LIFE-SPAN DEVELOPMENT

1. LIFE-SPAN DEVELOPMENT

2. Death and Grieving The Death System and Cultural Contexts Defining Death and Life/Death Issues A Developmental Perspective on Death Facing One’s Own Death Coping with the Death of Someone Else

3. Death in Different Cultures Perceptions of death vary; reflect diverse values and philosophies Individuals more conscious of death in times and places of war, poverty, disease. Most societies have Philosophical or religious beliefs about death Rituals that deal with death View that death does not end existence

4. U.S. Denial and Avoidance of Death Funeral industry emphasizes lifelike qualities Euphemisms — softening language for death Persistent search for “fountain of youth” Rejection and isolation of aged Concept of pleasant and rewarding afterlife Medical emphasis — prolonging life, not easing suffering

5. Changing Historical Circumstance Death becoming increasingly complex When to determine death has occurred Life expectancy has increased Most die apart from families Care for dying shifted away from family Minimized exposure to death and its pain

6. Issues in Determining Death Brain death — neurological definition of death All electrical activity of brain has ceased for a specified period of time Flat EEG recording Some medical experts argue criteria for death should include only higher cortical functioning

7. Decisions Regarding Life, Death, and Health Care Natural Death Act and Advance Directive Expresses person’s desires regarding extraordinary medical procedures that might be used to sustain life when medical situation becomes hopeless

8. Euthanasia Painlessly ending lives of persons suffering from incurable diseases or severe disabilities Passive euthanasia — withholding of available treatments, allowing the person to die Active euthanasia — death induced deliberately, as by injecting a lethal dose of drug Publicized controversy: assisted suicide

9. Needed: Better Care for Dying Individuals Death in U.S.: often lonely, prolonged, painful Plan for your death Make a living will Give someone power of attorney Give your doctor specific instructions Discuss desires with family and doctor Check insurance plan coverage

10. Needed: Better Care for Dying Individuals Hospice — humanized program committed to making the end of life as free from pain, anxiety, and depression as possible Palliative care — reducing pain and suffering and helping individuals die with dignity

11. Causes of Death Death can occur at any point in human life span Prenatal — miscarriage, stillborn Childhood — accidents or illness Adolescence — motor vehicle accidents, suicide, and homicide Older adults — chronic diseases

12. Death and Children Honesty may be best way to discuss death with children Explained in simple physical or biological terms to preschool children Be sensitive and sympathetic, encouraging feelings and questions Not unusual for terminally ill children to distance themselves in final stages, may be a result of depression

13. Attitudes Toward Death at Different Points in the Life Span

14. Suicide Serious physical illness Feelings of disparity, isolation, failure, loss Serious financial problems Drug use or prior suicide attempts Antidepressant links

15. Suicide in U.S. Adolescence 3rd leading cause of death in ages10-19 19% of high school students seriously considered or tried suicide in last 12 mos Adulthood and Aging Suicide rates increase in adulthood Older adults use more lethal ways, are more successful Racial and gender differences exist

16. Facing One’s Own Death Most dying individuals want to make decisions regarding their life and death Complete unfinished business Resolve problems and conflicts Put their affairs in order

17. Kubler-Ross’ Stages of Dying

18. Perceived Control and Denial When individuals believe they can influence and control events, they may become more alert and cheerful Denial can be adaptive or maladaptive

19. The Contexts in Which People Die Context of dying is important for most Most would rather die at home but worry over Burden at home Limited space May alter relationships Competency and availability of emergency medical treatment

20. Communicating with the Dying Person Establish your presence Eliminate distraction Limit visit time Don’t insist on acceptance Allow expressions of guilt or anger Discuss alternatives, unfinished business Ask if there is anyone s/he would like to see Encourage the dying individual to reminisce Talk with the individual when s/he wishes to talk Express your regard

21. Grieving Grief: emotional numbness; a complex emotional state of… Disbelief Separation anxiety Despair Sadness Loneliness Complicated grief Disenfranchised grief

22. Model of Grieving Dual-process model for effective coping Loss-oriented stressors Restoration-oriented stressors Coping and type of death Sudden or violent deaths have more intense and prolonged effects Many such deaths accompanied by PTSD

23. Cultural Diversity in Healthy Grieving Persistent holding on to deceased may be therapeutic Hopi of Arizona forget quickly Egyptians dwell on grief Netherlands: integrate loss into their lives Healthy coping involves Growth Flexibility Appropriateness within the cultural context

24. Making Sense of the World Grieving stimulates many to try to make sense of their world — positive themes linked to hopeful future and better adjustment Effort to make sense of it pursued more vigorously when caused by an accident or disaster

25. Losing a Life Partner Those left behind after the death of an intimate partner suffer profound grief and often endure Financial loss Loneliness linked to poverty and education Increased physical illness Psychological disorders, including depression

26. Adjustment to Widowhood Women live longer Widowed men more likely to remarry Measures of older women’s health Physical and mental health Health behaviors and outcomes Overall, women adjust better than men Older widows do better than younger widows Support programs aid adjustment

27. Forms of Mourning Approximately 80 percent of corpses are disposed of by burial, the remaining 20 percent by cremation Funeral industry is source of controversy Funeral is important aspect of mourning in many cultures Cultures vary in how they practice mourning

28. The Amish, Traditional Judaism, and Mourning Amish Conservative group; family-oriented society Live same unhurried pace as ancestors Time of death met with calm acceptance Neighbors notify community; funeral at home High level of support to family for one year

29. The Amish, Traditional Judaism, and Mourning Traditional Judaism Mourning in graduated time periods; each with appropriate practices 1st period: Aninut — between death and burial 2nd period: Avelut period — mourning proper Shivah period — 7-day begins at burial Sheloshim period — 30-day period after burial Mourning over for all but parents who mourn another 11 months

30. The End