death and dying

what 4 aspects / acknowledgments does a mature concept of death include?

Universality Irreversibility Nonfunctionality Causality

3 reasons for initiating end-of-life discussions

choices differ based on the information (more information yields more choices) could receive undesired treatments (CPR?) allows time for healing relationships, completing goals, completing wills, etc. Allows for Preparation!

aims of palliative care

control pain relieve suffering provide care for physical, psychological, spiritual, and existential needs help patients achieve a good or peaceful death

5 major social institutions delineated by sociologists

economy education system family political system religion

4 ways religion functions in societies

emotional and psychological support answers to "big questions" about human existence and purpose shared set of beliefs, values, and norms help form common identity for people foundation for norms and laws of a society

4 specific topics that should be included in end-of-life discussions

emphasis on life prolongation emphasis on quality of life advanced directives (living well) DNR orders palliative care

in which country was the most influential modern hospice established

england

list and describe four agents of socialization

family- first source of death education school/peers- socialization mass media- shows death is reversible, lessons sensitivity religion-

3 sources of caregiver stress

feeling of inadequacy too many demands devalued burnout

what is the leading cause of death in the United States today?

heart disease

what does institutional medical care consists of (3)

hospitals nursing homes hospice programs

4 urgent clinical indications for discussing end-of-life care

imminent death talk about wanting to die inquiries about hospice/palliative care severe suffering and poor prognosis

managed death

involves ending treatment at just the right time; "peaceful death"

approximate death rate per 1000 in the United States today?

less then 10

"mean world" syndrome

lessens sensitivity to real violence and its victims

industry vs. inferiority

lot of comparison making is going on 5-11 recognition and encouragement are keys during this stage death of a family member can greatly hinder getting thi

identity vs. role confusion

main issue is "Who am I?" 11-18 death at this age can affect one identity and self formation

what percentage of the gross domestic product of the United States in 2000 was spent on health care

more than 13% or $1.3 trillion

what percentage of Americans are affiliated with a religious tradition?

more than 90%

nonmaleficence

non-harming or inflicting the least harm possible to reach a beneficial outcome

justice

notion of fairness

autonomy

patient has right to choose

what does the health care triangle consists of (3)

patients staff institutions/administrations

autonomy vs. shame

period of "letting go" and "holding on" 2-3 death of parent can cause regression to earlier behaviors ex; clinging, crying, being more demanding

5 challenges to hospice care

presence of a primary caregiver who is available 24/7 adequate funding 6 month rule expanding access to underserved populations excessive bureaucracy leading to routinization of care (from a "good" death to a "peaceful" death?)

5 features and goals of hospice care

provide relief from pain and suffering promote an aura of peacefulness and acceptance of dying treat patient and family as the unit of care provide access to comprehensive services designed for those in the final stages of a terminal illness who agree to forgo medical interventions intended to extend life

initiative vs. guilt

seek own purpose and direction 3-5 looks for approval look to adults/parents for confirmation as to their actions

epidemiologic transition

shift in disease patterns describes changing patterns of population age distributions, mortality, fertility, life expectancy, and causes of death

traditional societies tend to view disease and death as..

something is "out of balance". Because of this, they are public, not private events. The whole community is disturbed.

palliative care

specialized medical care for people with serious illness focused on providing patients with relief from the symptoms, pain, and stresses of a serious illness

the sociological theory that most resembles the study of the human body is

structural-functionalism

thanatology

study of death and the practices associated with it including the study of the needs of the terminally ill and their families

respite care

temporary institutional care of a dependent elderly, ill, or handicapped person, providing relief for their usual caregivers

what does the statement "death involves causality" mean

that there are biological reasons for death

4 principles/goals for a "good death"

time to say goodbye access to emotional/spiritual support know death and coming and understand what to expect choice about where death occurs who is present for death access to hospice or palliative care adequate pain relief

beneficence

to do good/no harm

hospice care

type of palliative care focus is on comfort rather than cure can see patients if they are at home, in the hospital, or in the nursing place unlike hospitals and nursing homes, hospice is not necessarily a place, but a program of caring oriented toward the needs of dying patients and their families

discuss a mature concept of death

understanding its universal, irreversible, life sustaining functions cease,

approximately how much has the average life expectancy in the United States increased since 1900

30 years from 47 to 77

4 aspects that comprise cultural sensitivity

avoid stereotyping beware of judgment understand culture is not defined by ethnicity know that there may be more differences within than between cultural groups

DRGs

Diagnosis-Related Groups

QALYs

Quality Adjusted Life Years

hospital health care focuses primarily on which aspect of the patient's well-being

acute care of the sick and injured uses aggressive medical techniques to diagnose, provide treatment, and sustain life

childhood experiences with death are most likely to

affect a person's attitudes toward death throughout his or her lifetime

in many traditional societies, death is believed to occur because...

death as a works of the wind or moon, heredity, and behavioral excesses a variety of socioeconomic and psychosocial, as well as natural and supernatural, factors are explored result of negative social interactions

institutional denial

death avoidance

what are characteristics of the concept of invisible death

death is hidden from society care of dying is taken over by professionals mourning process is encouraged to be shortened by employers and friends and family ceremonies are shorter and more discreet

trust vs. mistrust

developing sense of self birth-2 seeking trust and predictability death can cause unpredictability in their environment