Dying death and bereavement midterm

5 stages of grief

- Denial - Anger - Bargaining - Depression - Acceptance (DABDA)

ideal death trajectory?

-the most ideal way for me to die, will be to die peacefully - My ideal way for me to die may not be the ideal way that my mom wants for me to die.

- What group sees life and death as a continuous cycle

Hispanic Americans

- What do women give at a Chinese funeral

candy to 'soften the sorrow'

puerto ricans see death as a

death sentence

If someone has attempted suicide previously then they are at significantly _______ risk for actually committing suicide later.

higher

meaning reconstruction

if lana never bought billy that car he would still be alive right now (car crash)

- Which group generally considers the diseased persons body as 'an empty shell'

native American group - apache

what are some of the critiques of kubler ross's work

the stages are presented as very concrete. There is no guarantee that one will go through all 5 stages before they die. There is no resolution at the end.

Terrorism

violent acts or threats designed to intimidate or create fear on behalf of some religious, political, or ideological goal while deliberately targeting or disregarding the safety of noncombatant civilians

Population pyramid

we are becoming top heavy. People are having less children. One kid - four parents.

Up to 2 years old

- will sense a loss - will pick up on grief of a parent or caretaker - may change eating sleeping habits - signs of distress can be confused with developmental milestones

- What is a group that generally identifies males as needing to be strong and less expressive

African Americans

- Which group is suspicious of the medical community

African Americans

what is grief

An emotion. Normally thought of as a negative emotion. Sadness, anger, confusion, discomfort. How a person feels after dealing with loss and death.

- This group relies on a patriotic model. Relies heavily of the patriot of the family

Asian and pacific islander

TQ agencies

Baby steps - website designed to help grieving family and friends cope with the lost of a young loved one. Al- anon - family Al‑Anon is a mutual support program for people whose lives have been affected by someone else's drinking. MADD (mothers against drunk driving -nonprofit organization in the United States and Canada that seeks to stop drunk driving, support those affected by drunk driving, prevent underage drinking

what is the difference between grief and bereavement

Grief - how an individual feels Bereavement - how a group of people feel.

attachment

If we do not attach to someone as an individual then you will not survive - research has shown that infant attachment goes to show how you love and allow yourself to be loved - distant and conflicted attachment will play out in adult life later on - breatfeeding is important, helps with bonding, even if only for the first few weeks

________ are at the greatest risk of dying from suicide

Men at/over 65

Elements of a death system include

PEOPLE - individuals who roles are associated w death PLACES- locations that have death related character TIMES- "memorial day" OBJECTS- death certificate, tombstone SYMBOLS - skull, organ music, black armband

what is loss

Something that you once had, that you no longer have. (Parents getting a divorce. Moving to a new town.)

functions to a death system

TO GIVE WARNINGS AND PREDICTIONS TO PREVENT DEATH TO CARE FOR THE DYING TO DISPOSE OF THE DEAD

western attitudes towards death Aries named (5)

Tame Death - Death of the self Remote/imminent death Death of the other Death Denied

____________ have the highest rate of suicide attempts of any age group in the United States.

Teenagers

forbidden death

a death related attitude that views death as offensive and unacceptable

Anger

a flood of emotions. "a storm". "blame laden." Anger is a secondary emotion, but it is normally stimulated by another emotion, normally, fear, or hurt. ---→ Give them space, but support. When necessary, remind them of appropriate expressions of anger. Do not tell them they are wrong. Instead, reframe. This stage is unpredictable, but it has a purpose.

What is Death

an end to something. The permanent end. The physical absence of a person place or idea.

Coping (3) focal domains

appraisal focused - denial - cognitive redefinition, mental preparation - paying attention to one crisis at time problem focused - seeking info. and support - taking problem solving action emotion focused - emotional discharge,

death of the self

attention is focused on the person who dies who is now seen as a separate individual. distinct from other members of society in both life and what follows in death

"a happy funeral"

book for young readers. describes two young chinene american girls who are gong to grandpas funeral. mother says he si going to have a happy funeral. they are confused "thats like saying a sad party or a hot snow it doesn't make sense" gave candy to sweeten the sorrow. laura fluctuates between happiness and sadness. grandpa left a good legacy

(4) dimensions of education and loss

cognitive - factual, information, medical. facts affective - feelings, emotions, skilled sensitivity behavioral - individual and relational responses. confidentiality and privacy. valuational - examining the meaning of death, certain situations, perspectives, and values

Four central dimensions of death education

cognitive - what people know affective -how they feel, behavioral - how they behave (why they act the way they do) valuational -what they value.

