Death and Dying

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Life expectancy

• In the U.S. 76 years• Higher for women• Lower in

developing countries

• Higher infant mortality rates

• Lowest infant mortality rate

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Theories of aging

• Preprogrammed– Maximum life

span– Longest

documented life 122

– Heredity factors– Hayflick limit

• Limit to the number of times a cell can divide

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Damage Theories– Wear and tear of life erodes

body– Eventually erodes faster than

can be repaired– Error accumulation theory

• Free radicals– Denham Harman (1956)– Metabolism of oxygen causes

damage to DNA by released electrons

– Use anti-oxidants to reduce effects

– SCS Synthetic Catalytic Scavenger Help repair damage caused by free radicals http://www.lef.org/shop/picts/dr.jpg

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Life extension

• Dietary restriction

– 30-40 percent reduction in caloric intake

• focus on trying not to die young

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Changing Conceptions of Death Across the Lifespan

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Understanding Death:

– Adults understand death in terms of three basic ideas:

• Permanence• Nonfunctionality• Universality

– Children master these concepts in a specific order

• By the age of 12 most children understand all three components

– Understanding of death continues to evolve across adolescence and adulthood

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Infants and Toddlers:

• Infants and toddlers have a very limited understanding of death

• May show distress, but this likely reflects social referencing

• Daily patterns change and caregivers are upset, and infants respond to these changes

• Typically physiological responses

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Preschool Children:– Between the ages of 3 and 5 are often curious

about death• It is often viewed as temporary or reversible

– Believe the dead person will be “back soon”

– Death is like sleep, and it can be undone– May believe that magic or special care can

“fix” the person– Often believe some functions continue

after death– May believe the person is cold, or lonely

and scared– Often believe that people only die if they

are “bad” (not universal)– May view death as punishment and ask

what the person did wrong• Matches Piaget’s view of heteronomous moral

development• At this point, none of the three aspects are well

understood

                                    

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Early Concrete Operations:

– Ages 5 - 9 an understanding of permanence emerges

– Still not clear on nonfunctionality

• Death because of an “accident”

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Late Concrete Operations:

– Ages 9 - 12 an understanding of universality emerges

– Children now understand all three components

– Recognize that:• death can happen to

anyone• it is sometimes accidental

Adolescence:

– Can think about the abstract concept of death

– Acting as though immortal suggests lack of a true understanding of the finality of death

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Facing Death:

– Preschool through early concrete operations:

• afraid they will be cold and lonely

• often think that death will “hurt”

– Late concrete operations and adolescence:

• try to fit everything in

• “wishes” match developmental stage

• concern about body image

• want to be more autonomouswww.krtdirect.com/.../secure/ 20010801/DYING-CHILD_1.jpg

Bluebond-Langer• Dying Children

– Know they are dying even by age three

– Children learn that talking abut their death may be socially unacceptable and maintain a “mutual pretence”

– Will learn to be secretive when talking about death

– Eventually will learn to talk to people in different ways

– Will experience full range of emotions

– Will strive for control over their environment

– Need support of loved ones

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Early Adulthood:

– Risk-taking often declines when adults achieve a sense of intimacy

– In early adulthood death is seen as something far off and remote

– Young adults facing death show high levels of anger and rage

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Middle and Late Adulthood:

– In mid adulthood focus shifts from “time since birth” to “time left”

– May spark generativity crisis (LAL)

– Often at this point they strive to fit in things that have been put off

– By late adulthood death is often seen as inevitable, and death anxiety declines substantially

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Grieving and Bereavement

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States of Grieving:– Occur when facing an impending loss– First identified by Kübler-Ross

• Denial:

• Anger:

• Bargaining:

• Depression:

• Acceptance:

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Coping with Death:

– Bereavement is the process individuals go through after a loss

• The loss may be expected or unexpected, but the same emotions generally appear

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Parkes-Bowlby attachment model of grieving

– The first stage is often shock, numbness or disbelief

– Shock typically gives way to yearning and searching

– Following this stage there may be a period of disorganization and despair

– Reorganizationhttp://www.cytware.net/images/broken%20chain%201.jpg

Expected/Unexpected Loss:

• The shock phase is usually longer for an unexpected death

• The depression phase may also be longer when the loss was not anticipated– This is more likely if the

bereaved feels guilt over unresolved issues

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Patterns of Bereavement

– Normal grief: 36% • high distress followed by relatively rapid recovery

• most common pattern

– Chronic grief: (33%)• high distress for several years following the loss

– Delayed grief: 26%)• little initial distress but extreme distress appears later

– Absent grief: 5% • no notable level of distress at any point in time

• this pattern is less typical

Factors influencing bereavement

• Widows with the best marriages show the most persistent grief reactions

• Individuals with a strong sense of personal control and self-esteem often have the most difficulty adjusting to a significant loss

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Griefwork

– Experience painful emotions in order to cope successfully

– Break bonds of attachment

– Related to psychoanalytic perspective

– Seems culture biased – Not well supported by

recent research

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Positives of bereavment

– Potential to foster personal growth

– Have to take on new roles

– Be self sufficient– More defined

perspective on life http://www.tempotek.com/alexinn/alex1.gif