Dying And Death

1. Dying And Death Chapter 20

2. Why Is There Death? • Life span is long enough to allow reproduction and the linage of our species. • Challenges our emotions and intellectual security. • We know that everything alive eventually dies.

3. Understanding Death and Dying • Defining death. • Defined as cessation of the flow of bodily fluids. • Life-support systems. • Brain death. • Lack of receptivity and response to external stimuli. • Absence of spontaneous muscular movement and breathing. • Absence of observable reflexes. • Absence of brain activity. • Electroencephalogram (EEG).

4. Learning About Death • Understanding of death changes as we age. • Mature understanding of death. • Four components (Mark Speece). • Universality. • Irreversibility. • Nonfunctionality. • Causality.

5. Denying Versus Welcoming Death • Anxiety associated with death. • Many seek to avoid any thought or mention of death. • United states attitude is to “death denying”.

6. Planning For Death • Making a will. • Estate. • Testator. • Interstate.

8. Considering Options for End-of Life Care • Spending your last days at home, cared for by relatives and friends? -OR- • Access to the sophisticated medical technologies in the hospitals. • Home care. • Hospital-based palliative care. • Hospice programs.

9. Deciding to Prolong Life or Hasten Death • Modern medicine. • Persistent vegetative state. • Ethical questions about the “right to die”. • U.S. Supreme Court in 1990. • The right to refuse life sustaining treatment is constitutionally protected.

10. Deciding to Prolong Life or Hasten Death • Withholding or Withdrawing Treatment. • Passive euthanasia. • Assisted Suicide and Active Euthanasia. • Physician-assisted suicide (PAS). • Active euthanasia.

11. Completing an Advance Directive • Living will. • Health care proxy. • Surrogate.

12. Becoming an Organ Donor • Human body is a valuable resource. • Each day 60 people receive an organ transplant. • Each day 18 people on the waiting list die because not enough organs to assist. • Uniform Donor Card.

14. Planning a Funeral or Memorial Service • Disposition of the body. • Arranging a Service. • Non-profit memorial society.

15. Coping With Dying • No one right way to live or die of a life-threatening illness. • Doctors treat diseases; people suffer from illness. • Concerns with: • Costly medical care. • Loss of income. • Repeated and lengthy hospitalization. • Physical pain.

16. Awareness of Dying • “Living-dying” experience. • Middle knowledge – patients and family seek a balance between hope and reality.

17. The Tasks of Coping • On Death and Dying (Elisabeth Kubler-Ross). • 5 Psychological stages: • Denial. • Anger. • Bargaining. • Depression. • Acceptance.

18. The Tasks of Coping • Charles Corr’s primary dimensions in coping with dying. • Physical. • Psychological. • Social. • Spiritual.

19. Patterns of Coping • Defense mechanisms. • Coping Strategies. • Different strategies: • Emotion-focused. • Problem-focused. • Meaning-based. • The Trajectory of dying. • Supporting a dying person.

20. Coping With Loss • Experiencing Grief. • Bereavement. • Mourning. • Tasks of Mourning. • Accepting the reality of the loss. • Working through the pain and grief. • Adjusting to a changed environment. • Emotionally relocating the deceased and moving on. • The Course of Grief.

21. Supporting a Grieving Person • Give kind and loving support. • Be a good listener. • Refrain from making judgments about the survivor’s feelings are “good” or “bad”. • Social support is critical.

22. Helping Children Cope With Loss • Children tend to cope with loss healthier fashion. • Adults must share the news with the children. • Natural curiosity. • Sudden changes in the family environment. • Keep the informational lines open for the child’s questions. • Be Honest.

23. Enjoy Your Day!