Tame death

death is inevitable. No attempt made to evade it. Person calmy awaits death. Social event.

remote and imminent death

death is viewed as a wholly natural event (not a supernatural one) but still great effort is made to keep it at a distance

native community

death part of natural ongoing of life. value in fours. four natures, four seasons four phases of the moon. will be reunited after death. optimistic view of death. acceptance with limited anxiety.

human induced death

deth resulting from the actions or inactions of human beings

- What is the Mexican holiday that is known as "the day of the dead"

dia delos muertos

death denied/forbidden death

dying persons are isolated from the rest of community. death no longer seen as natural.

Six goals of death education

enrich personal lives, inform individuals, prepare individuals with roles, support individulas and help them understand, enhance communication, and assist people in appreciating how development interacts with death related issues.

african americans

experinced 12% of all deaths in 2007. value interdependence. support is a key element. utilize funeral services. in a church. counseling services. importance of storytelling. women took on the role of various people when storytelling. accents.

what are the two forms of death education

formal and informal

hispanic americans

hispanics were the largest minority group in the uS making up a little over 13%. family plays a big role in shaping attitudes. families tightly knit. emotional supportive. religion significant influence. 90% roman catholic. funeral masses. reunited in the afterlife. continuous relationship between life and death. females are caregivers for relatives. find value in being with dying relative so unresolved issues can get worked out. women open expression in grief. open caskets.

Teens view death as

inevitable, universal, irreversible - Cognitive skills almost fully developed - Questions meaning of life if it ends in death - Associates death with aging - Sees self as invincible - "it will not happen to me' - Need for adult guidance (grief process, coping skills) - Needs someone to listen; talk with - May feel guilt, anger, even some responsibility for death that occurred - Not sure how to handle own emotions (public and private)

asians

insist on maintaining control over communication. restrained in communicating what they were feeling to health care providers. belief that talking about bad things may actually produce them. taboo subject. chinese canadians. dying persons not be told that they are dying. suicide considered prohibited act. disagreements within chinese community about the appropriateness of traditional customs. funeral rituals are very important. maintain healthy relationships between living and dead. mourning practices are conservative.

Media

is a culture within itself because it is very influential and shapes are subconscious and how we view things. The media changes how we practice and do behaviors.

shock

is not a stage, but is a pre-stage. Short term. Psychological reaction) the initial reaction to the news. Paralyzing, nodding, but not absorbing the information. - be proactive, take the person to a safe place where they are surrounded by loved ones.

nuclear era

the period from july 1945 to the present during which the splitting of the atom unleashed a new form of power that can be used for weapons or as a source of energy

death of the other

the main focus of attention is on the survivors. it can result in an intolerable separation from the one who dies

what is grief?

- An experience of the entire being - Various manifestations - It is as natural and normal as healthy as attachment - Grief is not an illness, not a disease, not going to end

When communicating with children (use the CHOOSE method)

- Clearly - Honestly - Openly - Often - Succinctly - Empatheticallly

Death denied, forbidden death, invisible death (1900-today)

- Death is medicalized and banished from the home - Death is not natural, instead is it a failure of the doctor - It is offensive and should occur in private. Daily life is unmarked by death. - Emotion is frowned upon. Often the dying and bereaved are isolated - Morticians create the illusion of life. - (we are creating a culture where we have unrealistic expectations about death. The media is helping shape these views. Emotions are sometimes frowned upon, because emotions cause anxiety.)

Western attitudes toward death - Death of the other (1800-1900)

- Death of the other (1800-1900) - - Focuses on the relationships broken by death - death is beautiful and a release from suffering - death is "sleep" until you are reunited with loved ones - the afterlife does not involve suffering. - The dead are pseudo living. May haunt places, leading to rise in spiritualism. - Cemeteries are still outside of towns. They are feared (haunted) and unclean.

