Approaching DeathKonsep dan Respon Kematian

pada Lansia

Sheizi Prista SariFakultas Keperawatan

Universitas Padjadjaran2015

Contents

1. Stages of dying and Related factors

2. Physical responses3. Psychosocial responses4. Spiritual responses

Stages of Dying

Denial Anger Bargaining Depression Acceptance of Death

Kubler-Rost (1969)

Following Factors(Restinas,1988)

1. Very old persons see themselves as confronting impending death

2. They are used the “sick role” and their gradual decrease of vitality

3. Roles have already been redefined4. Death may truly be timely for older persons

Kastenbum (1978)

Assumptions as older persons being ready for timely death as evidence of our society’s ageist

attitudes

Less fear of death among older persons than among younger ones, older adults are also

more concerned about being in control and life after death (Thorson, Powell, 1988)

Others Factors

Person who has had positive experiences of coping and is relatively well adjusted usually approaches the stress of being close to death

with adaptation and acceptance.

(Kohn, Menon, 1988; Kowalski, 1986; Matthews, 1979)

Physical Aspects

Life Expectancy of Indonesia CIA World Factbook (perkiraan 2011)

All : 70.76 yearsMale 68.26 yearsFemale 73.38 years

Continue…Physical Aspects

• Usually results from complications from one or more chronic illnesses

• The three leading causes of death among adults over age 65 : Heart disease, malignant neoplasms, cerebrovaskular diseases

• Other : COPD, pneumonia, influenza, etc.

Common Grief ResponsesPhysical Sensations

• Tightness in the chest

• Shortness of Breath

• Lack of Energy

• Panic Attack-like symptoms

Psychosocial Aspects

• Socio cultural and religious background• Social isolation and loneliness• Meaningfulness of everyday

Important factors

Engage in a process of dying

Life review (Butler, 1963)

Social

• Taboo Topics• Social Isolation• Abandon the dying person

Spiritual Aspects

• Play an important part• Three spiritual needs (Doka, 1993): – To search for the meaning of life– To die appropriately – To find hope that extends beyond the grave

Spiritual care (Hall, 1997)

• Preparation for death and afterlife• Anger over dying• Seeking forgiveness for past wrongs• Searching for peace• Needs of a family coping with loss

General Health Care Needs

• Stabilizing and supporting vital functions and facilitating integrated functioning

• Determining functional deviation and adjusting treatment

• Relieving distressing symptoms and suffering• Assisting client and family interaction• Supporting a client and his or her family in coping

Good Communication Skill

Hierarchy of Dying Person’s Needs (Ebersole & Hess, 1998)

To share and come terms with the unavoidable future, To Perceive meaning

in death

To maintain respects in the face of increasing weakness, To maintain independence, To feel like

a normal person, to preserve personal identity

To talk, to be listened to with understanding, to be loved and to share

love, to be with a caring person when dying

To be given the opportunity to voice hidden fears, to trust those who care, to feel that

he or she being told the truth, to be secure

To obtain relief from physical symptoms, to conserve energy, to be free of pain.

Thank You