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Why Is There Death?
There is no completely satisfying answerto the question of why
death exists
Death promotes variety through the
evolution of species
The perspective of species survival, thecycle of life and
death
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Understanding Death andDying Defining Death
Defined as cessation of the flow of vital bodily fluids.
Cessations of the heart beating and breathing
Life-support systems
Brain death Harvard medical School committee death involves:
1. Lack of receptivity and response to external stimuli
2. Absence of spontaneous muscular movement andspontaneous
breathing
3. Absence of observable reflexes
4. Absence of brain activity
Electroencephalogram (EEG)
Clinical death
Cellular death
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Learning About Death
A childs understanding of death evolvesgreatly from about age 5
to age 9. Most children cone to understand that death is
final, universal, and inevitable
Mature understanding of death
Mark Speece and Sandor Brent Factsabout death includes four
components
1. Universality2. Irreversibility
3. Nonfunctionality
4. Causality
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Denying Versus WelcomingDeath
Understanding death in a maturefashion does not imply that we
neverexperience anxiety about the deaths of
those we love or about the prospect ofour own death.
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Planning For Death
Making a WillA legal instrument expressing a persons
intentions and wishes for the disposition ofhis or her property
after death.
Estate
Testator
Intestate
Testamentary letter Document includes information about your
personal affairs (bank statements, creditcards, documents
etc.)
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Considering Options for End-of-Life Care
Home Care
Hospital-Based Palliative Care
Focuses on controlling pain and relieving
suffering by caring for the physical,psychological, spiritual,
and existentialneeds of the patient.
Hospice Programs Palliative care
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Deciding to Prolong Life orHasten Death
Withholding or Withdrawing Treatment
Assisted Suicide and Active Euthanasia
Physician-assisted suicide (PAS)
Physician provides lethal drugs or otherinterventions
Active euthanasia
Intentional act of killing someone who wouldotherwise suffer
from an incurable and painfuldisease
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Completing an AdvanceDirective
Any statement made by a competentperson about choices for
medicaltreatment should he or she become
unable to make such a decisions. Two forms:
1. Living will
2. Health care proxy Surrogate (the decision maker)
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Figure 23-1 Sample livingwill
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Becoming an Organ Donor
Each day about 77 people receive anorgan transplant while
another 19people on the waiting list die because
not enough organs are available. 98,000 Americans waiting for
organ
transplants
Uniform Donor Card First step
See In Focus Myths About Organ Donation
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Figure 23-2 The need for organdonors
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Planning a Funeral or MemorialService
Disposition of the Body
Social, cultural, religious, psychological, andinterpersonal
considerations
Burial Cremation
Embalming for a viewing or wake
Arranging a Service
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Coping With Dying Awareness of Dying
The Tasks of Coping 1969 book On Death and Dying, Elisabeth
Kubler-Ross
5 psychological stages1. Denial2. Anger3. Bargaining4.
Depression
5. Acceptance Charles Corr
4 primary dimensions in coping with dying1. Physical2.
Psychological3. Social4. Spiritual
Specific tasks that need to be addressed in coping with
dying
Prediagnostic Acute Chronic Terminal Recovery
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Coping With Dying
The Trajectory of Dying Understanding patients experiences as
they near death Supporting a Dying Person Coping With Loss
Experiencing Grief Bereavement Mourning
Tasks of Mourning1. Accepting reality2. Working through the
pain
3. Adjusting to a changed environment4. Emotionally relocating
the deceased and moving on with life
The Course of Grief Supporting a Grieving Person Helping
Children Cope with Loss
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Coping With Dying
The Course of Grief
Supporting a Grieving Person
Helping Children Cope with Loss
Coming To Terms With Death
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Chapter 23
17Chapter Twenty three
