PSYC 381 Chapter Notes - Chapter 13: Prolonged Grief Disorder, Clinical Death, Thanatology
14 Jun 2018
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Department
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Describe some of the cultural differences in how death is viewed. What are the legal
and medical definitions of death? (pp. 376-378)
Comment: The following links to an engaging lecture by Yale Professor, Shelly
Kagen on our fear of death and whether fear is an appropriate
emotion. http://videolectures.net/yalephil176s07_kagan_lec22/
This lecture was part of a open course on the philosophy of
death: https://legacy.saylor.org/phil201/Intro/
Thanatology is the study of death, dying, grief, bereavement, and social
attitudes toward these issues
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Medical death - 8 criteria must be met for a person to be declared dead
Clinical death -lack of heartbeat and respiration
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Whole-brain death - all 8 criteria met
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1.
What is meant by bioethics? What is euthanasia? Describe the differences between
active and passive euthanasia. What is physician-assisted suicide? Discuss the
ethical issues on the cost of life-sustaining care (pp. 378-383)
Bioethics - the study of the interface between human values and technological
advances in health and life sciences
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Physician-assisted suicide -physicians provide dying patients with a fatal
dose of medication that the patient self-administers
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Debate on whether secondary health conditions in terminally ill people should
be treated - it's expensive, the people will die soon, needlessly prolonging life
is a burden on society
Other side is that life is precious and we shouldn't "play God"
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2.
Describe the developmental pattern for thoughts about death. Describe the two
primary dying trajectories and the implications. 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. 383-385)
The shift from formal operational thinking to post forming thinking could be
important in young adults' contemplation of death.
Most people don't think about death until their parents have passed
away.
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The 2 primary dying trajectories are:
Kubler-Ross Work: 5 reactions to how people deal with death: Denial,
anger, bargaining, depression and acceptance. EMOTIONAL
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Contextual theory of dying (tasks a dying person faces from their
perspective): 4 dimensions to dying. Bodily needs, psychological
security, interpersonal attachments, and spiritual energy and hope.
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Acknowledges individual differences
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Recognizes the importance of coping efforts of friends/family
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3.
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. 385-387)
Death anxiety refers to peoples' anxiety or even fear of death and dying.
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Terror management theory - addresses the issue of why people engage in
certain behaviours to achieve particular psychological states based on their
deeply rooted concerns about mortality
Proposes ensuring the continuation of one's life is the primary motive
underlying behaviour and all other motives can be traced to this basic
one
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Neuroimaging research shows that terror management theory provides a
useful framework for studying brain activity related to death anxiety.
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Death anxiety consists of several components
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Older adults tend to have lower death anxiety than younger adults
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Exercises to deal with death anxiety
Write your own obituary
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Plan your own death and funeral services
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This is all DEATH EDUCATION - a popular way to reduce anxiety
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4.
What are the major end-of-life issues? What is a final scenario? What is a hospice,
and what are its main features? Describe the two types of hospices. What are the key
considerations when making hospice decisions? (pp.387-390)
Comment: The textbook describes end-of-life issues from an American perspective.
The following guide by the Canadian Association for Retired Persons provides a
Canadian perspective, including a section on Aboriginal
issues. http://www.carp.ca/wp-content/uploads/2013/01/A-Guide-to-End-of-Life-
Care.pdf
Major issues include what happens to ones body and how one is
memorialized.
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The final scenario is making choices known about how they do and do not
want their lives to end.
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Hospice is an approach to assist dying people emphasizing pain
management.
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The emphasis is on the dying persons' quality of life.
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Two types of hospices exist:
Inpatient: Provide all care for clients
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Outpatient: Provide services to clients who remain in their own homes.
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Consideration for hospice programs include:
Is the person completely informed about the nature and prognosis of
his or her condition?
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Is hospice covered by insurance?
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What options are available at this point in the progress of the persons
disease?
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5.
What are the mechanisms used in the US to make end-of-life intentions known?
How is patient competency related to these intentions? (pp. 390-392)
The two ways to make end of life intentions known are:
Living will: a person simply states his or her wishes about life support
and other treatments.
