the end of life
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Chapter 19. THE END OF LIFE. The Quest for “Healthy Dying”. Thanatology: The Study of Death and Dying. Living Will. - PowerPoint PPT PresentationTRANSCRIPT
THE END OF LIFE
The Quest for “Healthy Dying”The Quest for “Healthy Dying”
Thanatology: The Study of Death and Dying
Living WillLiving Will
A legal document that states an individual’s wishes regarding medical care in case the person becomes incapacitated and unable to participate in decisions about his or her medical care.
The Right-to-Die MovementThe Right-to-Die Movement
Physician-Assisted Suicide Trend: basing decisions less on legalistic
interpretations regarding specific treatments and more on balancing benefits on a case-by-case basis
Euthanasia: Mercy killing
Three concepts: (NIMH)1. Suicide ideas
2. Suicide attempts
3. Completed suicide
Who Commits Suicide and Why?Females attempt more suicides, but males complete most.
SuicideSuicide
Provides comfort and care but with the knowledge that the recipients are nearing the end of their life’s journey--that they’re dying
The Hospice MovementThe Hospice Movement
The Dying ProcessThe Dying Process
Defining Death
Brain Death occurs when the brain receives insufficient oxygen to function.
A Life Review
Elderly person takes stock of his life, reflecting and reminiscing about it
Confronting One’s Own Confronting One’s Own DeathDeath
Death drop Near-Death Experiences
– Dying individuals feel themselves leave their bodies and watch as spectators, the resuscitation efforts. Then they pass through a tunnel and enter a spiritual realm.
Changes Before DeathChanges Before Death
Other views:– (Siegel) Arousal of nervous system and
disorganization of brain– (Alkon) Anoxia induces such mental states– (Kastenbaum) Some heart-attack victims: no
recollection of experience
Near-Death ExperiencesNear-Death Experiences
Christian: Book of Revelation
Jewish: Speculation about afterlife is pointless
Buddhists: Detailed account
Religious BeliefsReligious Beliefs
(Elisabeth Kubler-Ross)
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
Stages of DyingStages of Dying
It is the nature of the disease that determines pain, mobility and length of terminal period.
Other factors:– Gender, ethnic group, personality,
developmental level and death environment
Kastenbaum’s Trajectories Kastenbaum’s Trajectories of Deathof Death
National Mortality Followback Survey: 1993
Data on 23,000 records of death in 1993. All states except South Dakota
Causes of DeathCauses of Death
Grief, Bereavement, and Grief, Bereavement, and MourningMourning
Adjusting to the Death of a Loved One Bereavement: state in which a person has
been deprived of a relative or friend by death
Grief: keen mental anguish and sorrow over the death of a loved one
Mourning: socially established manner of displaying signs of sorrow over death
Support groups to help people through grief work
Culture and Grief Work– Cultural variability in expressing grief
Expressing Anguished FeelingsExpressing Anguished Feelings
Survivor vulnerable to physical and mental illness and death
Adjusting to Violent and Premature Death– Most severe grief reaction
Consequences of GriefConsequences of Grief
Stages of bereavement for healthy adults who have lost a parent
1. Going back to the origins
2. Reevaluation phase
3. Assuming leadership
Adjusting to the Death of a Adjusting to the Death of a ParentParent
1. Shock, numbness, denial, disbelief
2. Pining, yearning, and depression
3. Emancipation from loved one and adjustment to new circumstances
4. Identity reconstruction
Phases in the Bereavement Phases in the Bereavement ProcessProcess
People handle grief differently Widows and Widowers
– Death rate for widowers higher– Difficulty expressing emotion
Individual VariationsIndividual Variations
Three types (Lopata)1. Better educated, middle class, strongly identifying with role of wife
2. Women who led multidimensional lives; husband only one part of total set of relations
3. Lower-or working-class women in sex-segregated worlds immersed in kin, neighboring or friendship relationships with other women
Types of WidowsTypes of Widows
Loss by Miscarriage– Sometimes receive no recognition of loss– Support Groups
Loss by Murder or Violence Bereavement process can go on indefinitely
Death of a ChildDeath of a Child