Death and Dying ID Test 3

Partial Acceptance/Partial Denial: Kübler-Ross

-As the dying process continues, denial turns into partial acceptance. Along with partial acceptance comes anger and a sense of unfairness. The patient feels that they have not accomplished everything and they wonder why they are the ones that have to die. Partial denial is all of the in between stages: anger, bargaining, and depression.

Bereavement: Lewis

-Coping with another person's death, it is a natural state of love and not interruption. -coping with another person's death, can cause both emotional and physical trauma

Confrontation for Death: Kübler-Ross

-Death is challenged so life can continue -"Confrontation with death and dying can enrich one's life and help one to become a more human and humane person." -Must go through the 5 stages in order to confront death -Usually face confrontation of death in the depression stage -In order to accept it you must confront it first

Death as Social, and as Individual: Kübler-Ross

-Death is not an individual process it is a social process. When someone dies it affects multiple people. -Social: The family and friends of the dying are coming to terms with the fact that person will die -Individual: While your family and friends may be all around and going through this process with you, you are the only one who is actually going to die. They don't know what it is like to face death

"It": Tolstoy

-Death, it takes on a human aspect and intrudes on Ivan's life. -He is trying to distract himself from death by he is unable to escape it -He needs to accept "it" (death)--> still in denial

Unconscious Refusal of Death: Kübler-Ross

-Denial acts as a buffer, giving time to gather themselves after getting the news. Our minds are immortal, making it hard to imagine death. When the time comes, the patient will drop the denial and go to other defense mechanisms. -Part of denial -Denial, unknowingly denying the fact that you're dying

Five Stages of Dying: Kübler-Ross

-Denial, anger, Bargaining, Depression, Acceptance -These five stages are the framework that people who are dying and who are losing a loved one go through -They are not linear - you can jump around and you can go through different waves of a stage -Why Important? Each step represents physiological steps that a person goes through when dealing with death. Process of healing and mourning

Therapeutic Communication: Kübler-Ross

-Face-to-face interacting that focuses on advancing the physical and emotion well-being of a patient. Nurses use this as a form of communicating and providing support to the patients.

Theodicy: Lewis

-God is supposed to be all god. But if he is good then why does he allow suffering? -Is he a surgeon or a cosmic sadist?

Ivan's Relationship to Other People: Tolstoy

-He has a very formal relationship with everyone. He prides himself of being detached from clients, allowing him to do his best work. He has shallow relationships and only does things because it is expected of him. -When he died, his co-workers thoughts were they were glad it wasn't them who had died -Frustrated at everyone - including the doctors --->They all gave him different diagnoses and so he just gave up on them -Married not because he was in love, but because it was good for him socially --->Throughout their marriage, he hated her

Guilt in Bereavement: Lewis

-He realizes he is being selfish. He has focused on so much of his own suffering he forgot what his wife also went through. -Might feel guilty getting over the grief - is it okay to no longer grieve? Is this offending the dead?

"The Lie": Tolstoy

-Ivan lives in a false world where all bonds created are artificial. Only when facing death does he realize that the life he created was a lie. -that he is not dying and that he will survive this -This "lie" allows him to ignore "it" (or the reality of death)

Hope: Kübler-Ross

-Kübler-Ross adds hope in the end of her book because it is an important thread running in the stages. This hope is the belief that there will be positive end to the change and that there is some meaning behind this whole experience.

Issue of Communication: Kübler-Ross

-Kübler-Ross stressed that patients truly wanted to review their lives, their deterioration, and imminent death. When patients and doctors could talk openly-and without fear- a good death could be achieved -There is a lack of communication about death both in and outside of the hospital -Doctors often weren't being clear or honest to their patients about terminal illness. This is now more monitored however since Kubler-Ross' book came out

Meaning of "Forgive": Tolstoy

-Moments before his death, Ivan sees how his death will be better for his family. Instead of asking his wife to forgive him, he asks her to forego. Although he misspoke he didn't mind because he knows God understands. -This offers closure → Ivan forgives his family but they must also forgive him -Suzy's Story - to forgive her for giving her son aids and for putting the husband through it all

Aloneness of the Bereaved: Lewis

-No one knows how to interact with someone who has just lost a loved one. This leads to a degree of loneliness and separation imposed by society.

