Development Through the Lifespan



Development Through the Lifespan

Chapter 18

Death, Dying, and

Bereavement

Phases of Dying

Agonal phase

Suffering in first moments body can no longer support life

Clinical death

Hear, breathing, brain stopped,

but still can resuscitate

Mortality

Permanent death

Defining Death

Brain death

All activity in brain and brain stem stopped

Irreversible

Persistent vegetative state

Activity in cerebral cortex stopped

Brain stem still active

Death with Dignity

Communication and care of dying person:

Assurance of support and care

Esteem and respect

Candid about certainty

of death

Information to make

end-of-life choices

Children’s

Understanding of Death

Most develop realistic concept of death by middle childhood

Permanence

Universality

Nonfunctionality

Factors that affect understanding

Experience with death

Religious teachings

Candid and sensitive discussion with adults

Adolescents’

Understanding of Death

Logically understand death, but problems applying idea to their real lives

High-risk activities

Talks with parents help understanding

Adulthood and

Understanding of Death

Age, Gender

and Death Anxiety

Kübler-Ross’s Theory

Denial

Anger

Bargaining

Depression

Acceptance

Factors than Influence Thoughts About Dying

Cause of Death

Nature of disease

Personality

Coping Style

Family Members

Health Professionals

Spirituality and Religion

Culture

Places of Death

Home

Most preferred

Only 20–25%

Hospital

Emergency room

Intensive care unit

Cancer care unit

Hospice

Hospice Approach

Comprehensive support for dying and their families

Family and patient as a unit

Team care

Palliative (comfort) care

Home or homelike

Bereavement help

Forms of Euthanasia

Advance Medical Directives

Living Will

Specify unwanted treatments

Durable Power of Attorney for health care

Appoint someone to make health care decisions

International Public Opinion on

Voluntary Active Euthanasia

Grief Process

Avoidance

“Emotional anesthesia”

Confrontation

Most intense grief

Restoration

Dual-process model of coping with loss

Alternate between dealing with emotions and with life changes

Grieving

Sudden or Prolonged Deaths

Sudden, Unexpected

Avoidance from shock and disbelief

May not understand reasons

Suicide especially hard

Prolonged, Expected

Anticipatory grieving

Allows emotional preparation

Reasons usually known

Difficult Grief Situations

Parents losing a child

Children or adolescents losing a parent

Adult losing an intimate partner

Bereavement overload

Death Education

Courses in death and dying

Offered at many educational levels

Lecture format

Increases discomfort

Experiential format

Role playing, discussions, guests, field trips

Can reduce death anxiety

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