Slide 1Reminders and AnnouncementsOutlineDefining DeathNatural Death Act and Advance DirectiveEuthanasiaCare for Dying IndividualsGenerational changesCultural VariationsDealing with DeathEvaluation of Kübler-RossCoping with Death and LossDevelopmental ChangesDevelopmental ChangesDevelopmental ChangesDimensions of GrievingDimensions of GrievingForms of MourningMaking Sense of the WorldDEATH, DYING, AND GRIEVINGChapter 17Reminders and AnnouncementsExam 5Optional make-up examGiven same day during finals. Finish exam 5, then open optional make-up.Must take exam on scheduled finals day.Outline Defining deathThe event of deathDevelopmental changes in conceptualizations of deathDealing with death: Grief and bereavementDefining DeathRecent changes – more technology = more complicatedBrain death – all electrical activity of the bran has ceased for some specified period of timeNatural Death Act and Advance DirectiveLiving will – filed while competence is not in questionAdvance directive - DNRAll 50 states accept advance directives http://www.wvendoflife.org/HomeEuthanasiaEuthanasia -- painlessly ending lives of individuals who are suffering from an incurable disease or severe disabilityTwo types: active - deliberately inducedpassive – withhold treatment, allow to dieCare for Dying IndividualsRespect for the goals, preferences, and choices of the patient and his or her familyHospice – a program commited to making the end of life as free from pain, anxiety, and depression as possiblePalliative care – involves reducing pain and suffering and helping individuals die with dignityGenerational changes1800’s: many children and young adults die1900: most people died at home, w/familyCurrently: most losses are among older adults80% in hospitalsCultural VariationsRole of war, famine, and plaguePhilosophical or religious beliefs about death In most societies, beliefs about immortality of soulDealing with DeathKübler-Ross’ Stages of DyingFive stagesdenial and isolationangerbargainingdepressionacceptanceEvaluation of Kübler-RossResearch support - noneLimits of stages – doesn’t consider contextPositive impact of Kübler-Ross – called attention to the issues of quality(Kastenbaum, 2007)Coping with Death and LossBest PracticesPersonal wishes about dyingPlan funeral Reminiscecan understand their physical sensations and medical procedures(Banja, 2005; Kalish, 1981)Developmental ChangesHow children understand loss and experience grief changes with ageInfant (0-2 years) – no understanding of deathMay experience separation anxietyEarly Childhood (2-6 years) – temporary/reversibleMay develop magical explanations/blame themselvesNeed to speak in concrete terms about the experienceDevelopmental ChangesMiddle Childhood (6-8 years) – final and irreversible, but not universalAngerLate childhood (8-12 years) – develop adult understanding – final, irreversible, universalInternalization= need to be included in ceremonies/ritualsDevelopmental ChangesAdolescence (12-18 years)Able to think abstactly about deathInterested in the existential meaning of deathIntense emotions At all ages, successful grieving is linked with havingAt least 1 significant adult presentSafe and emotionally-supportive environmentDimensions of GrievingGrief -- emotional numbness, disbelief, separation anxiety, despair, sadness, and loneliness that accompany the loss of someone we loveMany dimensionsPinning or yearningSeparation anxietyDespair and sadnessHopelessness and defeat”Roller Coaster” of emotionDimensions of GrievingProlonged Grief Enduring despair and is still unresolved over an extended period of timeDisenfranchised grief Grief over a deceased person that is a socially ambiguous loss that can’t be openly mourned or supportedForms of MourningOne decision is to decide what to do with the bodyBurial/cremationFuneral services Most meaningful to religious survivorsFamily and community have important rolesMaking Sense of the WorldOne beneficial aspect of grieving Stimulates many individuals to try to make sense of the worldUnexpected death vs. anticipatedIntensifies struggle for meaningBereaved want to put death in a perspective they can understandDivine intervention, logical sequence of events,
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