IM – Chapter 11 Quiz
Chapter 12 Test
Getting the Picture
In chapter 12, you read three articles pertaining to death and dying. The late Elizabeth Kubler-Ross spent hundreds of hours at the bedside of the terminally ill. After observing their reactions to their impending death, she divided the death and dying process into the five distinct stages discussed below.
Facing One’s Own Death – The Stages of Death
1) Knowledge of death’s inevitability permits us to establish priorities and structure our time accordingly. As we age, these priorities and structurings change in recognition of diminishing future time. Values concerning the most important uses of time also change. For example, when asked how they would spend 6 remaining months of life, younger adults described such activities as traveling and accomplishing things they previously had not done; older adults described more inner-focused activities – contemplation and meditation, for example.
2) Most dying individuals want an opportunity to make some decisions regarding their own life and death. Some individuals want to complete unfinished business; they want time to resolve problems and conflicts and to put their affairs in order. Might there be a sequence of stages we go through as we face death?
3) Elizabeth Kubler-Ross divided the behavior and thinking of dying persons into five stages: denial and isolation, anger, bargaining, depression, and acceptance. Denial and isolation is Kubler-Ross’s first stage of dying, in which the person denies that death is really going to take place. The person may say, “No, it can’t be me. It’s not possible.” This is a common reaction to terminal illness. However, denial is usually only a temporary defense and is eventually replaced with increased awareness when the person is confronted with such matters as financial considerations, unfinished business, and worry about surviving family members.
4) Anger is Kubler-Ross’s second stage of dying, in which the dying person recognizes that denial can no longer be maintained. Denial often gives way to anger, resentment, rage, and envy. The dying person’s question is, “Why me?” At this point, the person becomes increasingly difficult to care for as anger may become displaced and projected onto physicians, nurses, family members, and even God. The realization of loss is great, and those who symbolize life, energy, and competent functioning are especially salient targets of the dying person’s resentment and jealousy.
5) Bargaining is Kubler-Ross’s third stage of dying, in which the person develops the hope that death can somehow be postponed or delayed. Some persons enter into a bargaining or negotiation – often with God – as they try to delay their death. Psychologically, the person is saying, “Yes me, but...” In exchange for a few more days, weeks, or months of life, the person promises to lead a reformed life dedicated to God or to the service of others.
6) Depression is Kubler-Ross’s fourth stage of dying, in which the dying person comes to accept the certainty of death. At this point, a period of depression or preparatory grief may appear. The dying person may become silent, refuse visitors, and spend much of the time crying or grieving. This behavior should be perceived as normal in this circumstance and is actually an effort to disconnect the self from all love objects. Attempts to cheer up the dying person at this stage should be discouraged, says Kubler-Ross, because the dying person has a need to contemplate impending death.
7) Acceptance is Kubler-Ross’s fifth stage of dying, in which the person develops a sense of peace; an acceptance of one’s fate; and in many cases, a desire to be left alone. In this stage, feelings and physical pain may be virtually absent. Kubler-Ross describes this fifth stage as the end of the dying struggle, the final resting stage before death.
8) No one has been able to confirm that people go through the stages in the order described by Kubler-Ross. Kubler-Ross herself feels that she has been misread, saying that she never intended the stages to be an invariant sequence of steps toward death. Even though Kubler-Ross recognizes the importance of the individual variation in how we face death, she still believes that the optimal way to face death is in the sequence she has proposed. Given the controversy over Kubler-Ross’s stages, there probably is no one right way to die.
9) In facing their own death, some individuals struggle until the end, desperately trying to hang on to their lives. Acceptance of death never comes for them. Some psychologists believe that the harder individuals fight to avoid the inevitable death they face and the more they deny it, the more difficulty they will have in dying peacefully and in a dignified way; other psychologists argue that not confronting death until the end may be adaptive for some individuals. At any one moment, a number of emotions may wax and wane. Hope, disbelief, bewilderment, anger, and acceptance may come and go as individuals try to make sense of what is happening to them.
(Santrock, John W., Life-Span Development, 10th ed., New York: McGraw-Hill, 2006, pp. 643-644.)
Multiple Choice
1. The pattern of organization of Kubler-Ross’s theory is
a. spatial order
b. cause and effect
c. steps in a process
d. comparison and contrast
2. Which of the following statements best expresses Kubler-Ross’s theory?
a. All people go through the stages of dying in a predictable pattern.
b. Once people are told that they have a terminal illness, most go through five distinct stages of death and dying.
c. Some people try desperately to hang onto life.
d. The most important stage of the dying process is acceptance of one’s own death.
3. The author’s purpose in writing this selection is to
a. persuade the reader that it is important for a dying person to go through all of
these steps.
b. explain to the reader how all of the steps of the dying process are equally
important.
c. inform the reader about Kubler-Ross’s theory regarding the five stages of dying.
d. give insight into the dying process so that readers can help their loved ones
through a difficult time.
4. The main rhetorical mode of this article is
a. expository
b. descriptive
c. narrative
d. persuasive
5. The tone of this article is
a. formal, stiff
b. optimistic, encouraging
c. objective, sincere
d. solemn, grave
6. Kubler-Ross has used which of the following to come to her conclusions about the dying process?
a. deductive reasoning
b. inductive reasoning
c. both inductive and deductive reasoning
d. The selection does not state how Kubler-Ross came to her conclusions.
True or False
_____ 7. According to Kubler-Ross, a person demonstrates immaturity if she or he
does not go through each of the stages in the correct order.
_____ 8. A person who is in the final stages of death may become deeply depressed.
_____ 9. Samantha repeatedly promises her doctors, friends, and family never to
smoke again if she can just be given two more years of life. This is an
example of the acceptance stage.
_____10. When informed of a terminal illness, a person who says that it is all a big
mistake may be in the stage called denial.
Vocabulary in Context
Directions: If the vocabulary word is used correctly write C on the line. If it is used incorrectly, write I on the line.
____ 1. The visible part of the moon waxes and wanes throughout the month.
____ 2. An unpolluted environment with clean air and water is optimal for good health.
____ 3. She was green with envy over her friend’s flashy new car.
____ 4. A competent person does very little well.
____ 5. If something is temporary, it’s likely to last a long time.
____ 6. The prisoner was put in isolation so that he would have no contact with other
prisoners.
____ 7. If your money is diminishing, your wealth is increasing.
____ 8. The instructor went over the salient points of her lecture as a review for the
exam.
____ 9. When he made the terminal payment on his student loan, he went out to
celebrate.
___ 10. Sue felt bitter resentment at being left out of the wedding party.
In Your Own Words
1. Expressions of grief over losing a loved one vary from culture to culture. For instance, in Judaism there is “shiva,” a week-long period of grief and mourning. How does your particular culture show grief?
2. In your culture is cremation acceptable or not?
3. In your opinion, what does it mean to preserve the dignity of someone who is dying? What does it mean to die a “good death”?
4. Think about a person you knew who went through the dying process. Could these five stages be applied to that person? Did that person experience all of the stages? In the same order?
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