HDFS ch. 19

cognitive development on the ability to grieve in a child

- Children with an immature understanding of death may believe the dead parent left voluntarily, perhaps in anger, and that the other parent may also disappear -honesty, affection, and reassurance help them tolerate painful feelings of loss -Grief-stricken school-age children are usually more willing than adolescents to confide in parents -teens are more likely than children to become depressed or to escape from grief through acting-out behavior

loss of a sibiling

- deprives child of a close emotional tie - informs them, often for the first time, of their own vulnerability

loss of a child

-Parents often report considerable distress and resurgence of grief for years -the emotional consequences negatively affect parents' lives and likely contribute to the higher divorce rate among bereaved parents than other parents

African Americans and death

-a dying loved one signals a crisis that unites family members in care-giving -terminally ill person remains an active and vital force within the family---> creates respect that eases the dying process

adults grieving loss of an intimate partner

-after the death of a spouse, adaptation to widowhood varies greatly, with age, gender, social support, and personality making a difference -After a period of grieving, most widowed older adults in Western nations fare well, while younger individuals display more negative outcomes -loss of a spouse or partner in early or middle adulthood is a non-normative event that disrupts life plans

children grieving a family loss

-frequent crying -trouble concentrating in school -sleep difficulties -headaches -and other physical symptoms several months to years after a death persistent depression, anxiety, angry outbursts, social withdrawal, loneliness, and worries about dying themselves are common many children say they have actively maintained mental contact with their dead parent or sibling, dreaming about and speaking to them regularly

suggestions for resolving grief after a loved one dies

-giver yourself permission to feel the loss -accept social support -be realistic about the course of grieving -remember the deceased -when ready, invest in new activities and relationships, and master new tasks of daily living

spirituality with death

-higher in spiritual well-being--->express greater sense of inner peace, less end-of-life despair

Maori of New Zealand and death

-relatives and friends gather around the dying person to give spiritual strength and comfort -patient is encouraged to discuss important matters with closest loved ones

Kubler-Ross's Theory

1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance -coping strategies that anyone may call on in the face of threat

transition from life to death phases

1. agonal phase 2. clinical death 3. mortaility

3 phases of grieving

1. avoidance 2. confrontation 3. restoration

2 types of advance directives

1. living will 2. a durable power of attorney for health care

death with dignity

1. provide the majority of dying people,with humane and compassionate care 2. be candid about death's certainty 3. doctors and nurses can help dying people learn enough about their condition to make reasoned choices about whether to fight on or say no to further treatment

complicated grief

A bereaved person's severe, prolonged distress, depression, and lack of acceptance of the death that persists for years, impairing physical and mental health.

hospice

A comprehensive program of support services for terminally ill people and their families, which regards the patient and family as a unit of care and emphasizes meeting the patient's physical, emotional, social, and spiritual needs while also providing follow-up bereavement services to the family.

appropriate death

A death that makes sense in terms of the individual's pattern of living and values, preserves or restores significant relationships, and is as free of suffering as possible.

involuntary euthanasia

A doctor ends a suffering patient's life by some medical means, such as a lethal dose of medication, without the patient's consent

dual-process model of coping with loss

A perspective that assumes that effective coping requires bereaved people to oscillate between dealing with the emotional consequences of loss and attending to life changes, which- when handled successfully- have restorative, or healing, effects

persistent vegetative state

A state in which the cerebral cortex no longer registers electrical activity but the brain stem remains active. The person is unconscious and displays no voluntary movements.

durable power of attorney for health care

A written statement authorizing appointment of another person (usually, though not always, a family member) to make health care decisions on one's behalf.

living will

A written statement specifying the treatments a person does or does not want in case of a terminal illness, coma, or other near-death situation -cannot anticipate all future medical conditions -can easily be ignored

