Week 6 reading:Attachment, Love, Separation and Loss

Love, Friendship and Social Support

Introduction

• being socially connected is imperative to achieving personal well-being

• research has demonstrated the we are social creatures and we need others to survive thrive

• given that close relationships are so vital to well-being it is important to ask how interpersonal relationships begin.

Attraction: The Start of Friendship and Love

• Proximity

  • often we stumble upon friends or romantic partners

  • happens due to close proximity

  • physical nearness has been found to be significant factor in the development of relationships

  • allows people the opportunity to get to know one another and discover their similarities

  • not just about geographic distance but rather functional distance or the frequency with which we cross paths with others

• Familiarity

  • proximity breed familiarity

  • people are more attracted to what is familiar

  • being repeatedly exposed to a person increases the likelihood that we will be attracted to them

  • feel safe with familiar people as we know what to expect

    • this phenomenon the mere exposure effect

  • more we are exposed to a stimulus the more likely we are to view that stimulus positively

• Similarity

  • research has found that similarity is key in relationships

  • like others who are like us

  • age, social class, race, education, physical attractiveness, values and attitudes

  • matching hypothesis

  • we like others to validate our points of view

• Reciprocity

  • key component in attraction

  • like someone if they feel the same

• Friendship

  • research has found that close friendships can protect our mental and physical health when times get tough

• Workplace friendships

  • friendships often take root in the workplace

  • spend lots of time at work

  • through these relationships people receive mentoring and obtain social support and resources

• Internet friendships

  • virtual relationships imitate in person ones

• Love

  • three distinct areas

    • intimacy

      • caring, closeness, and emotional support

    • pasion

      • physiological and emotional arousal

      • can include physical attraction, emotional responses that promote physiological changes and sexual arousal

    • commitment

      • cognitive process and decision to commit to love another person

      • willingness to work to keep that love over the course of your life

      

    • Conversely, when a person experiences a breakup, the brain processes it in a similar way to quitting a heroin habit

• Love and the internet

  • 49% of people have dated someone online

  • dating sites have reduced the proximity problem

• Social support

  • Perceived

    • knowing there are people that will help you

    • linked to well being

  • Received

    • actual support or helping behaviours from others

  • Quantity or Quality

Death and Dying

Definition

• Death

  • An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain including the brain stem is dead.

• Social death

  • occurs when others begin to dehumanise and withdraw from someone who is terminally ill or has been diagnosed with a terminal illness

• Curative care

  • focus on actively treating and curing a disease, injury aiming for a full recovery

• Palliative care

  • care for the terminally ill and their families,

• Hospice care

  • A program that gives special care to people who are near the end of life and have stopped treatment to cure or control their disease

• Euthanasia

  • intentionally ending one’s life when suffering from a terminal illness or severe disability

• Grief

  • the normal process of reacting to a loss

• Bereavement

  • the period after a loss during which grief and mourning occurs

• Mourning

  • the process by which people adopt to a loss

Process

• Weeks before passing

  • Minimal appetite

  • Increase in the need for sleep

  • Increased weakness

  • Incontinence of bladder/bowel

  • Restlessness or disorientation

  • Increased need for assistance with care

• Days before passing

  • Decreased level of consciousness

  • Pauses in breathing

  • Decreased blood pressure

  • Decreased urine volume and urine colour darkens

  • Murmuring to people others cannot see

  • Reaching in air or picking at covers

  • Need for assistance with all care

• Days to hours before passing

  • Decreased level of consciousness or comatose like state

  • Inability to swallow

  • Pauses in breathing become larger

  • Knees, feet, and hands becoming cool or cold

  • Noisy breathing due to relaxed throat muscle often called a death rattle

  • skin colouring becoming pale, waxen

• Social death

  • dehumanisation includes ignoring them talking about them as if they were not present making decisions without consulting them first and forcing unwanted procedures

  • older people in general have a loss of personhood

Causes of Death

• Tobacco use is attributed as one of the top killers

  • heart disease and chronic lung diseases

  • 

Developmental Perceptions of Death and Death Anxiety

• the concept of death changes as we develop from early childhood to late adulthood

• Cognitive development, societal beliefs, familial responsibilities, and personal experiences all shape an ​individual’s view of death

