Practice Test 1

death and dying

a biological fact, but it also has social, cultural, historical, religious, legal, psychological, developmental, medical, and ethical aspects, and often these are closely intertwined

death and dying

today people in most countries live longer, and death is a less frequent and less visible occurrence

cultural context

include care of and behavior toward the dying and the dead, the setting where death usually takes place, and mourning customs and rituals

mortality revolution

advances in medicine and sanitation, new treatments for many once fatal illnesses, and a better-educated, more health-conscious population have brought about a mortality revolution. before, infant and childhood mortality is commonplace. today, the majority of deaths occur among people age 65 and older, primarily from diseases such as heart disease and cancer; the top two causes of death

thanatology

the study of death and dying - educational programs have been established to help people deal with death

care of dying

hospice care, palliative care

hospice care

personal, patient-and family-centered care for a person with a terminal illness

palliative care

care aimed at relieving pain and suffering and allowing the terminally ill to die in peace, comfort, and dignity

physical and cognitive changes preceding death

even without identifiable illness, people around the age of 100 tend to experience functional declines, lose interest in eating and drinking, and die a natural death / there also appear to be changes in life satisfaction that precede death / such changes also have been noted in younger people whose death is near

terminal drop

or terminal decline, refers specifically to a widely observed decline in cognitive abilities shortly before death

near-death-experience

often involving a sense of being out of the body or sucked into a tunnel and visions of bright, lights or mystical encounters / skeptics generally interpret theses reports as resulting from physiological changes that accompany the process of dying

near-death-experience

this phenomena can be induced by drugs (hallucinogens)

near-death-experience and the brain

reported altered sense of time, flying sensations, and light reported by some people are theorized to originate in the right hemispheric temporo-parietal junction / spiritual dimensions often reported, along w/sounds, music, and voices result > from left hemispherical TPJ / emotions and life review, another experienced aspects of NDEs, originate from the hippocampus and amygdala

near-death-experience

generally experienced as positive > as a result of the release of endorphins that are released during stressful experiences

confronting one's own death: kubler-ross's model

5 stages of coming into terms w/death: denial - i won't die / anger - why me? / bargaining - can i have some more time w/people? / depression - fudge / acceptance - okay / a person may go back and fort between anger and depression or may feel both at once

patterns of grieving: grief

the emotional response that generally follows closely on the heels of death

patterns of grieving: bereavement

loss, due to death. of someone to whom one feels close and the process of adjustment to the loss

patterns of grieving: grief work

working out of psychological issues connected w/grief

patterns of grieving: shock and disbelief

immediately following a death, survivors often feel lost and confused - awareness of the loss sinks in, the initial numbness gives away to overwhelming feelings of sadness and frequent crying

patterns of grieving: preoccupation w/the memory of the dead person

last 6 months to 2 years or so - survivor tries to come to terms w/the death but cannot yet accept it / experiences diminish w/time, though they may recur-perhaps for years

patterns of grieving: resolution

final stage has arrived when the bereaved person renews interest in everyday activities

patterns of grieving - other variations: recovery pattern

mourner goes from high to low distress

patterns of grieving - other variations: delayed grief pattern

there may be moderated or elevated initial grief, and symptoms gradually worsen over time

patterns of grieving - other variations: chronic grief pattern

mourner remains distressed for a long time - when a loved one is missing and presumed dead

patterns of grieving - other variations: resilience pattern

mourner shows a low and gradually diminishing level of grief in response to the death of a loved one

attitudes about death and dying across life span: childhood and adolescence

generally, although many feel uncomfortable doing so, most parents begin to talk about death w/their children at around the age of 3 years / children have mastered the biological understanding of death by about 10 years of age

attitudes about death and dying: infants

infants and very young children may respond to the death of a parent initially w/crying, despair, and, eventually, pathological detachment / they do not understand death, but they understand loss / depression may manifest as irritation or somatic complaints such as stomachaches

attitudes about death and dying: adolescents

teens must process their own grief, they are often also asked to take on more adult responsibilities, such as helping take care of younger siblings or providing emotional support to a surviving parent / bereavement process can lead to academic process and mental health issues, particularly depression, conduct disorder, and increased likelihood of substance abuse

attitudes about death and dying: adolescents and children

fortunately, much of the grief response in both children and adolescents declines over time / therapeutic interventions could have positive effects on the bereavement process

attitudes about death and dying: adults

if young adults are suddenly struck by a potentially fatal illness or injury, they are likely to be frustrated and angry / rather than having a long lifetime of losses as gradual preparation for the final loss of life, they find their entire world collapsing at once

attitudes about death and dying: middle age and older adults

may prepare for death emotionally as well as in practical ways by making a will, planning their funerals, and discussing their wishes w/family and friends

terror management theory

human's unique understanding of death, in concert w/self-preservation need and capacity for fear, results in common emotional and psychological responses when mortality, or thoughts of death, are made silent