Voluntary euthanasia

At a suffering patient's request, a doctor ends the patient's life in a painless way -illegal in U.S. but courts are usually lenient with doctors who engaged in it with patients near death and suffering profoundly

medical aid-in-dying

At an incurably ill patient's request, a doctor provides a prescription for a lethal dose of medication that the patient self-administers to end his or her life -legal in: Oregon, Washington, Montana, Vermont, and California -Nations that have passed medical aid-in-dying legislation: Belgium, the Netherlands, Luxembourg, Switzerland, Colombia, and Canada -support comes from: higher in SES, white, and less religious -used to be referred to as: "physician-assisted suicide"

palliative, or comfort, care

Care for terminally ill, suffering patients that relieves pain and other symptoms (such as nausea, breathing difficulties, insomnia, and depression), with the goal of protecting the patient's quality of remaining life rather than prolonging life.

anticipatory grieving

During prolonged dying, the bereaved person's acknowledgment that the loss is inevitable and emotional preparation for it.

loss of a parent

When a parent dies, children's basic sense of security and being cared for is threatened

bereavement overload

When a person experiences several deaths at once or in close succession -aging adults are at risk for bereavement overload -public tragedies can spark this overload

ending life-sustaining treatment

With the terminally ill patient's permission, or the permission of the patient's substitute decision maker, a doctor withholds or withdraws life-sustaining treatment, thereby permitting the patient to die naturally

disenfranchised grief

a sense of loss without the opportunity to mourn publicly and benefit from others' support(can disrupt grief process) -if relatives did not or limit let same-sex partner participate in funeral services

advance medical directive

a written statement of desired medical treatment should a person become incurably ill

china and japan death standard

absence of heartbeat and respiration -has hindered the development of national organ transplant programs because few organs can be salvaged from bodies without artificially maintaining vital signs -japanese law uses the brain death standard only when the dying person is a potential organ donor

grief process tasks

actions the person must take to recover and return to a fulfilling life 1. to accept the reality of the loss 2. to work through the pain of grief 3. to adjust to a world without the loved one 4. to develop an inner bond with the deceased and move on with life

Music thanatology

an emerging specialty in music therapy that focuses on providing palliative care to the dying through music

sudden, unexpected deaths

avoidance may be especially pronounced and confrontation highly traumatic because shock and disbelief are extreme -adjusting to this is easier when the survivor understands the reasons for it

participatory perspective

death and dying are viewed as natural and life-promoting, as fulfillment of life goals, and as a time to share one's experiences with others -less fearful

Native-American groups and death

death is met with stoic self-control: an approach taught at an early age through stories that emphasize a circular relationship between life and death and importance of making way for others

overcoming perspective

death is seen as imposed on people, as defeat or failure, and as robbing them of opportunities to achieve their goals -more fearful

Buddhism and death

emphasizes that all physical and mental states are transient, which fosters acceptance of death

death anxiety

fear and apprehension of death - can be caused by death-avoidant culture -those with less religious commitment have higher death anxiety -attainment of ego integrity reduces death anxiety -women more anxious than men -declines with age -can motivate people to strive to live up to internalized cultural values----> increases adults' sense of self-esteem, self-efficacy, and purpose in life

grief

intense physical and psychological distress following the death of a loved one

brain death

irreversible cessation of all activity in the brain and the brain stem. the definition of death accepted in most industrialized nations

end to a loving, fulfilling bond

leads to anguished confrontation with loss, but this soon resolves

suicide death

more likely to conclude that they contributed to or could have prevented it—self-blame that can trigger profound guilt and shame -reactions are likely to be especially intense and persistent when the griever's culture or religion condemns suicide as immoral -recovery from grief is prolonged

dissolution of a conflict-ridden, ambivalent tie

more likely to leave a long-term residue of anger, guilt, and regret

agonal phase

phase of dying characterized by a rattled breathing sound, due to fluid buildup in the throat, and by gasps and muscle spasms during the first moments in which the regular heartbeat disintegrates

clinical death

phase of dying in which heartbeat, circulation, breathing, and brain functioning stop, but resuscitation is still possible

mortality

phase of dying in which the individual passes into permanent death

Widowed older adults whose spouses experienced a painful death

report more anxiety, intrusive thoughts, and yearning for the loved one six months later

symbolic immortality

the belief that one will continue to live on through one's children or through one's work or personal influence

mourning

the culturally specified expression of the bereaved person's thoughts and feelings through funerals and other rituals -customs vary

bereavement

the experience of losing a loved one by death -root means: "to be robbed"

men with grieving

typically express distress and depression less directly and seek social support less readily