PSYC 381 Lecture Notes - Lecture 13: Personal Grooming, Palliative Care, Young Widows
26 May 2018
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Study Questions
Chapter 13
1. List and describe the 10 ways in which death is defined cross culturally. What are the legal
and medical definitions of death? (pp. 495-497)
2. What is meant by bioethics? What is euthanasia? Describe the differences between active and
passive euthanasia. (pp. 498-500)
3. Describe the life course approach to death and dying and the developmental pattern for
thoughts about death. Describe the two primary dying trajectories. Briefly describe Kubler-
Ross’s stage theory of how people deal with death. What is the contextual approach and how is it
different from Kubler-Ross’s theory? (pp. 503-506)
4. What are the components of death anxiety? What are the personality and demographic factors
related to death anxiety? What kind of strategies exist for dealing with death anxiety? (pp. 506-
508)
5. What is meant by the institutionalization of death and what are the major consequences of the
trend? What are the major end-of-life issues? What is a final scenario? (pp. 508-509)
6. What is a hospice? What are its main features? Describe the two types of hospices. What are
the key considerations listed by Kastenbaum when making hospice decisions? (pp. 509-511)
A hospice is defined as an approach to assisting dying people that emphasizes pain management,
or palliative care, and death with dignity. Quality of life is the emphasis in a hospice. There is an
important distinction between the prolongation of life and the prolongation of death. Rather than
focusing on delaying death, a hospice focuses on making a person peaceful and comfortable as
possible. A hospice aims to control pain, and restore normal functioning. Hospice services are
requested when a physician feels that no treatment or cure is possible.
When receiving service and care from a hospice, clients and their families are viewed as units,
clients should be kept free of pain, emotional and social impoverishment should be kept minimal,
clients should be encouraged to maintain competencies, conflict resolution and fulfillment of
realistic desires must be assisted, clients must be free to begin or end relationships, and staff
members must do everything possible to help alleviate paint and fear.
Hospices do not follow a hospital model because the client’s dignity is very important. The role
here is not necessarily to treat the client but rather to just be with the client. More attention is
allocated to appearance and personal grooming rather than medical tests. Hospices are not a
valuable alternative for everyone and it may not be an appropriate option for all patients. Some
may find that a hospice is unable to meet all their needs. Majority of patients in hospices have
cancer, AIDS or Lou Gehrig’s disease.
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There are two types of hospices:
1) inpatient hospices:
- provide all care for clients
2) outpatient hospices:
- provide services to clients who remain in their own homes
- a nurse visits clients in their home
- becoming a very popular option for a hospice
- the cost is lower than inpatient hospices
- a more viable option
The six considerations:
1) Is the person completely informed about the nature and prognosis of his or her
condition?
The person should always have a strong understanding and full knowledge of their condition.
They should always have the ability to communicate with the health professionals in order to
understand what it means to enter a hospice and if it is the right decision for them.
2) What options are available at this point in the progress of the person’s disease?
Understanding all the treatment options is very important. Exploring various treatment options
requires health care professionals to be aware of all the latest treatment approaches and these
professionals must be willing to discuss and disclose them to the patient.
3) What are the person’s expectations, fears, and hopes?
Some people will have a fear of suffering when it comes to the end of their lives as they have
heard various horror stories about what there is to expect at the end of life. Anxiety can result
from this and fears can play a role in making a decision. Discussing the sources of anxieties can
be very calming for the patient.
4) How well do the people in the person’s social network communicate with each other?
Discussing death can be a very uncomfortable topic in a family discussion. Even a family that
has strong communication, discussing the wishes of they dying individuals can be hard. The
dying person may feel they are unable to disclose their wishes to their families.
5) Are family members available to participate actively in terminal care?
Hospices relies on family members to provide much of the care and this care is complemented by
professionals and volunteers. In order for the hospice to be a viable option, a family member
must accept the responsibility of this care.
6) Is a high quality hospice care program available?
Not all hospices have a uniform level of quality and service to offer. The service and quality of
the hospice must be examined before making a decision on hospices.
7. Define bereavement and grief. Describe the grief process. What are the risk factors for a
difficult grief process? (pp. 513-515)
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Bereavement is the state or condition cased by loss through death. Grief s the sorrow, hurt, guilt,
confusion and other feelings that arise after suffering a loss. Mourning concerns the ways in
which we express our grief. Grief is involved with the emotional reactions following loss,
whereas mourning is the culturally approved behavioral actions of those feelings that are
associated with loss.
Grief is complicated and personal and does not have universal processes that every individual
will experience. Grief is a process that involves choice in coping, from confronting the reality
and emotions to using religion to ease one’s pains. When someone who means a lot to us dies,
we must reorganize our lives, establish new behaviors, and redefine and rebuild relationships
with families and friends.
Grief is an active process in which an individual must go through several changes:
1. Acknowledge the reality of the loss and come to terms with it
2. Work through the emotional turmoil
3. Adjust to the environment where the deceased is absent
4. Loosen ties to the deceased
There are some mistakes we should avoid in the grief process:
1) grieving is highly an individual experience and so the process that works for one person, may
not work for the other person
2) We must not underestimate the amount of time people need to deal with the various issues
3) Recovery ma be a misleading term to use. Instead we should focus on learning to live with out
loss rather than that we recover from
Risk Factors in Grief:
Some of the risk factors associated with grief include mode of death, personal factors, and
interpersonal context. Most people believe that the circumstances of how the individual died may
affect the grieving process. When death is sudden and unexpected they have a different
experience of grieving as compared to when death is anticipated. For anticipated deaths,
individuals go through an anticipatory grieving period. The strength and level of attachment to
the person who has died also makes a difference in dealing with the death. When the level of
attachment is high, and death is not expected, greater grief is experienced. Church attendance
and spirituality can help people deal with bereavement. There are two interpersonal risk factors
that can affect grief:
1. Kinship – they type of kinship involved affects grief.
2. Lack of Social Support – Social support can help buffer the effects of bereavement
8. Describe the normal grief reactions, both psychological and physiological. What were the 5
themes of grief as reported by Muller and Thompson? How does grief experience change over
time? (pp. 515-517)
The feelings associated with grief are very intense and unique for each individual. Some
individuals cope easier than others. Some of the normal grief feelings include:
a) sadness
b) disbelief
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Document Summary
Chapter 13: list and describe the 10 ways in which death is defined cross culturally. What are the legal and medical definitions of death? (pp. Describe the differences between active and passive euthanasia. (pp. 498-500: describe the life course approach to death and dying and the developmental pattern for thoughts about death. Ross"s stage theory of how people deal with death. What is the contextual approach and how is it different from kubler-ross"s theory? (pp. What kind of strategies exist for dealing with death anxiety? (pp. What are the key considerations listed by kastenbaum when making hospice decisions? (pp. A hospice is defined as an approach to assisting dying people that emphasizes pain management, or palliative care, and death with dignity. Quality of life is the emphasis in a hospice. There is an important distinction between the prolongation of life and the prolongation of death.
