death and dying midterm 1

Concrete operational

7-12 years - logical thinking and understands universality and irreversibility

What are four common ways people fix a belief?

-authority - taste -dogmatism -community of inquiry

James Werth, Jr. in his article, "Philosophical Principles and Ethical Judgments," elaborates on 5 ethical meta-principles. Be able to define and provide one challenge to accomplishing each of these in a medical setting!

-autonomy -nonmaleficence -beneficence -justice -fidelity

Describe three aspects that comprise cultural sensitivity:

-avoid stereotyping -beware of judging the worth of other communities -understand culture is not defined by ethnicity

What are characteristics of the concept of invisible death?

-care is done by hired professionals -deathbed dominated by efforts to delay death -family and friends as witnesses to loved one's dying has diminished -mourning customs seem excessive -funerals and memorial services are shorter

Provide three reasons for initiating end-of-life discussions:

-choices can differ based on info where more info yields more options -could receive undesirable treatment -allows for time to heal relationships, complete goals and wills, allows for preparation, etc

What are the Aims of Palliative Care?

-control pain -relieve suffering -provide care physically, psychologically, spiritually, and existentially -helpings patients achieve a good and peaceful death

Nonmaleficence

-do no harm; physician has responsibility to avoid treatments or interventions in which the potential for harm outweighs the potential for benefit -one challenge is it's hard to determine what will harm the patient --> may extend life but may harm more than doing good

What are the five major social institutions delineated by sociologists?

-economy -education system -family -political system -religion

Fidelity

-faith, trust in someone -you can't have good care without a good doctor, but typically, a close relationship isn't built with the doctor bc we typically see a different doctor each time

List and describe three agents of socialization.

-family: family first exposes people to their values, beliefs, habituations, etc -school and peers: you begin to learn knowledge and apply it to real-life situations -mass media: shows a different perspective of life & we end up reflecting what we see on the media through our actions

What are three sources of caregiver stress?

-feelings of inadequacy -non-reciprocal giving -too many demands -feelings of being devalued -inability of cure or save a life

Institutional Medical Care consists of:

-hospital -nursing homes -hospice care

Justice

-how goods and services are distributed in a healthcare setting -goods and services may not be given based off need but who can afford

List three Urgent Clinical Indications for Discussing End-of-Life Care:

-imminent death -talk about wanting to die -inquiries into hospice and palliative care -recently hospitalized for severe progressive illness -severe suffering and poor prognosis

Define Hospice Care:

a program for patients with a prognosis of living 6 months of less where the focus is on palliative care. it's used to care for the needs of the patients and their families

Respite care

a temporary care for primary caregivers --> allows for these caregivers to take a break while they take care of the patient

Trust vs. mistrust

birth - 2 years - children are seeking trust in their caretaker, exposure to death can cause unpredictability

Sensorimotor

birth-2 years - object permanence

palliative care

care more for the psychological, spiritual, and existential suffering, care that doesn't have a prognosis,

According to the text, what is the leading cause of death in the United States today?

chronic illnesses

Managed death

control over your death

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

more than 13%

According to the text, what percentage of Americans are affiliated with a religious tradition?

more than 90%

Childhood experiences with death are most likely to

most likely to be aware of the impact only in adulthood

DRGs (diagnosis-related groups)

predetermined schedule of fees for reimbursements to care providers --> when applying to health care, factors like gender, age, and ethnicity are taken to account

Define Epidemiologic transition.

redistribution of death from young to old

Define palliative care

reduce suffering by providing care to the patients in the more psychological, spiritual, and existential aspect

QALYs (quality-adjusted life years)

shows quality of life with and without intervention, considers time and health, good health will allow for a full QALY year but if health isn't good QALY is lessened

Institutional denial

socially institutionalized avoidance of death-related thoughts and emotions --> focus on prolonging life in institutions instead of focusing on quality of life

Traditional societies tend to view disease and death as ________________?

something out of balance --> sacrifices are done to purify and protect community from further calamity

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

structural functionalist view of studying a society's social structure

Thanatology

the study of death and the study of life worth living

What does the statement "Death involves causality" mean?

there are biological causes for death

"Mean world" syndrome

violence-related content from mass media makes people believe the world is more dangerous than it actually is

List 4 principles / goals for a "good death?"

-know death is coming and to understand what can be expected -retain reasonable control over what happens -afford dignity -have adequate relief of pain and other symptoms -have a choice of where death occurs -have access to info and expertise on whatever is needed -have access to desired spiritual and emotional support -have access to hospice or palliative care -to have a say on who is present and shares the end -be able to make advance directives that ensure wishes are respected -have time to say goodbye -be able to die when it's time without prolonging life pointlessly

The Health Care Triangle consists of:

-patients -staff -institution

What are three challenges to Hospice Care?

-presence of a primary caregiver who is available 24/7 -adequate funding -the six-month rule -expanding access to underserved populations -excessive bureaucracy leading to routinization of care

What are three Features and Goals of Hospice Care?

-provide relief from pain and suffering -promote an aura of peacefulness and acceptance of death -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 treatments intended to extend life

List three specific topics that should be included in end-of-life discussions.

-relative emphasis on life prolongation -relative emphasis on quality of life -advance directives -palliative care

Describe three ways religion functions in societies:

-shared set of beliefs, values, and norms that help people find a common identity -answers to big questions about human existence and purpose -emotional and psychological support

In many traditional societies, death is believed to occur because _______________?

-supernatural causes -wind and mood -hereditary -behavioral excess -social interactions

Autonomy

-the patient has the right to make decisions for themselves & this is the most important aspect the U.S. follows -one challenge is that patients need to be provided good information in order for them to make a decision themselves --> typically, info can be cut short so patients don't properly have all the info necessary to make an accurate decision for themselves

Beneficence

-to do good -hard to achieve because there are differing opinions on what the better options are

Discuss a Mature Concept of Death. What four aspects / acknowledgments does a mature concept of death include?

-universality: everyone dies -irreversibility: can't bring the dead back -non-functionality: can't do anything once you're dead -casualty: biological cause for death

Identity vs. role confusion

11-18 years - children are figuring themselves out and asking questions like who am i , exposure to death at this age can affect achievements

Formal operational

12+ years - abstract thinking and reasoning, when dealing with death they can exhibit ADHD symptoms

Autonomy vs. shame

2-3 years - children are learning to be independent but exposure to death at this age can cause crying clinging, and being more demanding --> play therapy

Preoperational

2-7 years - symbolic thoughts, understand universality, will ask questions like "are they in pain" when encountered with death

Initiative vs. guilt

3-5 years - children are typically looking for approval, exposure to death may make them feel guilty for the death

Industry vs. inferiority

5-11 years - children are looking for recognition and reassurance, children have a general understanding of death at this age

In which country was the most influential modern hospice established?

England

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

about 30 years

What is the approximate death rate per 1000 in the United States today?

about 8.7

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

curative care --> acute intensive care of a limited duration