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Health care power of attorney: an individual appoints someone to act as
his or her agent for health care decisions.
Do Not Resuscitate (DNR)
§
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One major concern regarding end of life decisions is whether the person is
cognitively or legally able to make them.
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Research shows family members and other surrogate decision makers are
often wrong about what the patient really wants.
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6.
Define bereavement, grief, and mourning. Describe the grief process. What are the
risk factors for a difficult grief process? (pp. 392-394)
Comment: In 2013, Natasha Josefowitz from the Stein Institute for Research on
Aging wrote an award-winning book, Living without the one you cannot live
without: Hope and healing after loss. In the following lecture, she describes her
reasons for writing about grief and the differences she found between men and
women in the grieving process in terms of her seven emotional states of
loss. http://www.uctv.tv/shows/Living-Without-the-One-You-Cannot-Live-
Without-Research-on-Aging-28363
-Bereavement is the state or condition caused by loss through death.
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-Grief is the sorrow, hurt, anger, guilt, confession, and other feelings that
arise after suffering a loss.
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-Mourning concerns the ways we express our grief.
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-Researchers agree a person needs at least a year following the loss to begin
recovery. Grief is an active process. Everyone reacts differently.
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-More important risk factors are the mode of death, personal factors, income
and interpersonal context.
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-Church attendance or spirituality in general helps people deal with loss
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7.
Describe the normal grief reactions, both psychological and physiological. What are
the five themes of grief according to Muller and Thompson (2003)? Describe the
four component model of grief and the dual process model of grief. How are they
different? (pp. 394-397)
-Normal grief reactions involve intense feelings.
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-The five feelings usually involved in normal grief reactions include sadness,
denial, anger, loneliness, and guilt.
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-The psychological side of coming to terms with bereavement is called grief
work.
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-There are five themes that are associated with grief.
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• Coping
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• Affect
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• Change
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• Narrative
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• Relationship
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-The four component model relies heavily on emotion. But encouraging
people to express their grief is not useful.
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-The dual process model (DPM) of coping with bereavement integrates
existing ideas regarding stressors. This model shows how bereaved people
cycle back and forth between dealing with grief and trying to move on with
life.
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-4 component model does not find it helpful for people to express their grief.
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8.
What is a complicated or prolonged grief disorder, and what are its distinguishing
features? Describe the developmental aspects of grief for the five different death
scenarios. How is each death experienced for adults at different levels of
development? What can be concluded about death in terms of developmental
forces? (pp.397-400)
-Complicated or prolonged grief disorder is when there is never any closure
and the grief continues to interfere with life.
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-It is distinguished from depression and normal grief in terms of separation
distress and traumatic distress.
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1. Challenges experienced by college students is learning how to respond to
people who ignore the grief, or who tell them to continue to grieve.
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2. The loss of ones partner is young adulthood is traumatic.
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3. The death of ones child.
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4. Loss of a young adult child
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5. The loss of a parent
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-Biological forces are essential to understanding death.
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-Death represents a complex interaction of biological, psychological,
sociocultural and life cycle factors.
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9.
Study Questions
L13 -End of Life
Tuesday, May 22, 2018
9:58 AM
Document Summary
Describe some of the cultural differences in how death is viewed. What are the legal and medical definitions of death? (pp. Comment: the following links to an engaging lecture by yale professor, shelly. Kagen on our fear of death and whether fear is an appropriate emotion. http://videolectures. net/yalephil176s07_kagan_lec22/ This lecture was part of a open course on the philosophy of death: https://legacy. saylor. org/phil201/intro/ Thanatology is the study of death, dying, grief, bereavement, and social attitudes toward these issues. Medical death - 8 criteria must be met for a person to be declared dead. Clinical death - lack of heartbeat and respiration. Describe the differences between active and passive euthanasia. Discuss the ethical issues on the cost of life-sustaining care (pp. Bioethics - the study of the interface between human values and technological advances in health and life sciences. Physician-assisted suicide - physicians provide dying patients with a fatal dose of medication that the patient self-administers.
