chapter 23. . © 2012 mcgraw-hill companies. all rights reserved why is there death? there is no...
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© 2012 McGraw-Hill Companies. All Rights Reserved.
Chapter 23
© 2012 McGraw-Hill Companies. All Rights Reserved.
Why Is There Death?
There is no completely satisfying answer to the question of why death exists
Death promotes variety through the evolution of species
The perspective of species survival, the cycle of life and death
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© 2012 McGraw-Hill Companies. All Rights Reserved.
Understanding Death and Dying Defining Death
Defined as cessation of the flow of vital bodily fluids.○ Cessations of the heart beating and breathing○ Life-support systems○ Brain death○ Harvard medical School committee – death involves:
1. Lack of receptivity and response to external stimuli2. Absence of spontaneous muscular movement and
spontaneous breathing3. Absence of observable reflexes4. Absence of brain activity
• Electroencephalogram (EEG)
• Clinical death• Cellular death
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Learning About Death A child’s understanding of death evolves
greatly from about age 5 to age 9.Most children cone to understand that death is
final, universal, and inevitable Mature understanding of death Mark Speece and Sandor Brent – Facts
about death includes four components1. Universality2. Irreversibility3. Nonfunctionality4. Causality
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Denying Versus Welcoming Death Understanding death in a mature
fashion does not imply that we never experience anxiety about the deaths of those we love or about the prospect of our own death.
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Planning For Death Making a Will
A legal instrument expressing a person’s intentions and wishes for the disposition of his or her property after death.
EstateTestatorIntestateTestamentary letter
○ Document includes information about your personal affairs (bank statements, credit cards, documents etc.)
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Considering Options for End-of-Life Care Home Care Hospital-Based Palliative Care
Focuses on controlling pain and relieving suffering by caring for the physical, psychological, spiritual, and existential needs of the patient.
Hospice ProgramsPalliative care
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Deciding to Prolong Life or Hasten Death Withholding or Withdrawing Treatment Assisted Suicide and Active Euthanasia
Physician-assisted suicide (PAS)○ Physician provides lethal drugs or other
interventionsActive euthanasia
○ Intentional act of killing someone who would otherwise suffer from an incurable and painful disease
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Completing an Advance Directive Any statement made by a competent
person about choices for medical treatment should he or she become unable to make such a decisions.
Two forms:1. Living will
2. Health care proxy○ Surrogate (the decision maker)
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Figure 23-1 Sample living will
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Becoming an Organ Donor Each day about 77 people receive an
organ transplant while another 19 people on the waiting list die because not enough organs are available.98,000 Americans waiting for organ
transplants
Uniform Donor CardFirst stepSee “In Focus” Myths About Organ Donation
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Figure 23-2 The need for organ donors
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Planning a Funeral or Memorial Service Disposition of the Body
Social, cultural, religious, psychological, and interpersonal considerations
BurialCremationEmbalming for a viewing or wake
Arranging a Service
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Coping With Dying Awareness of Dying The Tasks of Coping
1969 book On Death and Dying, Elisabeth Kubler-Ross○ 5 psychological stages
1. Denial2. Anger3. Bargaining4. Depression5. Acceptance
Charles Corr○ 4 primary dimensions in coping with dying
1. Physical2. Psychological3. Social4. Spiritual
Specific tasks that need to be addressed in coping with dying○ Prediagnostic○ Acute○ Chronic○ Terminal ○ Recovery
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Coping With Dying The Trajectory of Dying
Understanding patients’ experiences as they near death Supporting a Dying Person Coping With Loss
Experiencing Grief○ Bereavement○ Mourning
Tasks of Mourning1. Accepting reality2. Working through the pain3. Adjusting to a changed environment4. Emotionally relocating the deceased and moving on with life
The Course of GriefSupporting a Grieving PersonHelping Children Cope with Loss
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Coping With Dying The Course of Grief Supporting a Grieving Person Helping Children Cope with Loss
Coming To Terms With Death
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Chapter 23
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