Death and the Meaning of Life

1. Death and the Meaning of Life • Life and death are two facets of the same reality • Realization of death can revitalize our goals • Acceptance of death can lead to discovery of meaning and purpose in life • Because time on earth is limited, there is an urgency about living • Ancient Greek dictum — “Contemplate death if you would learn how to live.”

2. Death and Loss • FEARS OF DEATH AND DYING • Some of the aspects of death we may fear are --- • Ceasing to be • Leaving behind those we love • Losing ourselves • Encountering the unknown • Coping with the indignity of a painful and long dying process • Growing distant in the memories of others

3. Historical Perspective • Death was a normal, expected event, sometimes even welcomed as a peaceful end to suffering. • Caring for a dying family member at home, was a common experience for adult and children in the 19th century. • Advances in medicine and sanitation during the 20th century brought about a “mortality revolution” in developed countries. • Care of the dying and the dead, including preparation of the bodies for burial, became largely a task for professionals. • Avoidance and denial were fostered by such social conventions as isolation of the dying person in a hospital or nursing home, refusal to openly discussing his or her condition, and reluctance to visit, thus leaving the person to cope with dying alone. • With medical advances, death – even in the very old - came to be regarded as a failure of the medical treatment rather than as a natural end to life. • Today, the picture is changing again. Violence, drug abuse, poverty, and the spread of AIDS make it harder to deny the reality of death.

4. Grief Work: Three Stages • Grief work generally takes the following path: • Shock and disbelief: • This first stage may last several weeks, especially after a sudden or unexpected death. It may protect the person from more intense reactions. Hallucinations and constant crying may be very common. Usually, confusion is also present. Somatization may also be present: nausea, numbness, headaches, etc. • Preoccupation with the memory of the death person: • May last up to 6 months; the survivor tries to come to terms with the death but cannot yet accept it. Crying still continues, may diminish and increase once again on anniversary dates. • Resolution: • The final stage has arrived when the bereaved person renews interest in everyday activities; memories of the dead person bring fond feelings mingled with sadness, rather than sharp pain and longing.

6. Denial and Isolation • At first, we tend to deny the loss has taken place, and may withdraw from our usual social contacts. This stage may last a few moments, or longer.

7. Anger • The grieving person may then be furious at the person who inflicted the hurt (even if she's dead), or at the world, for letting it happen. • He may be angry with himself for letting the event take place, even if, realistically, nothing could have stopped it.

8. Bargaining • Now the grieving person may make bargains (with God), asking, "If I do this, will you take away the loss?"

9. https://suicidepreventionlifeline.org/ SUICIDE PREVENTION LIFELINE National Suicide Prevention Lifeline’s number: 1-800-273-TALK (8255).share WITH OTHERS

10. SUICIDE • National Statistics (General) • Over 32,000 people in the United States die by suicide every year. • In 2005 (latest available data), there were 32,637 reported suicide deaths. • Suicide is fourth leading cause of death for adults between the ages of 18 and 65 years in the U.S., with approximately 26,500 suicides. • Currently, suicide is the 11th leading cause of death in the United States. • A person dies by suicide about every 16 minutes in the United States. • An attempt is estimated to be made once every minute. • Ninety percent of all people who die by suicide have a diagnosable psychiatric disorder at the time of their death. • There are four male suicides for every female suicide, but twice as many females as males attempt suicide. • Every day, approximately 80 Americans take their own life, and 1,500 more attempt to do so. • Elderly Caucasian males have the highest suicide rates.

11. Some Suicide Myths • It is dangerous to ask people if they are contemplating suicide • People who talk about suicide do not commit the act • Suicide can’t be prevented, it happens on impulse • Suicidal people are intent on dying and will ultimately succeed despite all intervention • Only mentally ill people commit suicide • If the suicidal person seems happy, and at peace with themselves, then the risk is over • The propensity for suicide is inherited • Most suicidal young people never seek or ask for help with their problems. • Suicidal young people are always angry when someone intervenes and they will resent that person afterwards. • Every death is preventable. • People who threaten suicide are just seeking attention • Suicide is painless

12. When You Fear Someone May Take Their Own Life • Most suicides give some warning of their intentions. The most effective way to prevent a friend or loved one from taking their life is to recognize when someone is at risk, take the warning signs seriously and know how to respond. Take It Seriously • Seventy-five percent of all suicides give some warning of their intentions to a friend or family member. • All suicide threats and attempts must be taken seriously. Be Willing to Listen • Take the initiative to ask what is troubling them and persist to overcome any reluctance to talk about it. • If professional help is indicated, the person you care about is more apt to follow such a recommendation if you have listened to him or her. • If your friend or loved one is depressed, don't be afraid to ask whether he or she is considering suicide, or even if they have a particular plan or method in mind.