Fear of Dying: Kübler-Ross

-One fears death because there isn't physical evidence of what happens after death. It is the fear of the unknown. -A fear of pain/discomfort/decay -Death is an external force that invades you/assaulted you. It is unnatural -fear of dying because one was not able to accomplish all of the things they wanted to complete. Fear of unknown and leaving your family and the dying process

Self-Punishment and Guilt: Kübler-Ross

-One feels guilty for the things they have done or said in their life. Specifically, people that survived an event feel guilt that they survived when others died. Anger can be expressed through alcohol and drug abuse. - Universal reaction towards death

Decathexis

-Part of acceptance -Death is imminent and the person can tell it is their time to go -Removal of emotional energy -Psychological separation from others and the world → detachment

Reactive Depression

-Reacting to losses/what you have already lost both past and present -Specific losses -About the past, regrets past relations and past events. -Already regretting the things you can no longer do now that your are sick, but were once capably of doing

Anticipatory/Preparatory Depression: Kübler-Ross

-That grief that the terminally Ill patient has to undergo in order to prepare himself for his final separation from this world. This depression is typically silent and it is often shown by non-verbal expression. -Future depression about death/the fact you will die -Healthy because it is preparing you for what to come

Introjection: Lewis

-The idea that in your mind someone is a certain way, but in reality they are different. He makes reference about a man he once met and developed a picture of him throughout his life. He meets him ten years later and the man is completely different. -When someone dies, only the introjection version is left

Initial Denial

-The necessary denial stage because it provides a buffer/softens the blow of the devastating news -Healthy and natural

Extended Denial

-Unhealthy -Person might not do what they need to do/make the necessary arrangements, etc -If you die in this stage, it isn't peaceful

Depersonalization/Objectification: Kübler-Ross

-When a person is severely Ill they are treated as if they do not have an opinion and that are objectified. Doctors go to the families and not the patients, they work to find the cure and don't stop the answer the patients questions. -Doctors and nurses don't treat dying patients as if they are people. Rather they are just bodies needing to be fixed= dehumanization -Objectification of their bodies in that they just want to find a cure or fix the patient instead of managing their pain and helping them make the last days(months) comfortable -her criticism of the medical staff

Primary Narcissism/Passivity: Kübler-Ross

-When one goes back to the state children are in. Everything is a big glob of sensations.

Therapy of Silence: Kübler-Ross

-Where there is no hope left for the patient and they are ready to die. -Just being with the dying person so they aren't alone and so they know you are there Might hold their hand or may even just sit there

Question of Dignity

-? The quest for "healthy dying." Individuals need to die with dignity. -Her writing centers on treating patients with care and respect, which are the basis for dignity. She feels that people who accept death is coming have dignity.

Ivan's Resentment, Rage, Anger: Tolstoy

-After Ivan passed over promotion, he becomes enraged. This causes him to fight with his colleagues. He then leaves to seek a higher paying job to help his family. Anger was shown when he was on his deathbed and his family leaves him to go to the theatre. -He is angry at all those are young and healthy - can only stand Gerasim -When everyone's lives continued, but his stopped because he was dying. His wife and daughter pretended like his illness did not exist and continued their life. when he realized there was no true happiness in his life

Ivan's Moral Agony: Tolstoy

-Although the physical agony is painful, the moral agony hurts him the most. -The mental suffering that ivan is experiencing as a result of doing everything he was "supposed" to do however he never found real happiness in life -This causes him to question life→ in the face of death you are forced to question life

Intra-psychic process of dying

-An individual psychological process -The way in which people grapple with their prognosis of death is very objective. It takes people different amounts of time to accept their death or even work throughout the stages of dying. Like the psyche.... The stages of death and the way in which one works through these stages is individual -Inner mind thinking, 5 stages and how they want to be treated and why

Resentment: Kübler-Ross

-Anger directed at our dying or deceased loved one. -Emotionally, we resent a person for causing us pain and leaving us. We feel guilt for being angry.

Rage Against the Dead: Kübler-Ross

-Anger directed towards the deceased for leaving. Child example: why did my parents leave me?

"The Real Thing": Tolstoy

-As Ivan draws closer to death he realizes that his life was not "the real thing." All of his feelings towards people were fake and artificial.

Preparation for Death: Kübler-Ross

-As one approaches death they begin to isolate themselves, cutting off all earthly bond. They do not want visitors and do not want to talk to anyone. Instead, the dying like nonverbal communication. -The need to make amends -Planning a funeral/explaining after end of life wishes -Sort out a will, sorting family business, talking to loved ones

Beauvoir's Attitude for Death vs Kübler-Ross's Attitude Towards Death: Beauvoir

Beauvoir has a very rational approach to death. She is an existentialist. She wanted her mother's death to be comfortable and she wanted extraordinary measure. Kübler-Ross is against extraordinary measures and thing it is death prolonged. -Beauvoir's sees death as unnatural -Kubler-Ross sees it as natural

Ivan's Dream and it's Meaning: Tolstoy

The bag symbolizes death. He fights against entering the bag, however part of him also wants to enter. By entering the sack, he leaves his fake life and begins a new, more meaningful life. A metaphor for the limbo between life and death that he finds himself stuck in He knows he is going to die at this point but he can't until he accepts/overcomes his moral agony

Issue of Remorse: Beauvoir

The prognosis or diagnosis was never discussed with her mother. Simone viewed this as betrayal and because of this she felt remorse and guilt.

Beauvoir's Depiction of Maman's Death vs Tolstoy's Depiction of Ivan's Death Issue of Remorse: Beauvoir

Throughout the book de Beauvoir concedes that a purely rationalist approach to the dying and death of her mother neither does nor should apply. Family members are in denial about their deaths.