gero of death and dying exam 1: UNL
Drop in life expectancy
- 77 yo life expectancy in 2020 - 78.8 years in 2019 - Due to COVID, increased accidental deaths (overdose, car crash), suicide, chronic illness
Drug overdose deaths - profile of someone to die from a drug overdose
- Accidental overdose is based off the availability of lethal drugs - Profile: someone 35-44 years old, American Indian or native Alaskan with availability to drugs
Leading causes of death in 1960 Diseases of the heart
- Cancer - Vascular lesions affecting the CNS - Accidents -- Motor vehicle = 38,137 -- Other = 55,669 - Certain diseases of early infancy - Influenza and pneumonia - General arteriosclerosis - Diabetes mellitus - Congenital malformations - Cirrhosis of the liver
Coffins vs caskets
- Coffins - shaped shoulders/ toe pinchers - Caskets - square corners -- More of what we see in America
African American traditional beliefs:
- Death comes in three's - Impact on the community - With every death there is a birth - Acknowledging and honoring the dead - attending funeral, delaying service - Bringing about luck - Death serves as a release from oppression - it is a joyous moment
Leading causes of death in 1940: chronic
- Disease of the heart - Cancer - Intracranial lesions of vascular origin - Nephritis - Pneumonia - Accidents: excluding motor vehicle - Tuberculosis - Diabetes - Motor vehicle accidents - Premature birth
Unique aspects of African American traditions:
- First call: funeral homes first contact with family - Mourning wreath and porch light kept burning (southeastern US) - Person has passed/slipped away, gone home - Sit-ups and wakes (may be held in home) - Home going ceremony - rather than funeral - Expression of grief - nurses at funerals - Repast: a meal after the funeral - Black funeral home: a family tradition, a significant part of the African American experience
Leading causes of death in 2020: 3,383,729 death and 3,613,647 births
- Heart disease (696,962) - Malignant neoplasms (602,350) - COVID-19 (384,536) - Unintentionally injury (200,955) - Cerebrovascular disease (152,657) - Chronic, low, respiratory disease (152,657) - Alzheimer's disease (134,242) - Diabetes (102,188) - Influenza and pneumonia (53,544) - Nephritis (52,547)
Leading causes of death in 1920: acute illness/infectious disease
- Influenza and pneumonia - Diseases of the heart - Tuberculosis - Vascular lesions affecting the CNS - Nephritis - Cancer - All accidents - Diarrhea - Premature birth - Puerperal causes (infectious disease related to childbirth)
Leading causes of death in 1900: acute illness/infectious disease
- Influenza and pneumonia - Tuberculosis - Gastritis - Disease of the heart - Vascular lesions affecting the CNS - Chronic nephritis - All accidents - Cancer - Certain diseases of early infancy - Diphtheria
Death notification
- Informing family of a death that may have occurred violently and unexpectedly - Notification of next of kin - "in person, in time, in pairs, in plain language and with compassion" - "we're sorry to have to bring you this terrible news, Mrs. Jones. Your daughter, Helen, was killed in a store robbery" - After giving the news, be silent for a short time - Ask if there is someone they could call to be with the person - Provide details on next steps (identification, viewing, investigation)
Cultural aspects of death and dying
- Most societies have a concept of soul and immortality - Death rituals (burial) are related to the soul - with an intent to appease the soul - Ghosts - also seem to be a part of many cultures - Crying, fear, and emotion are common (western cultures are deviant from others - and even its own society 100+ years go)
what gender and race of people have the highest life expectancy
- Non-Hispanic Asian women have the highest life expectancy - Non-Hispanic Asian is the race/ethnic group with the highest life expectancy
Hispanic traditions - Mexico
- November 1st - the day of the dead (10/31 - 11/2) - Picnics in cemeteries - a day filled with eating, drinking and singing -- Candies and breads (skulls shapes) - On the night of November 1st, the spirits of the dead are welcomed back to the world - Gravesides are decorated with flowers (marigolds) and candles; Virgin Mary - Toys are provided for children and tequila for adults - Families will build ofrendas (alters) in their home - Memorial crosses at accident sites -- The person remains there
COVID-19: who is mostly like to die from COVID? When did it first enter into death data?
- Older people are most likely to die from COVID - daily death reports - freaks people out - Social isolation and social distancing - its contributions to death fears (did I unknowingly cause someone else to get sick?) - Psychological effects: constant high alert - Exploration of neuroticism and death anxiety - findings: a positive correlation between neuroticism and death anxiety. Along with a positive correlation between death anxiety and perceived stress
American Indians - Unique aspects
- Vast number of tribes (574) - each has its own experience and practice - Life is seen as cyclical - not linear (wholeness of life) - People are said to walk on - rather than die - Spiritual leaders play a key role in the ceremony for the living and the dead - Death song - common last words of the individuals - Remains of the dead are considered sacred - Native American Graves Protection and Repatriation Act -- Provides for the ownership or control of native American cultural items (humans remains and objects) excavated or discovered on federal or tribal lands - For the Lakota - grief is the closest one comes to God - as a person who is grieving is the most holy
Wholeness of life vs linear view
- Wholeness of life: African American traditions, African cosmogram - Western cultures have a linear view -- Life/death opposites
Asian traditions
- Yin-yang duality - embracing life and death - Becoming an ancestor; rites performed by family members and priests - Gravesite visitation; maintaining contact with the deceased - Ch'ing Ming - Chinese memorial day -- Families visit graves, burn replicas of items of the deceased in order to honor the deceased - O-bon - festival of the dead -- August 13-16 -- A Buddhist tradition and time to honor the dead -- Return of ancestral spirits -- Red lanterns are used as a symbol for the spirits of the dead -- Bon-Odori - a welcoming dance for deceased souls back to the mortal world - Japanese tombstones; reflection of the Buddhist tradition -- A listing of both the dead and the living -- Date found on tombstone is for when the stone was erected not a death date -- The marker is for the entire family
Mortality crossover - what is it and when does it happen? Who benefits?
