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Chapter Twenty

Chapter Twenty. Dying and Death. Defining Death. Death has been defined as cessation of the flow of vital bodily fluids This occurs when the heart stops beating and breathing ceases The concept of cellular ‘brain death’ involves the following:

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Chapter Twenty

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  1. Chapter Twenty Dying and Death

  2. Defining Death • Death has been defined as cessation of the flow of vital bodily fluids • This occurs when the heart stops beating and breathing ceases • The concept of cellular ‘brain death’ involves the following: • Lack of receptivity and response to external stimuli • Absence of spontaneous muscular movement and spontaneous breathing • Absence of observable reflexes • Absence of brain activity (EEG)

  3. Understanding of Death • Our understanding of death changes as we grow and mature • Based on work by Speece and Brent, the observable facts about death include 4 components: • Universality (all things eventually die) • Irreversibility (organisms that die cannot live again) • Nonfunctionality (death involves cessation of all signs of life) • Causality (there are biological reasons for death)

  4. Denying vs. Welcoming Death • Many people seek to avoid any mention of death • The saying, “out of sight, out of mind” appears to be the rule compared to facing death directly • Cartoons and video games give death a ‘two-dimensional’ concept which distorts reality • Problems can arise when the avoidance or denial that death can happen to you

  5. Planning For Death • Accepting that death will occur allows the ability to plan for this event • Basic tasks may include: • Making a Will • Considering options for ‘End-of-Life’ care • Home Care • Hospital based Care (palliative care) • Hospice Programs

  6. Deciding to Prolong Life or Hasten Death • Once someone is given the prognosis that life would end soon, the following decisions would have to be considered • Withholding or Withdrawing Treatment (passive euthanasia) • Assisted Suicide (active euthanasia or physician assisted) • Advanced Directive (document regarding treatment if you become unable to make them) • Living Will • Health Care Proxy • Organ Donation

  7. Planning a Funeral • A funeral are rites of passage that commemorate a person’s life and acknowledge their existence • Funerals provide a framework that allows survivors to support one another as they cope with the loss and express grief • The following need to be addressed when planning a funeral • Disposition of the body • Service Arrangement

  8. Coping With Dying • Charles Corr distinguishes 4 primary dimensions in coping with dying • Physical (satisfying bodily needs0 • Psychological (maximizing sense of security) • Social (sustaining significant relationships) • Spiritual (reaffirming sources of meaning) • Contemplating these dimensions gives us a framework for considering specific tasks that need to be addressed

  9. Coping With Dying • Charles Corr distinguishes 4 primary dimensions in coping with dying • Physical (satisfying bodily needs0 • Psychological (maximizing sense of security) • Social (sustaining significant relationships) • Spiritual (reaffirming sources of meaning) • Contemplating these dimensions gives us a framework for considering specific tasks that need to be addressed

  10. Coping With Loss • Grief is the reaction to loss and encompasses thoughts and feelings, as well as physical and behavioral responses • Mourning is closely related to grief and refers to the process by which a person adjusts to loss and incorporates this into their life • William Worden has identified 4 tasks when mourning • Accepting the reality of loss • Working through the pain • Adjusting to a change environment • Emotionally relocating the deceased and moving on

  11. Chapter Twenty Dying and Death

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