LIFE-SPAN DEVELOPMENT

1. 17 A Topical Approach to LIFE-SPAN DEVELOPMENT Death and Grieving John W. Santrock

2. Defining Death and Life/Death Issues 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

3. Defining Death and Life/Death Issues 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

4. Defining Death and Life/Death Issues 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

5. Defining Death and Life/Death Issues 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

6. Death and Cultural Contexts 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

7. Death and Cultural Contexts U.S. Denial of Death • Funeral industry emphasis on lifelike qualities of the dead • Euphemisms for death • Rejection and isolation of aged • Concept of pleasant and rewarding afterlife • Medical emphasis on prolonging life rather than diminishing suffering

8. A Developmental Perspective of Death Causes of Death • Death can occur at any point in human life span • Childhood - accidents or illness • Adolescence - motor vehicle accidents, suicide, and homicide • Older adults - chronic diseases

9. A Developmental Perspective of Death Attitudes Toward Death at Different Points in the Life Span Childhood Infants have no concept of death; perceptions of death develop in middle and late childhood; even very young children are concerned about separation and loss Develop more abstract conceptions of death; not unusual to think they are immune to death Adolescence Middle-aged adults fear death more than young adults or older adults; older adults think about death more Adulthood

10. Adolescence 3rd leading cause of death in 10 to 19 year olds in U.S. 19% of U.S. high school students seriously considered or attempted suicide in the last 12 months Adulthood and Aging U.S. suicide rates increase in adulthood Reach highest level in the 85 and over age group A Developmental Perspective of Death Suicide

11. Facing One’s Own Death 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

12. Facing One’s Own Death Kubler-Ross’ Stages of Dying Denial and isolation Denies she/he is going to die Anger Denial gives way to anger, resentment, rage, and envy Bargaining Develops hope that death can somehow be postponed Comes to accept the certainty of her or his death Depression Acceptance Develops sense of peace and may desire to be left alone

13. Facing One’s Own Death 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

14. Facing One’s Own Death The Contexts in Which People Die • Most individuals say they would rather die at home • Many worry • Burden at home • Limited space • May alter relationships • Competency and availability of emergency medical treatment

15. Establish your presence Eliminate distraction Limit visit time Don’t insist the person feel acceptance Allow person to express guilt or anger Discuss alternatives, unfinished business Ask if there is anyone he or she would like to see Encourage the dying individual to reminisce Talk with the individual when she or he wishes to talk Express your regard Coping with the Death of Someone Else Communicating with the Dying Person

16. Coping with the Death of Someone Else Grieving • Emotional numbness • Disbelief • separation anxiety • Despair • Sadness • Loneliness that accompany the loss of someone we love

17. Cultural Diversity in Healthy Grieving • Contemporary western orientation • Breaking bonds with the dead • Return of survivors to autonomous lifestyle • Non-Western cultures • Maintenance of ties with deceased varies • Healthy coping involves • Growth • Flexibility • Appropriateness within the cultural context

18. Coping with the Death of Someone Else Making Sense of Grief • Grieving stimulates many to try to make sense of their world • Effort to make sense of it pursued more vigorously when caused by an accident or disaster

19. Coping with the Death of Someone Else Losing a Life Partner • Those left behind after the death of an intimate partner suffer profound grief and often endure: • Financial loss • Loneliness • Increased physical illness • Psychological disorders, including depression

20. Coping with the Death of Someone Else Marital Quality and Adjustment to Widowhood • Widowhood associated with increased anxiety among those highly dependent on their spouses • Lower anxiety for those who did not depend on their spouse very much

21. Coping with the Death of Someone Else Forms of Mourning • Approximately 80 percent of corpses are disposed of by burial, the remaining 20 percent by cremation • Funeral is important aspect of mourning in many cultures • Cultures vary in how they practice mourning