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Epilogue:
Death and Dying
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THANATOLOGY
Thanatology The study of death and dying
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DEATH AND HOPE – UNDERSTANDING DEATH THROUGHOUT THE LIFE SPAN
Death in Childhood Children have a different perspective of
death.
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DEATH IN ADOLESCENCE AND EMERGING ADULTHOOD Teenagers have little fear of death
Adolescents often predict that they will die at an early age
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DEATH IN ADULTHOOD When adults become responsible for work
and family death is to be avoided or at least postponed.
Death anxiety usually increases from one’s teens to one’s 20s and then gradually decreases.
Ages 25 to 60: Terminally ill adults worry about leaving something undone or leaving family members—especially children—alone.
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DEATH IN LATE ADULTHOOD Death anxiety decreases and hope rises. Mental health Many older adults accept death
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DYING AND ACCEPTANCE
Good death
Bad death
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HONEST CONVERSATION
Stages of Dying I. Kübler-Ross: Identified emotions experienced
by dying people, which she divided into a sequence of five stages:
1. Denial (“I am not really dying.”)
2. Anger (“I blame my doctors, or my family, or God for my death.”)
3. Bargaining (“I will be good from now on if I can live.”)
4. Depression (“I don’t care about anything; nothing matters anymore.”)
5. Acceptance (“I accept my death as part of life.”)
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HONEST CONVERSATION
II. Stage Model based on Maslow’s hierarchy of needs:
1. Physiological needs (freedom from pain)2. Safety (no abandonment)3. Love and acceptance (from close family
and friends)4. Respect (from caregivers)5. Self-actualization (spiritual transcendence)
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THE HOSPICE
HospiceAn institution or program in which
terminally ill patients receive palliative care
Two principles for hospice care:1.Each patient’s autonomy and decisions are
respected.2.Family members and friends are counseled
before the death, shown how to provide care, and helped after the death.
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PALLIATIVE MEDICINE
Palliative careCare designed not to treat an illness but to
provide physical and emotional comfort to the patient and support and guidance to his or her family.
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CHOICES AND CONTROVERSIES
WHEN IS A PERSON DEAD? Brain death: Prolonged cessation of all brain
activity with complete absence of voluntary movements
Locked-in syndrome: The person cannot move, except for the eyes, but brain waves are still apparent; the person is not dead.
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CHOICES AND CONTROVERSIES
Coma: A state of deep unconsciousness from which the person cannot be aroused.
Vegetative state: A state of deep unconsciousness in which all cognitive functions are absent, although eyes may open, sounds may be emitted, and breathing may continue; the person is not yet dead.
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HASTENING OR POSTPONING DEATH
Longer LifeThe average person lived twice as long in
2010 as in 1910.
Later death due to drugs, surgery, and other interventions (e.g., respirators, defibrillators, stomach tubes, and antibiotics) .
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ALLOWING DEATHPassive Euthanasia
DNR (do not resuscitate)
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ALLOWING DEATHActive Euthanasia
Physician-Assisted Suicide
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ADVANCE DIRECTIVESAdvance Directive
Living Will
Health Care Proxy
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BEREAVEMENT
Normal Grief
BereavementThe sense of loss following a death
GriefThe powerful sorrow that an individual
feels at the death of another
MourningThe ceremonies and behaviors that a
religion or culture prescribes for people to employ in expressing their bereavement after a death