Health Psych Chapter 12

Main causes of death among children under age 15

accidents and cancer

Children’s understanding of death up to age 5

think of death as a great sleep, curious about death

Children’s understanding of death between ages 5-9

idea that death is final develops, no biological understanding of death

Children’s understanding of death ages 9-10

moderate understanding of the processes involved in death, realize that the person who has died will not return

Leading causes of death in adolescence and young adulthood

unintentional injuries, suicide, homicide, cancer, heart disease, and AIDS

Why does death in middle age become more realistic?

it is more common and chronic health problems leading to death can develop

Premature death

occurs before the projected age of 79; mainly caused by heart attack or stroke

Why are the elderly more prepared for death?

seen friends and relatives die and have thought about their death

Causes of death in old age

degenerative diseases and physical decline that predisposes them to infectious disease or organ failure

Factors that predict mortality in the elderly

new illnesses and the worsening of preexisting conditions, poor mental health and reduced satisfaction with life

The Patient Self-Determination Act

requires health facilities to have policies concerning patients’ wishes for life-prolonging therapy

Right to die movement

maintains that dying is more a matter of personal choice and personal control

Euthanasia

ending the life of a person who is suffering from a painful terminal illness

Living will

instructions and legal protection for the physician; does not always ensure that the patient’s requests are met (DNR)

Psychological and social issues related to dying

changes in the patient’s self-concept, issues of social interaction, and communication issues

Why do people fall prey to dubious remedies?

hope for a miracle cure, deteriorating relationship with the formal health care system, and desire for a more humanistic care

5 stages of dying

denial, anger, bargaining, depression, and acceptance

Denial

patient’s initial reaction on learning of the diagnosis; defense mechanism by which people avoid the implications of an illness

Anger

hard response for family and friends to deal with; patient is not really angry with them but fate

Bargaining

trading good behavior for good health

Depression

time for anticipatory grief; patient mourns the prospect of his or her death

Acceptance

a tired, peaceful calm descends; patients decide to divide up their possessions and say goodbye to friends and family

Evaluation of Kubler-Ross’s Theory

patients do not go through the stages in a predetermined order, and the theory does not fully acknowledge the importance of anxiety (one of the most important responses)

Terminal care

physical care that is palliative rather than curative

Palliative care

designed to make the patient feel comfortable

Curative care

designed to cure the patient’s disease

Achieving an appropriate death

informed consent, safe conduct, significant survival, anticipatory grief, and timely and appropriate death

Therapy with the terminally ill

short term, nature and timing of visits depend on the patient’s desires and energy level

Thanatologists

study death and dying; believe that cognitive behavioral therapies can be constructively employed with dying patients

How do children learn about their terminally ill condition?

taking cues from their treatments and people around them

Hospice care

provides palliative care and emotional support to dying patients and their family members

Hospice

place that provided care and comfort for travelers in medieval Europe

What happens in hospice care?

painful or invasive therapies are discontinued and it’s oriented toward improving a patient’s social support system

Home care

very popular and economically feasible, provides psychological advantages for the patient, but is stressful for the family

Grief

feeling of hollowness marked by preoccupation with the image of the deceased, expressions of hostility toward others, and guilt over the death

Grief response is more aggravated in who?

men, caregivers, and people whose loss was sudden and unexpected

Biggest burden for women survivors

financial strain

Biggest burden for men survivors

strains of managing a household

What raises complications for child survivors?

the death of a sibling

How should children be prepared for the death of another?

questions should be answered honestly and information should be provided at the right time

Causes of death in infancy and childhood

lack of free or low cost maternal care programs and congenital abnormalities

Sudden Infant Death Syndrome (SIDS)

condition where an infant stops breathing, most likely to occur in lower class urban environments and is associated with sleep position and prenatal factors