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clinical death

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*a period during which vital signs are absent * resuscitation is still possible

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brain death

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*the point at which vital signs are absent -including brain activity *resuscitation is no longer possible

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social death

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the point at which family members & medical personnel treat the deceased person as a corpse

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hospice care

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*an approach to care for the terminally ill * emphasizes individual & family control of the process of dying

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3 types of hospice care

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*home-based programs ~family caregivers supported by specially trained health-care workers *hospice centers ~ a small # of patients care for by specially trained health-care workers in a homelike setting *hospital based programs ~palliative care ~ provided by hospital personnel with daily involvement of family members

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palliative care

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*a form of care for the terminally ill *focuses on relieving patients' pain rather than curing their disease

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A person who has survived on life support for several years has experienced what type of death?

answer

*brain death

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A growing number of families are turning to _____ care for their dying loved ones, a form of care that emphasizes the normative nature of death.

answer

*hospice care

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what are the characteristics of clinical, brain & social death?

answer

*death = nonspecific term *medical personnel refer to clinical & brain death *social death occurs when deceased person is treated like a corpse by those around him

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how do hospice & hospital care differ with respect to their effects on the terminally ill?

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*about 1/2 of adults in industrialized countries die in hospitals *hospice care emphasizes ~ patient & family control of dying process ~palliative care rather than curative treatment

question

what are the characteristics of children & adolescent ideas about death?

answer

*until age 6 or 7 ~ children don't understand death is permeant & inevitable ~involves loss of function *teens ~ understand the physical aspects of death more than children do ~sometimes have distorted views about death (especially their own mortality)

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how do young, middle-aged & older adults think about death?

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*young adults - think they have unique characteristics that protect them from death *for middle-aged adults & older adults death has many possible meanings: - a signal of changes in family roles - a transition to another state (such as life after death) - a loos of opportunity & relationships *awareness of death may help person organize their remaining time

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unique invulnerability

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*the belief that bad things happen only to others -including death *usually seen in young adults

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what factors are related to fear of death in adults?

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*fear of death peaks in mid-life & then after it drops sharply *older adults talk more about death but are less afraid of it *deeply religious adults may help a person organize their remaining time

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how do adults prepare for death?

answer

*many prepare in practical ways: -buying life insurance _writing a will -making a living will *reminiscence may also serve as preparation *there are signs of deeper personality changes immediately before death: - more dependence & docility -less emotionality & assertiveness

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at what age do children start to understand that death is a biological event?

answer

6 or 7

question

young adults' thinking about death is often influenced by a set of beliefs called _____ ____.

answer

unique invulnerability

question

which age group (middle-aged or elderly) fears death most?

answer

middle-aged

question

as a result of the terminal psychological changes that occur in the 3 years prior to death, individuals become more: ____, ____, _____ & ____.

answer

*conventional (conforming to the norm) *docile (submissive) *dependent *warm

question

How did Kubler-Ross explain the process of dying?

answer

5 stages of dying: *denial *anger *bargaining *depression *acceptance *research fails to support the hypothesis that all dying adults go through all 5 stages or that the stages occur in this order *emotion most commonly observed = depression

question

Kubler-Ross' 5 stages of dying

answer

*denial - people's first reaction to news of terminal diagnosis is disbelief *anger -once diagnosis is accepted as real, individuals become angry *bargaining - anger & stress are managed by thinking of the situation in terms of exchanges - i.e. if i take my medicine,i'll longer if i pray hard enough, God will heal me *depression - feelings of despair follow when disease advances despite individual's compliance with medical & other advice *acceptance - grieving for the losses associated with one's death results in acceptance

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what are some other views of the process of dying?

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*critics of Kubler-Ross suggest that her finding may be culture specific *also argue that process of dying is less stage-like than her theory claims

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How do people vary in the ways they adapt to impending death?

answer

*research with cancer & aids patients suggests that: - those who are most pessimistic & docile in response to diagnosis & treatment have shorter life expectancies -those who fight hardest & even display anger = live longer *dying adults who have better social support live longer than those who lack such support - have support from family & friends or from specially created support groups

question

thanatology

answer

the scientific study of death & dying

question

Edwin Shneidman's "themes" of death process (alternative view to Kubler-Ross)

answer

*suggested alternative approach of dying process that has many 'themes' that can appear, disappear & reappear in 1 patient in the process of dealing with death. *themes -terror -pervasive uncertainty -fantasies of being rescued -incredulity -feelings of unfairness -concern with reputation after death -fear of pain