• Infancy

  • do not comprehend death

  • do react to the separation caused by death

  • when separated from their mothers they may become sluggish and quiet no longer smile or coo, sleep less, and develop physical symptoms such as weight loss

• Early childhood

  • experience difficulty distinguishing reality from fantasy

  • lack understanding of death

  • do not see death as permanent

  • may have feelings of responsibility

• Middle childhood

  • begin to understand the finality of death

  • think they could have prevented the death in some way and consequently feel guilty and responsible for the death

• Adolescence

  • understand death as well as adults

  • with formal operational thinking can abstractly think about death, philosophise about it, and ponder their own lack of existence

  • feel immune to the death

  • engage in risky behaviours, such as substance use, unsafe sex, reckless driving

• Early adulthood

  • differences in the level of fear and anxiety concerning death experienced by those in different age groups

  • expect a long life ahead of them

• Middle adulthood

  • report more fear of death than those in early and late adulthood

  • caretaking responsibilities contribute to their fears

• Late adulthood

  • lower fears of death than other adults

  • fewer caregiving responsibilities

Curative, Palliative, and Hospice Care

• Curative promotes complete recovery

• Palliative apart of hospice care

• The aim of hospice is to help the dying be as free from pain as possible, and to comfort both the patients and their families during a difficult time.

• Basic elements of hospice

  • Care of the patient and family as a single unit

  • Pain and symptom management for the patient

  • Having access to day and night care

  • Coordination of all medical services

  • Social work, counseling, and pastoral services

  • Bereavement counseling for the family up to one year after the patient’s death

Family Caregivers

• takes a toll physically, emotionally, and financially

• providing care by themselves with little professional intervention and there are high costs in lost productivity

Advanced Directives

• Advanced care planning

  • all documents that pertain to end of life care

• Advanced directives

  • documents that mention health care agent and living wills

  • initiated by the patient

• Living wills

  • written or video statements that outline the health care initiates the person wishes under certain circumstances

• Durable power of attorney for health care

  • names the person who should make healthcare decisions in the event that the patient wishes

• Medical orders

  • are crafted by a medical professional on behold of a seriously ill patient

Cultural Differences in End of Life Decisions

• cultural factors influence how doctors, other health care providers and family members communicate bad news to patients

• in some cultures revealing the truth is viewed as harm to the patient

Euthanasia

• Active euthanasia

  • intentionally causing death, usually through a lethal dose of medication

• Passive euthanasia

  • life sustaining support is withdrawn

• Physician assisted suicide

  • form of active euthanasia whereby a physician prescribes the means by which a person can die

Religious Practices after Death

• Hindu

  • belief in reincarnation accelerate the funeral ritual

  • cremated as soon as possible

  • ashes in the holy river

• Judaism

  • burial must occur as soon as possible after death

  • simple service

• Muslim

  • buried as soon as possible

  • no casket directly in dirt

• Roman Catholic

  • if ill anointed by a priest

  • Funeral first the wake, then prayers than the graveyard

Grief, Bereavement, and Mourning

• Grief reactions

  • mental, physical, social and or emotional responses

  • feelings of numbness, anger, guilt, anxiety, sadness and despair

• Complicated grief

  • atypical grief reactions

  • disbelief, preoccupation with the dead loved one, distressful memories, feeling unable to move on with ones life, and a yearning for the deceased

• Disenfranchised grief

  • grief that is not socially recognised

  • Examples of disenfranchised grief include death due to AIDS, the suicide of a loved one, perinatal deaths, abortions, the death of a pet, lover, or ex-spouse, and psychological losses, such as a partner developing Alzheimer’s disease.

• Anticipatory Grief

  • Grief that occurs when a death is expected and survivors have time to prepare to some extent before the loss

Models of Grief

• 5 stages of grief

  • Denial

  • Anger

  • Bargaining

  • Depression

  • Acceptance

• Dual process model of Grieving

  • individual move back and forth between grieving and preparing for life without their loved one

  • focus on loss orientation which emphasises the feelings of loss and yearning for the deceased

  • restoration orientation which centers on the grieving individual re-establishing roles and activities they had prior to the death of their loved one