Ages 9-12

- Develops morality - strong sense of good and bad behavior - May see death as punishment for poor behavior - Still some magical thinking; needs reassurance that wishes do not kill - Begins an interest in biological factors of death - Theorizes: people die to make room for new people - Asks more about "what happened" - Interested in spiritual aspects of death - Concerns about rituals, burying - Questions relationship changes caused by death, life changes - Worries about who provides and cares for them

Ages 2-6 years

- Family is center of child's world; confident family will care for needs - Plays grown up/imitates adults - Functions on a day to day basis; no understanding of time or death - Death brings confusion. Guilt - Cannot imagine life without mom or dad - Thinks dead people continue to do things ( eat, drink, go to the bathroom) but only in the sky - Thinks if you walk on the grave the person feels it - Tendency to connect things which are not related - Magical thinking... if you wish it, it happens ( bring the dead back or wishing someone was dead)

what are some things to look out for when a person may be suicidical or depressed

- Feel like life isn't worth living - Wish they had died w thier loved one - Blame self for loss or for failing to prevent it - Feel numb and disconnected from others for more than a few weeks - Are having difficulty trusting others since loss - Are unable to perform normal daily activities

Western attitudes toward death Death of the self (1100-1600)

- In the 12th century the emphasis on the last judgment became more important - Thus, death can now be a threatening event - Moment of death was now viewed as a threatening ordeal where your souls fate was decided. - A key element of this philosophy is a view of the self as unique and distinct. - Combination of fasicantion with and revulsion of the body. Coffins are used faces are shrouded.

Medicaid vs medicare

- Medicaid is a needs based program for individuals that are at a certain resource level. Supported healthcare program (soonercare) pregnant women) can be used for people of all ages with or without children income has to be at a certain rate. Minimal resources. Often don't have a home. Hard to be eligible - Medicare - usually for people over 65. Government supported.

Inhibited grief

- those who do not allow themselves to experience the pain of grief directly may develop some kind of somatic complaints or illness (keep it all in) - choose to mourn some aspect of the loved one not another ( I understand that you lost your brother but I refuse to admit that I lost a child) - encompasses maladaptive behavior that the person will usually be unaware of or not attribute it to their grief response

_________ are very "one with nature"

- Native americans

Death Rates

- Numbers of deaths among members of a given pop. Group divided by the total number of those in the group.

How does SES shape ones death experience?

- The better job you have, the better health care. Some people may not have insurance. - How did SES shape the way we die? If the person does not have any money, the burden can fall on the family, a family had to hold a fundraiser just to pay for the persons casket. Some people will get turned away when they tell people that they do not have insurance.

Death related concerns

- The death of ones self - what happens to the self at the moment of death. Does death equal a battle for your soul? Absolute nothingness? - - Four major concerns reappear consistently throughout history (noting the European influence) - One won dying - often a reflection of fears and anxiety (long and painful death) one result is a living will

Remote and imminent death (1600-1800)

- Transition period. Renaissance and reformation leads to a loosening of religious controls - Death is viewed as natural and beautiful, but also as fearsome and dangerous. - Fascination with cadavers. Eroticization of death as people keep parts of the dead (heart, or hair) - Cemeteries are moved outside of town, no longer viewed as social places.

Absent grief

- acting as though nothing has happened - no feelings of grief or mourning and become detached from reality as if the death never occurred - emotional numbness is common - maladaptive behavior is also common but often the bereaved is unable to associate them with the loss

Helping those who are bereaved (4 ways of grieving)

- cognitive - they will want information - affective - be a source of comfort - behavioral - participate - valuational - listen to their views

Factors influencing invisible death

- death and the media - death is abstract and superficially portrayed - death is fun and revocable - cartoon characters - death is brutal but fast - death is resolved in 60-90 minutes - death is horrible but distant - happens to people other than us

Tame death

- death is a familiar and public event. One calmly accepts the inevitable the rationale is that death is merely "sleep: until the second coming. Poor are buried in common grave, rich in churches. Cemeteries are the public squares.

how has the rise in modern-cure medicine shaped the death experience?

- focused more on giving out medicine afterwards to cure people, as opposed to taking preventative measures to prevent these diseases from happening. - Die slower. People are living longer than they ever have. But is that a good thing? We are sustaining life, but we aren't living. (- coma, keeping someone alive, but not living. ) - There are pros and cons to expanding a persons life with medicine.

chronic grief

- intense grief reactions that are common in the early stages of grief but continue long term - there is little or no progress - the bereaved seems to keep the deceased alive with their mourning - this form of grief is maintained by feelings of insecurity and insecure attachment to the deceased - the extremes continuing constantly - (refusing to sign death certificate)

conflicted grief

- involves an exaggeration of one or more behaviors commonly displayed in normal grief while other aspects of the grief is suppressed - this form of grief is often characterized by extreme anger and guilt - panic attacks are common - substance abuse problems may also arise or existing problems may be exacerbated - the conflicted grief pattern is long term - is normally associated with dependent or ambivalent attachment - (common with individuals who were abused)

Best practices for all ages (when it comes to death) and communicating with children. communicate by

- maintaining routine (to best of your ability) - communicate with children......Avoid vagues terms and clichés. Such as (rest in peace, final resting place , she has gone home) use literateure, books, resources, school counselors never, ever place emotional expectations on children such as (big boys don't cry; don't ask those questions ) .