- past 85 yo you have lived through a lot of things that would have killed you and now have more time to live - Native Alaskans have lowest life expectancy but it increases after they live past 85 yo
What are the leading causes of death in the United States?
1. Heart disease 2. Malignant neoplasms - cancer 3. Covid-19 4. Unintentional injury 5. Cerebrovascular disease 6. Chronic, low respiratory disease 7. Alzheimer's disease 8. Diabetes 9. Influenza and pneumonia 10. Nephritis: kidney issues
When was the NFDA founded?
1882
Total number of deaths in 1900 vs. 2020
1990 = 2.15 million 2020 = 3.6 million
ages most likely to die from drug overdose
35-44 25-34 45-54
Women tend to have a higher life expectancy than men
5.7 year difference at birth 2.8 year difference at 65 years old
the average life expectancy in the US is _____ years overall - varies based on gender and race
76.1
amplification effect
A process whereby the actions of terrorists are broadcast through the mass media to a larger audience than such acts would have in the location where they occur.
Epidemiologic transition - defined
Changing patterns of population distributions in relation to changing patterns of mortality, fertility, life expectancy, and leading causes of death
drug overdose death increased from 2019 to 2020
Increased during COVID because people have so much more free, alone time
What happened in 1918? Who was most likely to die?
Influenza pandemic - People younger than 5 years old - 20-40 years old - 65 and older - wash your hands!!!
Internment vs. interment
Internment - Act of detaining a person or a group of people, especially a group perceived to be a threat during wartime - Inter n to jail Interment - What happens when a deceased person is laid to rest. - Refers primarily to the burial but it can denote all the parts of the burial process
ethnicity most likely to die from drug overdose
Non-Hispanic American Indian or Alaskan Native most likely to die from a drug overdose - Non Hispanic black - Non Hispanic white
Components of the death system
People - Funeral director, police, firefighters, reporters, world-leaders, recovery workers, health care workers (jobs/stable roles) Places - Funeral homes, hospitals, building (sacred ground - death related character) Times - Memorial day, day of the dead, September 11th, holocaust remembrance day (moments in time associated with death) Objects - Hearse, death certificate, tombstone, memorial crosses (things that are linked to death) Symbols - Funeral music, skull and crossbones, flag at half-staff (objects that signify death)
The wake: as a cultural experience
Purpose - To bring people together to honor the dead - To prevent the ravaging of the corpse; rats, cats, etc. - To deter grave robbers from taking body for medical research - To comfort survivors - To acknowledge the person has died - a chance to take a photograph of the person
Functions of the death system (varies form one society to another and from one time to another)
Warnings and predictions - Disasters, terror alerts Preventing death - Public health notices - COVID-19 pandemic flu, mumps, police, EMTs Caring for the dying - Hospice/palliative care Disposing of the dead - Respectful removal - Social consolidation after death - Grief, normalcy Making sense of death - Religion, scientific explanations Killing - War, capital punishment
what are the four things that matter most
What are the four things that matter most?
life span
fixed biological constant, maximum number of years a person can expect to exist (120 yo)
life expectancy
average number of years of life remaining at any specific age (birth, or at another age) - Dependents on genetics, life style, behaviors
majority of deaths are due to ______ conditions
chronic
Cultural humility and cultural competence
cultural competence is the ability to work respectfully with people from diverse cultures while recognizing one's own cultural biases cultural humility is the ability to recognize one's own limitations in order to avoid making assumptions about other cultures
mortality
death
thanatophobia
fear of death
what gender is most likely to die from over dose
males
undertakers in late 19th century
person who supervises or conducts the preparation of the dead for burial or assist with arranging for a funeral
Etiquette timeline
purpose: to provide structure/guidance to a culture on acceptable behaviors - late 1800s - home funeral, invitations sent to the home - early 1900s - women and veils, notice in newspaper, home funerals; embalming still in the home - 1920s and 30s - funerals in a church, use of mortuaries - 1970s - the need to have someone at the house, blended families, acknowledgement cards (everyone gets paid) - Today, with COVID-19 - what is appropriate? Is streaming a video enough when attending a service? - Undertakers in late 19th century: person who supervises or conducts the preparation of the dead for burial or assist with arranging for a funeral - Funeral homes in 1920s advertising of coffins and furniture in late 1800s - 1882 establishment of NFDA - national funeral directors association - Late 19 and early 20th century - embalming in the US -- Embalming of deceased in home
morbidity
rate of occurrence of disease
hay flick limit
suggest the is a maximum number of doubling for cells - Cancer and stem cells have no maximum
what is the leading cause of drug overdose
synthetic opioids - fentanyl
leading for identification from 9/11
teeth
comorbidity
the co-occurrence of two or more disorders in a single individual
Death system:
the interpersonal, socio-physical and symbolic network through which an individual's relationship to mortality is mediated by his or her society A way of understanding death related practices and how a society interacts with death-related experiences
mortality rate (death rate)
the number of deaths per 1,000 population - Increase in population increases mortality rate - More older people = more people dying
thanatology
the study of death-related behavior including actions and emotions concerned with death, dying, and bereavement
terror management theory (TMT)
the theory that people deal with the potentially crippling anxiety associated with the knowledge of the inevitability of death by striving for symbolic immortality through preserving valued cultural worldviews and believing they have lived up to their standards
Main causes of death in 1990-1920
were acute illness and infectious disease were quick and unexpected
leading causes of death in 1940-2020
were chronic illnesses lingering, long term death