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Dying and Death

Chapter 23. Dying and Death. Why Is There Death?. There is no completely satisfying answer to the question of why death exists Death promotes variety through the evolution of species The perspective of species survival, the cycle of life and death. Understanding Death and Dying.

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Dying and Death

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  1. Chapter 23 Dying and Death

  2. Why Is There Death? • There is no completely satisfying answer to the question of why death exists • Death promotes variety through the evolution of species • The perspective of species survival, the cycle of life and death Chapter Twenty-three

  3. Understanding Death and Dying • Defining Death • Defined as cessation of the flow of vital bodily fluids. • Cessations of the heart beating and breathing • Life-support systems • Brain death • Harvard medical School committee – death involves: • Lack of receptivity and response to external stimuli • Absence of spontaneous muscular movement and spontaneous breathing • Absence of observable reflexes • Absence of brain activity • Electroencephalogram (EEG) • Clinical death • Cellular death Chapter Twenty-three

  4. Learning About Death • A child’s understanding of death evolves greatly from about age 5 to age 9. • Most children cone to understand that death is final, universal, and inevitable • Mature understanding of death • Mark Speece and Sandor Brent – Facts about death includes four components • Universality • Irreversibility • Nonfunctionality • Causality Chapter Twenty-three

  5. Denying Versus Welcoming Death • Understanding death in a mature fashion does not imply that we never experience anxiety about the deaths of those we love or about the prospect of our own death. Chapter Twenty-three

  6. Planning For Death • Making a Will • A legal instrument expressing a person’s intentions and wishes for the disposition of his or her property after death. • Estate • Testator • Intestate • Testamentary letter • Document includes information about your personal affairs (bank statements, credit cards, documents etc.) Chapter Twenty-three

  7. Considering Options for End-of-Life Care • Home Care • Hospital-Based Palliative Care • Focuses on controlling pain and relieving suffering by caring for the physical, psychological, spiritual, and existential needs of the patient. • Hospice Programs • Palliative care Chapter Twenty-three

  8. Deciding to Prolong Life or Hasten Death • Withholding or Withdrawing Treatment • Assisted Suicide and Active Euthanasia • Physician-assisted suicide (PAS) • Physician provides lethal drugs or other interventions • Active euthanasia • Intentional act of killing someone who would otherwise suffer from an incurable and painful disease Chapter Twenty-three

  9. Completing an Advance Directive • Any statement made by a competent person about choices for medical treatment should he or she become unable to make such a decisions. • Two forms: • Living will • Health care proxy • Surrogate (the decision maker) Chapter Twenty-three

  10. Figure 23-1 Sample living will Chapter Twenty-three

  11. Becoming an Organ Donor • Each day about 77 people receive an organ transplant while another 19 people on the waiting list die because not enough organs are available. • 98,000 Americans waiting for organ transplants • Uniform Donor Card • First step • See “In Focus” Myths About Organ Donation Chapter Twenty-three

  12. Figure 23-2 The need for organ donors Chapter Twenty-three

  13. Planning a Funeral or Memorial Service • Disposition of the Body • Social, cultural, religious, psychological, and interpersonal considerations • Burial • Cremation • Embalming for a viewing or wake • Arranging a Service Chapter Twenty-three

  14. Coping With Dying • Awareness of Dying • The Tasks of Coping • 1969 book On Death and Dying, Elisabeth Kubler-Ross • 5 psychological stages • Denial • Anger • Bargaining • Depression • Acceptance • Charles Corr • 4 primary dimensions in coping with dying • Physical • Psychological • Social • Spiritual Specific tasks that need to be addressed in coping with dying • Prediagnostic • Acute • Chronic • Terminal • Recovery Chapter Twenty-three

  15. Coping With Dying • The Trajectory of Dying • Understanding patients’ experiences as they near death • Supporting a Dying Person • Coping With Loss • Experiencing Grief • Bereavement • Mourning • Tasks of Mourning • Accepting reality • Working through the pain • Adjusting to a changed environment • Emotionally relocating the deceased and moving on with life • The Course of Grief • Supporting a Grieving Person • Helping Children Cope with Loss Chapter Twenty-three

  16. Coping With Dying • The Course of Grief • Supporting a Grieving Person • Helping Children Cope with Loss • Coming To Terms With Death Chapter Twenty-three

  17. Chapter 23 Dying and Death Chapter Twenty-three

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