1) acknowledge one’s mortality –2) understand the grief process –3) effective listening and appropriate response –4) commitment to the dying –5) knowledge of personal limits

9. Social Responses to Death Page 53 (PAD&D) variety of socialization processes demographic norms Preindustrial: high mortality rates –small, tightly integrated communities Postindustrial: drop in mortality rates –death is distanced, sanitized

10. Death of a Parent Page 60 (PAD&D) natural event unfinished emotional business little/no allowance for untimely, violent, or unexpected death allow the adult child to express the feelings of loss support groups

11. Death of a Spouse Page 62 (PAD&D) secondary losses (Figure 12-1 page 155) social issues support groups

12. Death of a Child Page 63 (PAD&D) parents and siblings aren’t the only ones who mourn the loss of a child, but the parental grief response is the most complex friends may avoid the parents “service guilt”, “survivor’s guilt”

13. Guilt Composed of: –Regrets –Misgivings –Unresolved past conflicts with the child –Every aspect of the relationship and childcare

14. Secondary Losses child may have filled a “gap” child as well as friend sense of status/self-esteem/purpose continued guilt can give rise to complications changed identity camily structure is altered

15. Parental Anger feel that core identities have been ripped out world no longer makes sense rage at those perceived to have a role in the death feelings of betrayal anger directed toward survivors

16. Coping With Other People Need to be aware that there are people in their lives from whom they will never get the support they would have expected or desire.

17. Parental Fear Fear of losing other children or any close person causes bereaved parents to overprotect.

18. “New Me in a New World” The image of the child exists within but is no longer physically available as an external reality. Create a new internal picture of who they are in the outside world. Their loss and grief accompany them everywhere they go.

19. Painful Reminders seasonal reminders unexpected “moments” continual acknowledgment of the child at family events can still feel connected

20. Linking Objects and Continuing Bonds Page 65 (PAD&D) helps maintain continuity of a relationship provide support for grieving parents

21. FD Responsibilities Page 65 (PAD&D) reinforce that their feelings are acceptable and normal point out to them society’s inability to comprehend their loss well-meaning people’s comments create an atmosphere of security, comfort and accessibility

22. Death of a Sibling greater chance of healing if parents remain in their lives parents grieve openly parental grief is shared siblings may experience shame or embarrassment preteens and teens are particularly sensitive

23. Replacement Expectations parents may inappropriately place expectations on children parents may consciously or unwittingly communicate that surviving children take on the dead sibling’s role parents may deify the dead child parents may focus on the dead child to the exclusion of the surviving siblings

24. Surviving Adult Siblings Page 65 (PAD&D) least acknowledged by society facing the death of someone in their own generation…..personal confrontation with their own mortality FD should be available to them

25. Implications for Funeral Directors Page 66 (PAD&D) 1) society’s perception of the death may not “track” with the individual’s response 2) be sensitive to conflict between what is expected and what they feel 3) provide information about resources 4) small library of books, tapes etc. 5) provide clear, complete and accurate communication