DEATH AND DYING

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DEATH AND DYING
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DEFINITIONS OF DEATH

• BRAIN DEATH
• A NEUROLOGICAL DEFINITION OF DEATH WHICH STATES
  THAT A PERSON IS BRAIN DEAD WHEN ALL ELECTRICAL
  ACTIVITY OF THE BRAIN HAS CEASED FOR A SPECIFIED
  PERIOD OF TIME
• A FLAT EEG RECORDING FOR A SPECIFIED PERIOD OF
  TIME IS ONE CRITERION OF BRAIN DEATH
• EUTHANASIA
• ACTIVE EUTHANASIA
• OCCURS WHEN DEATH IS INDUCED BY DELIBERATE
  ATTEMPT TO END A PERSONS LIFE, SUCH AS IN THE
  INJECTION OF A LETHAL DOSE OF A DRUG

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DEFINITIONS OF DEATH

• EUTHANASIA
• PASSIVE EUTHANASIA
• OCCURS WHEN A PERSON IS ALLOWED TO DIE BY
  WITHHOLDING AN AVAILABLE TREATMENT, FOR EXAMPLE,
  WITHDRAWING A LIFE-SUSTAINING THERAPEUTIC DEVICE

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DEVELOPMENTAL CHANGES IN UNDERSTANDING DEATH AND
ATTITUDES TOWARD DEATH

• NEWBORN TO 3 YEARS
• INFANTS DO NOT UNDERSTAND THE CONCEPT OF DEATH
• AS THEY DEVELOP ATTACHMENT TO A CAREGIVER, THEY
  CAN EXPERIENCE LOSS OR SEPARATION AND
  ACCOMPANYING ANXIETY
• CHILDREN 3 TO 5 YEARS
• HAVE LITTLE OR NO IDEA OF WHAT DEATH REALLY MEANS
• CONFUSE DEATH WITH SLEEP
• RARELY GET UPSET BY BEING TOLD THAT A PERSON HAS
  DIED

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UNDERSTANDING DEATH AND ATTITUDES TOWARD DEATH

• BELIEVE THE DEAD CAN BE BROUGHT BACK TO LIFE BY
  MAGIC OR BY GIVING THEM FOOD OR MEDICAL TREATMENT
• OFTEN BELIEVE THAT ONLY PEOPLE WHO WANT TO DIE,
  OR WHO ARE BAD OR CARELESS, ACTUALLY DIE
• MAY BLAME THEMSELVES FOR THE DEATH OF SOMEONE
  THEY KNEW WELL, ILLOGICALLY REASONING THAT THE
  EVENT MAY HAVE HAPPENED BECAUSE THEY DISOBEYED
  THE PERSON WHO DIED

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UNDERSTANDING DEATH AND ATTITUDES TOWARD DEATH

• MIDDLE AND LATE CHILDHOOD
• CHILDREN 6 TO 9 BELIEVE THAT DEATH EXISTS BUT
  ONLY HAPPENS TO SOME PEOPLE
• CHILDREN 9 YEARS AND OLDER RECOGNIZE THAT DEATH
  IS FINAL AND UNIVERSAL
• DEATH SHOULD BE DISCUSSED HONESTLY WITH CHILDREN
• DEATH IS RARELY DISCUSSED IN OUR SOCIETY, BUT
  DEATH SHOULD NOT BE TREATED AS AN UNMENTIONABLE
  TOPIC

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UNDERSTANDING DEATH AND ATTITUDES TOWARD DEATH

• ADOLESCENCE
• DEATH IS REGARDED AS SOMETHING VERY REMOTE
• THE SUBJECT OF DEATH MAY BE AVOIDED, GLOSSED
  OVER, KIDDED ABOUT, OR CONTROLLED BY A COOL,
  SPECTATORLIKE ORIENTATION
• SOME ADOLESCENTS DO SHOW A CONCERN FOR DEATH,
  TRYING TO UNDERSTAND ITS MEANING AND CONFRONT
  THEIR OWN DEATH
• NOTIONS OF DEATH BECOME MORE ABSTRACT
• DEVELOP RELIGIOUS AND PHILOSOPHICAL VIEWS ABOUT
  THE NATURE OF DEATH AND WHETHER THERE IS LIFE
  AFTER DEATH

