Dealing with Death & Bereavement PDF

**Dealing with Death & Bereavement** **THE MORTALITY REVOLUTION** - Advances in medicine and sanitation, new treatments for many once fatal illnesses, and a better-educated, more health-conscious population have brought about a mortality revolution. - Looking death in the eye, bit by...

**Dealing with Death & Bereavement** **THE MORTALITY REVOLUTION** - Advances in medicine and sanitation, new treatments for many once fatal illnesses, and a better-educated, more health-conscious population have brought about a mortality revolution. - Looking death in the eye, bit by bit, day by day, people growing up in traditional societies absorbed an important truth: dying is part of living. - As death increasingly became a phenomenon of late adulthood, it became \"invisible and abstract\" - Care of the dying and the dead became largely a task for professionals. - **Death**-even of the very old-came to be regarded as a failure of medical treatment rather than as a natural end to life (McCue, 1995). - **Thanatology** - the study of death and dying, is arousing interest, and educational programs have been established to help people deal with death **CARE OF THE DYING** - Along with a growing tendency to face death more honestly, movements have arisen to make dying more humane - **Hospice Care** - personal, patient- and family-centered, compassionate care for the terminally ill - **Palliative Care** - includes relief of pain and suffering, control of symptoms, alleviation of stress, and attempts to maintain a satisfactory quality of life - The goal is to allow the person to die in peace and dignity, while minimizing any pain and suffering, and it often includes self-help support groups for both dying people and their families FACING DEATH AND LOSS - **Terminal Drop** - refers specifically to a widely observed decline in cognitive abilities shortly before death, even when factors such as demographics and health are controlled for **5 Stages in Coming to Terms with Death** Elisabeth Kübler-Ross - **Denial** - **Anger** - **Bargain** - **Depression** - **Acceptance** - **Grief** - the emotional response that generally follows closely on the heels of death - **Bereavement** - is a response to the loss of someone to whom a person feels close, process of adjustment to the loss **The Classic Grief Work Model** **Grief Work** - the working out of psychological issues connected with grief - **Shock and Disbelief** - immediately following a death, survivors often feel lost and confused - As awareness of the loss sinks in, the initial numbness gives way to overwhelming feelings of sadness and frequent crying. - This first stage may last several weeks, especially after a sudden or unexpected death. - Preoccupation with the memory of the dead person - may last 6 months to 2 years or so, the survivor tries to come to terms with the death but cannot yet accept it - relieving the memories of the dead - These experiences diminish with time, though they may recur - **Resolution** - the final stage has arrived when the bereaved person renews interest in everyday activities - Memories of the dead person bring fond feelings mingled with sadness rather than sharp pain and longing - **Commonly Expected Pattern** - the mourner goes from high to low distress - **Absent Grief Pattern** - the mourner does not experience intense distress, either immediately or later - **Chronic Grief Pattern** - the mourner remains distressed for a long time - Chronic grief may be especially painful and acceptance most difficult when a loss is ambiguous HASTENING DEATH - **Passive Euthanasia** - involves withholding or discontinuing treatment that might extend the life of a terminally ill patient, such as medication, life support systems, or feeding tubes - **Active Euthanasia** - involves action taken directly or deliberately to shorten a life, and it is generally illegal - **Advance Directive (Living Will)** - contains instructions for when and how to discontinue futile medical care - **Durable Power of Attorney** - legal instrument that appoints an individual to make decisions in the event of another person\'s incapacitation - **Assisted Suicide** - suicide in which a physician or someone else helps a person take his or her own life - **Ethical Arguments (for)** - based on the principles of autonomy and self-determination: that mentally competent persons should have the right to control the quality of their own lives and the timing and nature of their death - **Medical Arguments (for)** - hold that a doctor is obligated to take all measures necessary to relieve suffering - **Legal Argument (for)** - legalizing assisted suicide would permit the regulation of practices that now occur anyway out of compassion for suffering patients - **Ethical Arguments (Against)** - center on two principles: **(1)** the belief that taking a life, even with consent, is wrong; and **(2)** concern for protection of the disadvantaged - **Medical Arguments (Against)** - include the possibility of misdiagnosis, the potential future availability of new treatments, the likelihood of incorrect prognosis, and the belief that helping someone die is incompatible with a physician\'s role as healer and that adequate safeguards are not possible - **Legal Arguments (Against)** - include concerns about enforceability of safeguards and about lawsuits when family members disagree about the propriety of terminating a life **Reviewing a Life** - Reminiscence about one\'s life in order to see its significance