GERONTOLOGY 437: Social & Psychological Aspects of Death ...



Leonard Davis School Instructor: Susan Enguidanos, PhD

Andrus Gerontology Center Phone: 740-9822

University of Southern Calif. Office Hours: Mon. 10:00-11:30,

e-mail sengui@ Wed. 2:00-3:00 or by appointment

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GERONTOLOGY 437: Social & Psychological Aspects of Death & Dying

CLASSES WIL MEET ON: Monday & Wednesday 12:00 – 1:50 pm

TEXT: Despelder & Strickland: THE LAST DANCE (7th edition) Mayfield, 2005

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Course Overview

GERO 437 is an introductory, upper division level course designed to give students an introduction and critical survey of the current issues, concepts, and research of the social and psychological aspects of death and dying. In addition, the course provides students with an open forum to engage in dialog on issues surrounding death, dying, and bereavement. Topics covered in this course include the cultural, social, theological, and spiritual views of death, the bio-ethics of end-of-life decision-making, bereavement support through expected and traumatic loss, and professional care for those experiencing loss.

While death and dying is a natural course of the lifespan, little attention is given to the discussion and preparation of the dying process. This course will provide an overview of the theoretic underpinnings of dying, loss, and coping with a chronic illness as well as provide expert knowledge and opinion through a variety of teaching aids including films, lectures, guest speakers, audio tapes, and experiential lessons.

Course Objectives

Upon completion of this course, students will be able to:

1. Understand the rates and causes of death in the United States and California.

2. Provide information on the historical issues and theories that have influenced current perspectives on death and dying.

3. Contrast the various ways different cultural and sub-cultural groups express/experience death, dying, and subsequent grief.

4. Describe the various models of health care designed to care for terminally ill.

5. Understand the impact of death on survivors and the sources available to support the bereaved.

6. Describe the legal and ethical controversies surrounding euthanasia and assisted suicide for the terminally ill.

Required Readings

Despelder & Strickland: THE LAST DANCE (7th edition) Mayfield, 2005

Other assigned articles

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COURSE OUTLINE

Session 1 (1/14/08)

Introduction to the Course

◦ Explanation of course requirements

◦ Background on death in America & California

Changing mortality rates

Life expectancy rates among races

Causes of death

Film: Bill Moyer: Death in America

Assignment: Reflection paper on why you took this course, your educational/experiential background in death & dying, and your educational aspirations in taking this class. (2 pages double-spaced) Due 1/16/08

Reading in Despelder & Strickland: Chapter 1

Session 2 (1/16/08)

Development of an understanding of death

◦ Freud: Psychosexual model

◦ Erikson: Psychosocial model

◦ Piaget: Cognitive Development model

Socio-Cultural Forces

◦ A mature concept of death

◦ Sociocultural influences on our concept of death

Symbolism

Social learning approach

Religion and death

Early experiences with death (children and death)

Ethnicity and death

Importance of death rites

Reading in Despelder & Strickland: Chapter 2

1/21/08 HOLIDAY – NO CLASS

Session 3 (1/23/08)

: Cultural Perspectives

◦ Mythologies of the past

◦ Power of the dead

◦ Names of the dead

Death in Western Culture

◦ Neanderthal burials and other burial customs

◦ Death macabre

Socio-Cultural Forces (intro)

◦ Native American traditions

◦ African traditions

◦ Mexican traditions: el Dia de los Muertos

◦ Japanese traditions

◦ American Gypsies

Film: Bill Moyer Death in America

Reading in Despelder & Strickland: Chapter 3

Session 4 (1/28/08)

Film: Tuesdays with Morrie

Assignment: Reflection paper on Tuesdays with Morrie (2 page double-spaced) Due 1/30/08

Reading in Despelder & Strickland: Chapter 3

Session 5 (1/30/08)

Health Care Systems

◦ Background on quality of care for the dying

◦ Hospitals & emergency settings

◦ History of Hospice

◦ Emerging models of care: Palliative care movement

Films: My Grandma is Dying and Kaiser Permanente Home-based Palliative Care Program

Reading in Despelder & Strickland: Chapter 4

Session 6 (2/4/08)

I. Patient-Physician Communications

◦ Barriers to communications

◦ Models of care to facilitate communication

Guest Speaker: Hospice Social Worker or Physician

Audio (in class): Doctors and Death ()

Reading in Despelder & Strickland: Chapter 5

Session 7 (2/6/08)

Facing Death: Living with Life threatening Illness

◦ Kubler-Ross Stages

◦ Coping

◦ Treatment Options

Reading in Despelder & Strickland: Chapter 6

Audio Clip (in class)

Session 8 (2/11/08)

Medical Ethics

◦ Informed Consent

Choosing Death

◦ Euthanasia

-Physician assisted death (Oregon)

◦ Right to die

-Seriously ill newborns

Film: Meet Dr. Kevorkian

Reading in Despelder & Strickland: Chapter 7

Session 9 (2/13/08)

Film: Ordinary People

Assignment: Reflection paper on Ordinary People (2 page double-spaced) Due 2/20/08

2/18/08 HOLIDAY – NO CLASS

Session 10 (2/20/08)

◦ Advanced Directives

-Go Wish Cards

-Will & Probate

◦ End of life issues

Reading in Despelder & Strickland: Chapter 7

Session 11 (2/25/08)

Modern Psychics—

- What is the draw?