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Charles Corr's model of process of dying (alternative view to Kubler-Ross)

answer

*Corr viewed coping with dying is like coping with any other problem -certain specific 'tasks' need to be taken care of *His 4 suggested tasks for the dying person 1. satisfying bodily needs & minimizing physical stress 2.maximizing: - psychological security - autonomy - richness of life 3. sustaining & enhancing significant interpersonal attachments 4. identifying, developing or reaffirming sources of spiritual energy *he didn't deny importance of various emotional themes described by Shneidman - he argues that for health professionals who deal with dying individuals, its more helpful to think in terms of the patient's tasks ~ because the dying person may need help in performing some or all of them

question

Responses of Death

answer

*Denial (positive avoidance) *fighting spirit *stoic acceptance (fatalism) *helplessness/hopelessness *anxious preoccupation

question

Denial (positive avoidance)

answer

*person rejects evidence about diagnosis *person insists that surgery was just precautionary

question

fighting spirit

answer

* person maintains an optimistic attitude & searches for more info about disease * these people often see their disease as a challenge & plan to fight it with every available method

question

stoic acceptance (fatalism)

answer

*person acknowledges diagnosis but makes no effort to seek further info about it OR * person ignores diagnosis & carry on normal life as much as possible * a passive response toward death

question

helplessness/hopelessness

answer

* person acts overwhelmed by diagnosis *person sees themselves as dying gravely ill & as devoid of hope * a passive response toward death

question

anxious preoccupation

answer

* women in this category had originally been included in teh helplessness group - were included in helplessness group but were later separated out *the category includes those whose response to the diagnosis is: - strong & persistent anxiety (anxiety about death) *if they seek more information, they interpret each ache or pain as a possible recurrence

question

how does Freud's psychoanalytic theory view grief?

answer

*emphasizes loss as: - an emotional trauma - the effects of defense mechanisms - the need to work through feelings of grief

question

what are the theories of Bowlby & Sanders of grief?

answer

*Bowlby's attachment theory views grief as: - natural response to loss of an attachment figure *Attachment theorist suggest that grief process involves several stages

question

what theories of grief have been proposed by critics of psychoanayltic & attachment theories?

answer

*alternative views suggest that neither Freud's nor Bowlby's theory accurately characterizes grief experience *responses to grief are more individual than either theory might suggest *the dual-process model suggests that the bereaved individuals alternate between confrontation & restoration phases

question

Bowlby's(*) & Sander's 4 stages of grief?

answer

1. Numbness* & Shock 2. Yearning* & Awareness 3. Disorganization/dispair* & Conservation/withdrawal 4. Reorganization* & Healing/Renewal

question

Numbness* & Shock

answer

* characteristic of 1st few days after death of love one & occasionally longer * mourner experiences - disbelief - confusion - restlessness feelings of unreality - a sense of helplessness

question

Yearning* & Awareness

answer

*the bereaved person tries to recover the lost person *may actively search or wander as if searching *may report that they see the dead person *mourner feels full of: - anger - anxiety - fear - frustration *may sleep poorly & weep often

question

Disorganization/dispair* & Conservation/withdrawal

answer

*searching creases & the loss is accepted *acceptance of loss brings: - depression & despair -sense of helplessness *this stage is often accompanied by: - fatigue -desire to sleep all the time

question

Reorganization* & Healing/Renewal

answer

*Bowlby views this stage as only 1 (Reorganization) - & Sanders 2 (Healing/Renewal) *both see this as the period when the individual takes control again *some forgetting occurs *some sense of hope emerges along with: - increased energy - better health - better sleep patterns - reduced depression

question

Wortman & Silver's alternate view on pattern of grieving

answer

*suggests that grieving does not include all of the elements - they don't agree that distress is an inevitable response to loss - their research challenges the notion that failure to experience distress = sign that individual has not grieved "properly" *their 4 distinct patterns of grieving - normal - chronic - delayed -absent

question

normal pattern of grieving

answer

* person feels great distress immediately following loss *recovers relativity rapidly

question

chronic pattern of grieving

answer

*person's distress continues at a high level over several years after loss

question

delayed pattern of grieving

answer

*the grieving person feels little distress in first few months *they feel high levels of stress months or years after loss

