Chapter 17

Death, Dying, and Grieving

PowerPoints developed by Jenni Fauchier, Professor Carney

Circumstances of Death

200 yrs ago Average life

expectancy 47 1900

Most people died at home

• Cared for by family

Today Average life

expectancy 78 80% deaths occur

with professional caregivers

• Institutions • Hospitals

(U.S. Census Bureau, 2006)

Kubler-Ross’ Stages of Dying

Five stages denial & isolation anger bargaining depression acceptance

Coping with Death & LossBest for dying persons & family to

know death is immanent Individuals can

• Close life with own ideas about proper dying• Complete some projects & plans• Make funeral arrangements• Make arrangements for survivors• Reminisce• Experience physical sensations & medical

procedures

Adjustment to Death of a SpouseOptimal adjustment depends on

several factors Women do better

• Better networks of friends • Care for selves psychologically

Older widows do better • Death may be more expected

Widowers more likely • Better financial resources• Remarry

Effective Strategies for Communicating with a Dying PersonEstablish presence at same eye levelDon’t be afraid to touch Eliminate distraction, including excessive

small talkKeep visits short with frail individualsDon’t prescribe or deny feelings of

acceptanceAllow & encourage expressions of feeling

Ask: expected outcome of illness someone like to see or contacted

Discuss alternatives & unfinished businessEncourage reminiscencesTalk to individual when he/she wishes to talkExpress your caring, & love

Effective Strategies for Communicating with a Dying Person

Coping & Type of Death

Sudden, untimely, violent, or traumatic deaths More intense & prolonged effects

Diverse grieving patterns culturally embedded practices

Making Sense of the World

Beneficial aspect of grieving Make sense of world

Death caused by accident or disaster Effort to make sense of it is pursued

vigorously

Bereaved want to put death in a perspective they can understand

Losing a Life PartnerSuffer profound grief Financial lossLonelinessIncreased physical illnessPsychological disorders

Major depression

Widows outnumber 5 - 1