Chpt 19 Death, Dying and Bereavement
Bereavement: Coping with the Death of a Loved One: Describe the phases of grieving, factors, that underlie individual variations and bereavement interventions.
Bereavement-losing a loved one to death Grief-intense physical and psychological distress to loss Mourning- expression of the bereaved. Avoidance, Confrontation, Restoration Dual-process model of coping with loss- oscillating between dealing with emotions of loss and attending to life's changes which is restorative.
How We Die: Describe the physical changes of dying, along with their implications of defining death.
Death long and drawn out for 3/4. Sudden death 80-90% heart attack Dying takes place in 3 phases (1) agonal phase- gasping/muscle spasms, regular heart beat disinegrates (2) clinical death- short interval where resuscitation is possible. (3) Mortality- permanent death. Brain death-irreversible cessation of all activity in brain/stem Persistent vegetative state- cerebral cortex no longer registers but stem is active.
Thinking and Emotions of Dying People: Describe and evaulate Kubler-Ross's theory, cite factors that influence dying patient's responses.
Dying people typically express 5 responses: Denial, Anger, Bargaining, Depression and Acceptance. Appropriate death- matches living and values, preserves or restores significant relationships, and free of suffering if possible.
The Right to Die: Discuss controversies surrounding euthanasia and assisted suicide.
Euthanasia- ending the life of a person suffering from incurable condition Passive euthanasia- withholding treatment for ill pt Advanced Medical Directive Living Will Durable Power of attorney for health care Voluntary active euthanasia- Dr acts directly to end suffering. Assisted suicide
A Place to Die: Evaluate the extent to which homes, hospitals, nursing homes, and the hospice approach meet the needs of dying people and their families.
Only 1/4 die at home. Highly demanding. Sudden death typically hospital ER. ICU- lingering between life and death by machine Nursing home-die in pain w/o needs met Hospice-support dying needs pallative or comfort care relieves pain rather than prolonging life
What is the meaning of death with dignity?
Supporting dying patient with physical and psychological needs Being candid about deaths certainty Help them learn about condition to make reasonable choices in treatment
Attitudes Toward Death: Discuss factors that influence attitudes toward death, including death anxiety.
Young generations little contact with death-unease Death Anxiety- women greater than men Spiritual or philosophical views on death fare better