Delayed grief

- may result from pressing responsibilities resulting in postponed grief that may last for years. - Another loss or an event may trigger a grief response

Ages 6-9 years

- personifies death: a thing or monster who takes you away - still has magical thinking, yet begins to see death as final, but outside the realm of the child's realistic mind - fails to accept that death will happen to them - or to anyone (although begins to suspect that it will) - fears that death is contagious - confusing of wording (soul/sole, dead body, live soul) - Develops an interest in the causes of death (violence, old age, sickness)

Layers of loss (4)

- primary - death of a parent/grandparent ect. - secondary - relationships that changes as a result to that loss (grandma dies, don't see grandpa very much any more) the ripple effects - immediate - losing someone very suddenly - long term

abbreviated grief

- short lived but normal form of grief - often mistaken for unresolved grief - often shortened or abbreviated commonly because the attachment figure or lost person is immediately replaced (remarrying immediately after the spouse died) or there has been limited connection to the deceased - sometimes due to anticipatory grief where the grieving process occurs before the actual loss

______ of older adults who attempt suicide, die. -> older adults are much more successful for completing suicide

25%

Bargaining

A final attempt to postpone. Some of this may be silent, done in their mind, or in a journal. A desperate attempt for control Usually bargains with a higher power. Religious.--→ Reiterate the reality. Don't go along with their unrealistic expectations, this can offer false hope. Find a win - win. Help them be present in the moment, stay connected to things they enjoy. Help them control what they do have control over.

TQ - The history of Kubler Ross

known for the five stages of dying. - did not study grieving people, studied people who were actually dying. starting researching n the 60's - what happens to people with terminal diagnosis- stages and processes after that - these people would receive very little reaction from the medical community - she was a professor type - training upcoming medical physicians - would interview them as the stages of dying - and crafted the 5 stage of dying - the general pattern of the stages that people went through - research not based on grieving but on people who were terminally ill. - found that it helped make terminally ill patients lives better - interviews brought them hope and values - able to talk to loved ones about their fears and thoughts

amish community

life centered on religious belief. known for distinctive dress. men wear plain dark clothes fastened with hooks and eyes, broad rimmed hats and full beards. women dress in bonnets and long dresses.use horn drawn buggies instead of automobiles. reject many modern devices. slow changing culture. central guideline "be not conformed to this world" turn the other cheek. trust gods plan. trust children go to heaven. love ones enemies.

ars moriendi

literally the art of dying. a practice that focused on what one should do to die well

roman catholic tradition

november 2 feast of all souls. mexican tradition. surrounding day of the dead. food offering to spirits of the dead and family visits to the cemetery to put flowers on grave. ongoing connection w dead.

For every 150 teenagers that attempt suicide, only ______ will die by suicide.

one

puritans

originated a reformist group. importance of preaching and conversion through intense personal experience. everything part of a divine purpose.

four areas of task work in coping with dying

physical- bodily needs psychological - autonomy social = interpersonal attachments spiritual

when commitng suicide teenagers normally take ____ while adults normally use ______

pills; firearms

Denial

pretending it is not real. "im feeling better already." "The diagnosis is wrong, doctors make mistakes too." -----→ Empathize; provoke them into anger by showing anger yourself. This will bring emotions to the surface. Some people may stay in this stage until they die. People in this stage will deny everything that you say.

Acceptance

recognition of reality. Often comes with a sense of peace. Understand what is happening. But family normally really struggles.

Death anxiety

regulate our behavior out of fear of dying (wearing a seatbelt, wearing helmet, locking your door)

there is a difference between sustained depression and being sad (trigger). similarities v differences

similarities: sadness, insomnia, poor appetite, and weight loss. Differences: triggers (diagnosis of cancer, Alzheimer's) v sustained (general diagnosis of depression, chemical imbalance). THE risk of suicide is elevated here.

by ____ years we learn to internalize to where we start to understand right from wrong.

teen

- Among native American attitude the _______ generally do not believe in an after life

the Navajo