Film: Crossing Over with John Edward, Lisa Williams

Assignment: Reflection paper on the role of psychics in our society. (2 page double-spaced) Due 2/27/08

Session 12 (2/27/08)

Understanding Loss

Bereavement, Grief, Mourning

◦ Symptoms, phases, variables, values

Ways of Dying

◦ Sudden death, anticipated death

◦ Suicide, homicide

◦ High-grief, low-grief

Film: Grief & Mourning

Reading in Despelder & Strickland: Chapter 8

Session 13 (3/3/08)

Life Legacies

Guest Speaker: Linda Grant

Reading in Despelder & Strickland: Chapter 8

Session 14 (3/5/08)

Last Rites

◦ Funeral, rituals, charges

◦ Embalming

◦ Body disposition

-burials

-cremation

-cryonics

Film: On Ice

Reading in Despelder & Strickland: Chapter 9

Assignment: Collect five memorials or obituaries from the newspaper. Write a brief reflection paper of your perception of the role of obituaries and their importance in our society. Please turn in obituaries with your paper.

Session 15 (3/10/08)

Death in the Lives of Children

◦ Early Childhood Encounters with Death

◦ Major Causes of Death in Childhood

◦ Children with Life-Threatening Illnesses

◦ Children as Survivors

◦ Helping Children Cope with Death and Loss

Reading in Despelder & Strickland: Chapter 10

Session 16 (3/12/08)

Film/Guest Speaker: TBN

Reading in Despelder & Strickland: Chapter 10

Spring Recess -- March 17-22

Session 17 (3/24/08)

Adults and Death

◦ Psychosocial Stages of Adulthood

◦ Parental Bereavement

-miscarriage

-induced abortion

-still birth

-neonatal death

-SIDS

Death of an Adult Child

Death of a Parent

Spousal Bereavement

Aging, Illness and Death

◦ Support groups for all of the above

Assignment Due:1-2 page proposal for term paper due

Readings: in Despelder & Strickland: Chapter 11

Caring for bereaved patients: "All the doctors just suddenly go"

Prigerson & Jacobs. JAMA. Chicago: Sep 19, 2001. Vol. 286, Iss. 11; p. 1369 (available online)

Session 18 (3/26/08)

Audio Clips (in class): The Story of Helen Payne

Reading in Despelder & Strickland: Chapter 11

Session 19 (3/31/08)

Suicide

◦ Statistics and the Psychological Autopsy

◦ Explanatory theories of suicide

-Durkheim

-Psychodynamic theories

-Is there such a thing as “Rational Suicide?”

Risk Factors: culture, personality, individual situation, biological

Lifespan Perspectives

◦ Childhood

◦ Adolescence

◦ Middle adulthood

◦ Old age

Methods, Suicide Notes

Prevention, Intervention, Postvention

Reading in Despelder & Strickland: Chapter 12

Audio Clip (in class)

Session 20 (4/2/08)

Film: The Hours

Session 21 (4/7/08)

Legal Issues

◦ Defining death

◦ Organ donation

Death Certificates

◦ The medical examiner

◦ The coroner

Reading in Despelder & Strickland: Chapter 5

Session 22 (4/9/08)

Film: 48 Hours: Dealing with Death

Session 23 (4/14/08)

Beyond Death/After Life

--Belief Systems and Death

◦ Jewish ◦ Buddhist

◦ Hellenistic ◦ Islamic

◦ Christian ◦ Hindu

◦ Secular

Near-Death Experiences

Death Themes in Dreams & Psychedelic Experiences

Reading in Despelder & Strickland: Chapter 14

Session 24 (4/16/08)

Death by Violence

◦ Accidents

◦ Disasters; coping

◦ Homicide; criminal and non-criminal

-capital punishment

◦ Steps toward reducing violence

Reading in Despelder & Strickland: Chapter 13

Session 25 (4/21/08)

War, Violence, and Terrorism: Specialized Grief and Loss

◦Combat related trauma and dismemberment

◦Mass fatalities; Natural and man-made disasters

◦Community violence

◦Communicable diseases

Reading:

• Goodman, R.F., & Fahnestock, A.H. (2002). The Day Our World Changed: Children’s Art of 9/11. New York: Abrams.

Session 26 (4/23/08)

Where do we go from here?