13. Do not attempt to argue anyone out of suicide. • Rather, let the person know you care and understand, that he or she is not alone, that suicidal feelings are temporary, that depression can be treated and that problems can be solved. • Avoid the temptation to say, "You have so much to live for," or "Your suicide will hurt your family." Seek Professional Help • Be actively involved in encouraging the person to see a physician or mental health professional immediately. Individuals contemplating suicide often don't believe they can be helped, so you may have to do more. • For example, a suicidal college student resisted seeing a psychiatrist until his roommate offered to accompany him on the visit. A 17-year-old accompanied her younger sister to a psychiatrist because her parents refused to become involved. • You can make a difference by helping the person in need of help find a knowledgeable mental health professional or reputable treatment facility.

14. Warning signs of suicide include: • Observable signs of serious depression: Unrelenting low mood, Pessimism, Hopelessness, Desperation,Anxiety, psychic pain and inner tension, Withdrawal,Sleep problems • Increased alcohol and/or other drug use • Recent impulsiveness and taking unnecessary risks • Threatening suicide or expressing a strong wish to die • Making a plan:Giving away prized possessionsSudden or impulsive purchase of a firearmObtaining other means of killing oneself such as poisons or medications • Unexpected rage or anger • The emotional crises that usually precede suicide are often recognizable and treatable. • Although most depressed people are not suicidal, most suicidal people are depressed. • One can help prevent suicide through early recognition and treatment of depression and other psychiatric illnesses.

15. Highest risk behaviors for suicide • Research has shown that the following behaviors are very high risk for attempted and/or completed suicide: • Feeling helpless, hopeless and pain (physical and/or emotional) • History of previous attempts • Having a plan and the means to carry it out

16. In an Acute Crisis • In an acute crisis, take your friend or loved one to an emergency room or walk-in clinic at a (psychiatric) hospital. • Do not leave them alone until help is available. • Remove from the vicinity any firearms, drugs or sharp objects that could be used in a suicide attempt. • Hospitalization may be indicated and may be necessary at least until the crisis abates. • If the above options are unavailable, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK. American Foundation for Suicide Prevention:http://www.afsp.org/

17. Protective factors against suicide Factors that buffer suicide risk • Creator standpoint: skills in problem solving, conflict resolution, nonviolent ways of handling disputes • Self-esteem and a sense of purpose or meaning in life • Connectedness: feelings of social support and support from family and/or friends • Access to mental health resources and support for seeking help • Personal, cultural and/or religious beliefs that discourage suicide • Life skills, including coping skills and ability to adapt to change

18. Being “Dead” Psychologically and Socially • Are you caught up in deadening roles? • Are you alive to your senses and your body? • Can you be spontaneous and playful? • Are you alive to your feelings? • Are your relationships alive? • Are you alive intellectually? • Are you alive spiritually?

19. FYI: Death and Dying – Important Definitions • Thanatology: the study of the death and dying. • Hospice care: warm, personal, patient and family centered care for the terminally ill, focused on the relief of pain, control of symptoms, and quality of life. • Palliative care: relieving the pain and suffering and allowing people to die in peace and dignity. • Self help groups: consist of people who have banded together for treatment, for social support, to solve a problem, or to meet some other mutual need. (i.e. self help groups for survivors of suicide, widows-widowers, etc.) • Terminal drop: a sudden decrease in cognitive functioning shortly before death, typically present on intelligence tests. • Bereavement:is the loss of someone to whom a person feels close and the process of adjustment to it. • Grief: is the emotional response experienced in the early phases of bereavement, ranging from numbness to rage.

20. Anticipatory grief: symptoms of grief experienced while the person is still alive; may help survivors handle the actual death more easily. Grief work (Kubler-Ross) the working out of psychological issues connected with grief. Mourning: refers to the ways, usually culturally accepted, in which the bereaved and the community act while adjusting to a death. Active euthanasia / mercy killing: direct action taken deliberately to shorten a life in order to end suffering or allow a terminally ill person to die with dignity. (generally illegal.) Passive euthanasia: is deliberately withholding or discontinuing treatment, such as medication, life-support systems, or feeding tubes, that might extend the life, or postpone the natural death, of a terminally ill patient. Assisted suicide: in which a physician or someone else helps a person bring about a self-inflicted death by, for example, prescribing or obtaining drugs or enabling a patient to inhale deadly gas. (illegal in most states – Kevorkian.)

21. Living will: a person who signs a living will must be legally competent at the time, and the document generally cannot be witnessed by anyone who stands to gain. May explain specific provisions with regard to: relief of pain, cardiac resuscitation, mechanical respiration, antibiotics, and artificial nutrition and hydration. • Persistent vegetative state: a state while technically alive, they have no awareness and only rudimentary brain functioning. • Durable power of attorney: the appointing of a person to make such decisions, if the person him/herself is unable to do so.