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UNDERSTANDING DEATH AND ATTITUDES TOWARD DEATH

• ADULTHOOD
• AN INCREASED CONSCIOUSNESS ABOUT DEATH
  ACCOMPANIES INDIVIDUALS AWARENESS THAT THEY ARE
  AGING, WHICH USUALLY INTENSIFIES IN MIDDLE
  ADULTHOOD
• MIDDLE-AGED ADULTS FEAR DEATH MORE THAN YOUNG
  ADULTS OR OLDER ADULTS DO
• OLDER ADULTS THINK ABOUT DEATH MORE AND TALK
  ABOUT IT MORE THAN DO YOUNG AND MIDDLE-AGED
  ADULTS
• OLDER ADULTS HAVE MORE DIRECT EXPERIENCE WITH
  DEATH AS THEIR FRIENDS AND RELATIVES BECOME ILL
  AND DIE
• OLDER ADULTS EXAMINE THE MEANING OF LIFE AND
  DEATH MORE FREQUENTLY THAN YOUNGER ADULTS
• DEATH MAY BE LESS EMOTIONALLY PAINFUL FOR OLDER
  ADULTS BECAUSE THEY ARE MORE LIKELY TO HAVE HAD
  THEIR SPOUSES DIE AND ARE LESS LIKELY TO HAVE
  UNFINISHED BUSINESS

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KUBLER-ROSSS STAGES OF DYING

• DENIAL AND ISOLATION
• INDIVIDUAL DENIES THAT DEATH IS REALLY GOING TO
  TAKE PLACE
• ANGER
• THE DYING PERSON RECOGNIZES THAT DENIAL CAN NO
  LONGER BE MAINTAINED DENIAL OFTEN GIVES WAY TO
  ANGER, RESENTMENT, RAGE, AND ENVY
• BARGAINING
• PERSON DEVELOPS THE HOPE THAT DEATH CAN SOMEHOW
  BE POSTPONED OR DELAYED
• DEPRESSION
• THE DYING PERSON COMES TO ACCEPT THE CERTAINTY OF
  DEATH AT THIS POINT A PERIOD OF DEPRESSION OR
  PREPARATORY GRIEF MAY APPEAR
• ACCEPTANCE
• THE PERSON DEVELOPS A SENSE OF PEACE AND
  ACCEPTANCE OF ONES FATE AND, IN MANY CASES, A
  DESIRE TO BE LEFT ALONE

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STAGES OF GRIEF

• STAGES NOT NECESSARILY DONE IN ORDER (BETTER TO
  UNDERSTAND GRIEFS DIMENSIONS RATHER THAN STAGES)

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STAGES OF GRIEF

• SHOCK AND DISBELIEF
• SURVIVOR FEELS SHOCK, DISBELIEF, AND NUMBNESS,
  OFTEN WEEPING OR BECOMING EASILY AGITATED
• OCCURS JUST AFTER THE DEATH AND LASTS FOR 1 TO 3
  DAYS
• DEVELOPING AWARENESS
• PAINFUL LONGING FOR THE DEAD, MEMORIES AND VISUAL
  IMAGES OF THE DECEASED, SADNESS, INSOMNIA,
  IRRITABILITY, AND RESTLESSNESS

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STAGES OF GRIEF

• MAY EXPERIENCE PHYSICAL SYMPTOMS SUCH AS NAUSEA,
  VOMITING, LOSS OF APPETITE, CRYING, ANGER
• BEGIN NOT LONG AFTER THE DEATH AND OFTEN PEAKS IN
  THE SECOND TO FOURTH WEEKS FOLLOWING THE DEATH
• MAY SUBSIDE AFTER SEVERAL MONTH, ALTHOUGH IT CAN
  PERSIST FOR 1 TO 2 YEARS
• RESOLUTION
• MARKED BY RESUMPTION OF ORDINARY ACTIVITIES, A
  GREATER PROBABILITY OF RECALLING PLEASANT
  MEMORIES ABOUT THE DECEASED, AND THE
  ESTABLISHMENT OF NEW RELATIONSHIPS WITH OTHERS
• ACCEPTANCE OCCURS
• USUALLY APPEARS WITHIN A YEAR AFTER THE DEATH