Future research, policy issues, missing links

Reading in Despelder & Strickland: Chapter 15

Session 27 (4/28/08)

Class presentations

Session 28 (4/30/08)

Class presentations

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Assignments and Evaluation

Assignments are designed to enable students to integrate and apply class content. All written work will be assessed in light of clarity of presentation, organization, and the ability to integrate and apply the various concepts presented through readings, lectures, and class discussions.

Grading will be based on the percentage earned: 98-100 = A+; 93-97=A, 90- 92=A-, 88-89 = B+; 83-87=B, 80-82=B-, 78-79=C+, 73-77=C, 70-72 = C-, 68-69 = D+, 63-67=D, 60-62=D-, < 60 = F

1. Class Participation 10%

Participation is an important component of this course and of the students’ final grade. Participation will be monitored weekly and the final grade set according to the rate of participation across the class sessions.

2. Reflections Papers: 15%

A series of reflection papers will be assigned and will account for a total of 15% of your grade. The reflections papers will consist of a brief interpretation or explanation of the students’ interpretation of meaning or impact of specific films, assignments, and/or class discussion. Grading of the papers will include clarity of the concept, thoughtfulness of the reflections, and grammatical presentation of the paper.

3. Mid-Term Assignment: 25% Development of Two Advanced Directives and comparative analysis of the two. Each student will develop their own advanced directives and identify someone age 65 or over who has not yet developed an advanced directive. The student will interview the older adult and document their wishes in the advance directive form. After the two advance directives are completed, each student will prepare a comparative analysis of the two Advance Directives, covering the following areas: areas of convergence, areas of divergence, discussion of the differences and similarities in the directives, and a final section discussing situations that would change the student’s choices of treatment and care designated in his/her directives.

4. Final paper proposal (5%). Please submit a proposal for your final paper providing a 2-3 page outline following the criteria listed below. The purpose of the proposal is to determine that you are on track and provide a mechanism for feedback prior to completion of your final paper. A thorough synopsis is recommended in order to obtain adequate feedback and guidance from the instructor.

5. Diversity in Religious/Cultural Views of Death – Term Paper (30% of final grade)

You should start thinking about your term paper topic early in the semester, and submit a 1-2 page proposal of your project by Monday, March 24th. The final paper will be due on May 7th. The paper should be approximately 18 pages (excluding references), typed, grammatically correct, clearly written, with no spelling errors. The content (including cover page, abstract, citations, and references) should be in APA format (see examples in APA publication manual, 5th edition). Formatting is important, so if you have questions regarding formatting your paper, you should contact the TA. Students will review the practices of any religious/cultural group they choose that relate to illness, suffering, death, dying, grief, mourning rituals, and burial/cremation and then write a comprehensive research-based paper on this topic. All topics MUST be approved by the instructor prior to starting the project. Details regarding this assignment will be distributed in class, however, information in the paper should be provided on the background of the population, concepts, practices, ethical dilemmas for health care practitioners, and implications for grieving patterns.

6. Diversity in Religious/Cultural Views of Death - Presentation (15% of final grade)

At the end of the semester, students will formally present their research topic in an experiential and/or didactic format to the class for our collective education and understanding regarding their research. Presentations will be approximately 15 minutes in duration. As part of their presentation, students should prepare a PowerPoint presentation and are encouraged to use handouts, articles, and other media to support their topic. Grades for presentations will be assigned by the instructor and your classmates (your audience). This peer grading system will require critical listening by the audience, so that grades are fair and consistent across presentations.

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Academic Integrity [VERY IMPORTANT]

I will strictly adhere to the University Student Conduct Codes® established expectations of academic honesty. This means students’ work should be submitted with the respect for the intellectual property rights of others; the ideas and wordings of another writer must be acknowledged and appropriately used.

According to SCAMPUS University Governance sections 11.00 and 11.11, plagiarism is the unacknowledged and inappropriate use of others’ works. It includes:

• "The submission of material authored by another person but represented as the student’s own work, whether the material is paraphrased or copied in verbatim or near verbatim form;"

• "The submission of material subjected to editorial revision by another person that results in substantive changes in content or major alteration of writing style;" and

• "Improper acknowledgement of sources in essays or papers."[1]

Plagiarism is serious student misconduct. If such behavior is found, the instructor has the responsibility to report to the Office of Student Conduct and may apply appropriate sanctions to students who violate principles of academic integrity.

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Note: Any student requesting academic accommodations based on a disability is required to register with Disability Services and Programs (DSP) each semester.  A letter of verification for approved accommodations can be obtained from DSP.  Please be sure the letter is delivered to me (or to TA) as early in the semester as possible.  DSP is located in STU 301 and is open early 8:30 a.m.  5:00 p.m., Monday through Friday.  The phone number for DSP is (213) 740-0776.

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