question

absent pattern of grieving

answer

* person feels no notable level of distress -immediately or at any later time

question

dual-process model

answer

*developed by Stroebe & Schut - takes a different approach to grief *proposes that bereaved individuals alternate between 2 phases: - confrontation - restoration *suggests that the attachment relationship between the bereaved individual & the deceased influences the grieving process - like Bowlby's model suggests *emphasizes the loss of a loved one as an analogous to other forms of stress

question

confrontation phase

answer

*an emotional state in which bereaved individuals confront their loss & actively grieve

question

restoration phase

answer

*bereaved individuals focus on moving forward with their lives *provides the bereaved individuals with respite from the emotional turmoil - that is seen in the confrontation phase

question

grieving

answer

the emotional response to a death

question

how do funerals & ceremonies help survivors cope with grief?

answer

*funerals & other rituals after death serve important functions including: - defining roles for the bereaved - bringing family together - giving meaning to the deceased's life & death

question

what factors influence grieving process?

answer

*grief responses depend on a number of variables *grief process is shaped by -age of bereaved -mode of death

question

how does grief affect the physical & mental health of widows & widowers?

answer

*death of a spouse evokes the most intense & long lasting grief *widows & widowers show high levels of illness & death in the months immediately following the death of a spouse - perhaps as a result to the effects of grief on the immune system * widowers appear to have a more difficult time than widows do in managing grief

question

age of bereaved (children)

answer

*children express feelings of grief very much the same as teens & adults do - sad facial expressions - crying - loss of appetite - age-appropriate displays of anger *most children resolve feelings of grief within first year following the death

question

age of bereaved (adolescents)

answer

*adolescents may be more likely than children or adults to experience prolonged grief - continue to have problems with grief related behaviors (i.e. intrusive thoughts) *teen grief responses are probably related to their general cognitive characteristics * they often judge real world by idealized images - they may get caught up in fantasizing about how the world would be different if a friend/loved one had not died *prolonged grieving among adolescents may be rooted in their tendency in "what if" thinking - this kind of thinking lead teens to believe they could have prevented the death -causes them to develop irrational guilt feelings

question

age of bereaved (adults)

answer

*express feelings of grief very much the same as teens & children do - sad facial expressions - crying - loss of appetite - age-appropriate displays of anger

question

mode of death

answer

*how an individual dies contributes to the grief process of those in mourning *deaths with meaning (death of soldier) or due to illness = less likely to suffer from grief related depression - i.e. illness was long and painful & solider dying while defending country has intrinsic meaning *sudden & violent deaths evoke more intense grief responses - especially those involving suicide - mourners start to suffer from PTSD & depression *death in context of a natural disaster is associated with: -prolonged grieving & development of symptoms of PTSD -such events bring to mind the inescapable reality of the fragility of human life

question

benefits of public memorial services & mode of death

answer

*common experiences of survivors are recognized * the differences between controllable & noncontrollable aspects of life are emphasized -can help survivors cope with this kind of grief *can also be helpful to survivors whose loved ones died as a result of "politcally motivated" mass murders - i.e 1995 bombin of a federal govt office building

question

bereavement

answer

*experienced following a death of a loved one by the survivors *is a change in status - as in the case of a spouse becoming a widow or widower

question

mourning

answer

the behavioral response of the bereaved person

question

Thanatologists

answer

*examine all aspects of death, including: - biological (the cessation of physiological processes) - psychological (cognitive, emotional, and behavioral responses) - social (historical, cultural, and legal issues).

question

pathological grief

answer

*symptoms of depression brought on by death of a loved one

question

mode of death & suicide

answer

responses of the family & close friends *their grief is complicated by feeling that they could or should have have done something to prevent suicide *are less likely to discuss the loss with other family &friends because of: - their sense that suicide in the family is a source of shame *suicide survivors may be more likely than others who have lost loved ones to experience long term negative effects

question

mode of death & death from violent crime

answer

*inability to find meaning is the most frustrating aspect of the grieving process for people who lost a love one who lost loved one in a violent crime grief process = initial phase... *survivors protect themselves against frustration through cognitive defenses -denial -focusing on tasks that are immediately necessary next phase... * survivors often channel their grief & anger into the criminal justice process -through which they hope that the perpetrator of crime is justly punished ultimately... *many survivors become involved in organizations: - that support crime victims & survivors of murdered loved ones - that seek to prevent violence

CH 19 Death, Dying & Bereavement – Flashcards

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