Death as part of life

• Inevitable

Death as part of life

• Loss– Something removed

Death as part of life

• Coping– process

Death as part of life

• Grief– Expression of loss

Death as part of life

• Mourning– Process following loss

Elisabeth Kubler-Ross’s stages

1. Denial2. Anger3. Bargaining4. Depression5. Acceptance

John Bowlby’s stages of separation

1. Protest2. Despair3. Detachment

Bowlby’s Phases of Mourning

1. Numb stage2. Painful stage3. Disorganized & despair4. Reorganization stage

Types of lose

• Physical– Death of spouse– Death of parent– Death of child– Death of friend

• Symbolic losses– Loss of work – Loss of status– Loss of mobility– Loss of independence

Loss of a Spouse

• Great magnitude• Risk of death– >2yrs

• Men– Feel alone

• Women – Feel abandoned

• Widows younger than widowers

Loss of a parent

• Age?

Loss of a child

• One of most difficult • Blame

Loss of unborn child

• Hold child

Loss of sibling

• Blame self

Facing one’s own death

• Terminal illness

Signs of approaching death

• Withdraw• i senses• Cheyne-Stokes

Respirations

• BP– i

• Pulse– i

• Temp– i

Development of concept of death

• Infant– No concept

• Toddler– Separation anxiety

• Preschool– Pain avoidance

• 5-6 – Punishment

• School-age– Have capacity to understand!

Advanced directive

• Legal document• Wishes for medical

treatment is they cant make these decisions

Living Will

• Form of advanced directive

• States wishes regarding life-sustaining treatment

Durable power of attorney for health care

• Appoint someone to make their wished known in the event they can’t any longer

Do not Resuscitate (DNR)

Euthanasia

• Assisted suicide• “Mercy killing” • Oregon

Right to die

• Can refuse medical treatment

Palliative care

• Relieve suffering

Hospice Care

• Part of Medicare/medicaid

• Emphasizes comfort