Caring for the DyingCompassion and empathy as basic human qualitiesThe Development of Altruism and CaregivingCaregiving behavior: Biological and social rootsCaregivers FearsSlide 6… Caregivers FearsDying in a HospitalThe PhysicianSocial Death and DepersonalizationGenuine and compassionate careThe Hospice AlternativeSlide 13Caring for the DyingCaring for the Dying2007 Psyc 4562007 Psyc 456Dusana RybarovaDusana RybarovaCompassion and empathy Compassion and empathy as basic human qualitiesas basic human qualities•We are biologically programmed to be We are biologically programmed to be cooperative, supportive, and altruisticcooperative, supportive, and altruistic•In the right environment empathy, In the right environment empathy, compassion, and caring behavior will unfold compassion, and caring behavior will unfold naturally and both the caregiver and the naturally and both the caregiver and the care-recipient will grow and thrive from care-recipient will grow and thrive from their participation in it (Larson, 1993)their participation in it (Larson, 1993)•Harsh and unloving childhood can inhibit Harsh and unloving childhood can inhibit the full expression of these tender, human the full expression of these tender, human qualities, but compassion and caregiving qualities, but compassion and caregiving are part of our biological inheritanceare part of our biological inheritanceThe Development of Altruism The Development of Altruism and Caregivingand Caregiving•Newborns react by crying to distress of others in their Newborns react by crying to distress of others in their presencepresence•Children 1 ½ to 2 years old attempt to comfort a Children 1 ½ to 2 years old attempt to comfort a distressed person by patting, hugging, or presenting an distressed person by patting, hugging, or presenting an objectobject•Role-taking ability developing around 2-3 years of age Role-taking ability developing around 2-3 years of age •Later we are able to empathize beyond our immediate Later we are able to empathize beyond our immediate situation, beyond individuals (compassion for groups of situation, beyond individuals (compassion for groups of people such bereaved parents, victims of an attack people such bereaved parents, victims of an attack etc.)etc.)•50% of Americans report performing some kind of 50% of Americans report performing some kind of volunteer work during the past yearvolunteer work during the past year•Later gestures of caregivingLater gestures of caregiving–Suggestions about how to solve problemsSuggestions about how to solve problems–Trying to cheer others upTrying to cheer others up–Alternative helping responses to reduce suffering in othersAlternative helping responses to reduce suffering in othersCaregiving behavior: Caregiving behavior: Biological and social rootsBiological and social roots•Animals demonstrate almost universal tendency Animals demonstrate almost universal tendency towards cooperation and altruism and tend to become towards cooperation and altruism and tend to become aroused in the presence of a distressed member of aroused in the presence of a distressed member of their speciestheir species•Caring for injured, incapacitated members of group in Caring for injured, incapacitated members of group in chimpanzees and monkeyschimpanzees and monkeys•Survival value of altruism and caringSurvival value of altruism and caring essential for essential for human species that is not physically superior to other human species that is not physically superior to other speciesspecies–Reciprocal altruismReciprocal altruism–Non-reciprocal altruismNon-reciprocal altruism•Support of compassionate and altruistic tendencies Support of compassionate and altruistic tendencies through through social learningsocial learning–Seeing reactions of others to caring acts and learning that Seeing reactions of others to caring acts and learning that responding with empathy and compassion is both rewarded responding with empathy and compassion is both rewarded and rewardingand rewardingCaregivers FearsCaregivers Fears–Caregiving can reveal a vulnerable, more Caregiving can reveal a vulnerable, more fearful side of our nature fearful side of our nature –We may face a mixture of compassion, anxiety, We may face a mixture of compassion, anxiety, and fearand fear–How to relate to a dying person at other than How to relate to a dying person at other than superficial levelsuperficial level–Social barriers – expression of grief connected Social barriers – expression of grief connected to the death of a patient is often considered to the death of a patient is often considered unprofessional, associated with feelings of unprofessional, associated with feelings of inadequacy and incompetenceinadequacy and incompetenceCaregivers FearsCaregivers Fears•Fear of our own deathFear of our own death–Experience of caring for a dying person can Experience of caring for a dying person can arouse our own fear of mortality without a arouse our own fear of mortality without a conscious experience of itconscious experience of it–It can lead to detachment from the person we It can lead to detachment from the person we are caring forare caring for–Important facing the issues and developing Important facing the issues and developing strategies of copingstrategies of coping•Fear of hurting the person we are helpingFear of hurting the person we are helping–Often combined with time pressure, the urge to Often combined with time pressure, the urge to be perfect, often the necessity to make decision be perfect, often the necessity to make decision based on vague or incomplete informationbased on vague or incomplete information–Powerful emotional consequences of mistakes Powerful emotional consequences of mistakes for a caregiverfor a caregiver… … Caregivers FearsCaregivers Fears•Fear of Being HurtFear of Being Hurt–Fear of being the target of others’ angerFear of being the target of others’ anger–Fear of being hurt when our patient or a loved one finally Fear of being hurt when our patient or a loved one finally diesdies–Repressed and unacknowledged feelings over long periods Repressed and unacknowledged feelings over long periods of time can generate ongoing stress and activate grief and of time can generate ongoing stress and activate grief and fear from other parts of the caregiver’s lifefear from other parts of the caregiver’s