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The End of Life

The End of Life. Dr. Arra PSY 232. The End of Life. 25% of people die suddenly (heart attack) For 75% of people, death is long and drawn out, due to life-saving (extending) medical technology. The End of Life. Three phases of dying:

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The End of Life

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  1. The End of Life Dr. Arra PSY 232

  2. The End of Life • 25% of people die suddenly (heart attack) • For 75% of people, death is long and drawn out, due to life-saving (extending) medical technology

  3. The End of Life Three phases of dying: • Agonal phase (struggle): gasps and muscle spasms during the first moments in which the body can no longer sustain life • Clinical death: phase in which heartbeat, circulation, breathing, and brain functioning stop but resuscitation is possible • Mortality: permanent death

  4. The End of Life The three deaths (Smith & Wilson, 1982): • When you take your last breath • When you are last seen • When you are last thought of • Philosophical slant or approach to death

  5. The End of Life • Brain death: irreversible cessation of all activity in the brain and the brain stem • is generally accepted as the definition of death in most industrialized nations

  6. The End of Life • Persistent vegetative state: cerebral cortex does not register electrical activity, but the brain stem remains active (reflexes) • Case where brain death standard does not solve the dilemma of when to halt treatment • Consciousness and body movement is typically not restored • Few cases regain consciousness although with very limited functioning

  7. The End of Life UNDERSTANDING OF ATTITUDES TOWARD DEATH MIDDLE CHILDHOOD (6-11) • by this age, children tend to understand some of the concepts related to death • permanence: once a living thing dies it cannot be brought back to life • universality: all living things eventually die • nonfunctionality: body processes such as thought, feeling, and movement cease at death • Can vary by culture, religion, experience, parental conversations

  8. The End of Life ADOLESCENTS • Are aware that death happens to everyone and can occur at any time • Generally, do not apply this understanding to their everyday life • High risk takers, immortal, don’t take death personally

  9. The End of Life EARLY AND MIDDLE ADULTHOOD • Become more conscious of the finiteness of their lives • May begin to prepare wills • Begin to ‘reminisce’

  10. The End of Life LATE ADULTHOOD • Focus on practical matters • Focus on how and when death may occur

  11. The End of Life DEATH ANXIETY • Defined as fear of death • Varies culturally and individually • Generally declines with age • Lowest in adults with deep faith • Erikson: Ego Integrity vs. Despair

  12. The End of Life: Coping BEREAVEMENT • The experience of losing a loved one by death GRIEF • The intense physical and psychological stress that accompanies the loss MOURNING • Customs that are culturally prescribed expressions of thoughts and feelings designed to help people work through the grief

  13. The End of Life CARE FOR DYING • Hospice care: personal, patient and family centered care for terminally ill • Make patient comfortable, respected • Palliative Care: type of care for terminally ill which focuses on relief of pain and suffering, control of symptoms, maintain quality of life, allow person to die in dignity and peace • Hospice care is a type of palliative care

  14. The End of Life COMING TO TERM’S WITH ONE’S OWN DEATH • Five stages (Kubler-Ross, 1969) • Denial • Anger • Bargaining for extra time • Depression • Acceptance • Similar to feelings of people faced with imminent bereavement

  15. The End of Life AID IN DYING • Active euthanasia ( good death): deliberate action taken to shorten/end a life in order to end suffering or allow a terminally ill person to die with dignity • Passive euthanasia: ending a life by withholding of discontinuing treatment that might extend the life of a terminally ill patient (e.g., medication, life support, feeding tubes)

  16. The End of Life • Active euthanasia is typically illegal • Passive euthanasia is sometimes legal if it is voluntary • Controversial • State and federal court involvement

  17. The End of Life • Assisted suicides: physician or someone else helps take the person’s life • The person who wants to die performs the deed • Illegal in most states • controversial

  18. The End of Life MAKING ARRANGEMENTS FOR TERMINAL ILLNESS • Advance directive: living will in which a person specifies how they wish to be treated • Pain relief, cardiac resuscitation, feeding tubes…. • Durable power of attorney: appoints another person to make decisions with regard to will if the maker of the will becomes incompetent (e.g., coma, persistent vegetative state)

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