Chapter 13 — Death and Dying

Infectious diseases

illnesses caused by bacteria, viruses, or other pathogens that were the major cause of death throughout most of human history

Life expectancy

average number of years a person is expected to live

Coronary heart disease

narrowing of arteries supplying blood to the heart due to plaque buildup

Atherosclerosis

buildup of plaque inside arteries that restricts blood flow

Angina pectoris

severe chest, neck, or arm pain caused by restricted blood flow to the heart

Heart attack

death of heart tissue caused by blocked blood flow

Stroke

brain damage caused by interrupted blood flow in the brain

Blood clot

clump of blood blocking circulation in a blood vessel

Cancer

uncontrolled growth of abnormal cells

Tumor

mass of rapidly multiplying abnormal cells

Oncogenes

genes that promote abnormal cell duplication leading to cancer

Tumor suppressor genes

genes that normally prevent abnormal cell growth

Stability genes

genes that repair mistakes during DNA replication

Suicide

intentionally ending one’s own life

Telomeres

protective ends of chromosomes that shorten with each cell replication

Hayflick limit

limit on how many times cells can replicate before stopping

Telomerase

enzyme that regulates telomere length

Free radicals

unstable oxygen molecules that damage cells and DNA

Antioxidants

substances that neutralize free radicals and reduce cell damage

Human growth hormone (hGH)

hormone involved in physical growth and tissue maintenance

DHEA

hormone related to muscle growth, bone density, and cardiovascular functioning

Calorie restriction

reducing calorie intake to potentially slow aging and extend life

Hospice care

care focused on reducing pain and improving quality of life for terminally ill people

Palliative care

treatment focused on relieving pain and suffering rather than curing illness

Euthanasia

intentionally ending life to relieve suffering from incurable illness

Passive euthanasia

ending medical treatment that prolongs life

Active euthanasia

taking deliberate action to hasten death

Assisted suicide

providing a person with the means to end their own life

Terminal sedation

use of strong medications to relieve severe pain near death even if death may occur sooner

Advance directive

written instructions regarding end-of-life care

Living will

document specifying desired medical treatment if a person becomes incapacitated

Do Not Resuscitate (DNR)

instruction not to restart breathing or heartbeat if they stop

Health care proxy

person authorized to make medical decisions for someone unable to decide

Bereavement

experience of losing a loved one

Grief

emotional response to bereavement

Prolonged grief disorder (PGD)

intense grief lasting beyond 6 months and interfering with functioning

Anticipatory grief

emotional preparation for an expected death

Widow

woman whose spouse has died

Widower

man whose spouse has died

Stage theory of dying

Kübler-Ross theory proposing five emotional stages before death

Denial

refusal to believe a terminal diagnosis

Anger

resentment and frustration about impending death

Bargaining

attempting to negotiate for more time before death

Depression

sadness and hopelessness after recognizing death is near

Acceptance

peaceful acknowledgment of approaching death

Death anxiety

fear or worry about death

Euphemisms for death

indirect phrases such as “passed away” used instead of directly saying “died”

Afterlife beliefs

cultural or religious beliefs about existence after death

Mourning rituals

cultural practices used to express grief and honor the dead

Filial piety

cultural expectation of respecting and honoring parents and ancestors

Yahrzeit

Jewish anniversary observance of a person’s death

Kaddish

Jewish prayer recited in memory of the dead

Shiva

Jewish seven-day mourning period after burial

Schloshim

Jewish 30-day mourning period following burial

Anointing of the Sick

Catholic ritual preparing a dying person spiritually for death

Vigil

gathering before burial involving prayer, remembrance, and support

Requiem Mass

Catholic funeral service

Eulogy

speech honoring and remembering the deceased

Day of the Dead (Día de los Muertos)

Mexican celebration honoring deceased loved ones

Ghost Month

Chinese period when spirits of the dead are believed to visit the living

Fortnight of the Ancestors

Hindu period devoted to honoring ancestors

Pinda

rice ball offering made to Hindu ancestors

Cremation

burning of the body after death

Burial

placing a body in the ground after death

Centenarian

person age 100 or older

Main causes of death throughout most of human history

infectious diseases, childbirth complications, and war

Main causes of death today in developed countries

heart disease, stroke, and cancer

Main causes of death among young people in developed countries

automobile accidents, homicide, and suicide

Why infectious disease deaths declined during the 20th century

vaccines, antibiotics, and improved sanitation

Why heart disease became more common in modern times

people began living long enough to develop age-related diseases

Main cause of coronary heart disease

plaque buildup narrowing arteries

Main symptoms of a heart attack

chest pain, weakness, dizziness, confusion, and shortness of breath

Main lifestyle factors increasing heart disease risk

smoking, obesity, poor diet, and lack of exercise

Why fish consumption reduces heart disease risk

fish contain Omega-3 fatty acids that improve heart health

Main reason heart disease deaths declined in the United States

major reductions in smoking rates

How smoking affects heart disease

damages heart functioning and increases plaque buildup

Main causes of stroke

smoking, obesity, and hypertension

Meaning of FAST for stroke recognition

Face drooping, Arm weakness, Speech difficulties, Time to call 911

Why immediate stroke treatment is important

treatment within 6 hours can prevent severe brain damage

Why cancer rates increase in late adulthood

aging makes cell replication less accurate

How cancer develops biologically

damaged genes allow uncontrolled cell multiplication

Why cancer symptoms are often missed in older adults

symptoms resemble normal aging or depression

Main cause of cancer worldwide

smoking

Why men have higher cancer rates than women

men smoke more often

Why suicide rates differ by gender

men use more lethal methods while women attempt suicide more often

Why suicide is especially common among elderly adults

declining quality of life and illness increase hopelessness

Main contributor to aging according to cellular clock theory

telomere shortening

How telomeres contribute to aging

cells stop replicating once telomeres become too short

Relationship between telomeres and disease

shortened telomeres are associated with diseases such as cancer

How telomerase may slow aging

it helps maintain telomere length

Main problem caused by free radicals

damage to cells and DNA

How antioxidants help the body

neutralize free radicals and reduce cell damage

Foods naturally high in antioxidants

fruits and vegetables

Why antioxidant supplements are controversial

some studies show they may harm health

Effects of human growth hormone treatment

increased muscle mass, reduced fat, and stronger bones

Problems with growth hormone treatments

side effects include liver damage and abnormal bone growth

How calorie restriction may extend life

slowing metabolism and reducing cellular aging

Main goal of hospice care

helping dying people remain comfortable and die with dignity

Difference between hospice care and standard hospital care

hospice focuses on comfort rather than curing illness

Main benefits of hospice care

emotional support, pain reduction, dignity, and family counseling