Tiêu đề 11 DevPsy - Death and Bereavement.pdf ✅

11 – Death and Bereavement PY104 | DVPSY | 2023 - 2024 OUTLINE 1. The Many, Changing Meanings of Death and Dying 2. Facing Death and Loss 3. Significant Losses 4. Medical, Legal, and Ethical Issues: The “Right to Die” 5. Finding Meaning and Purpose in Life and Death MEANINGS OF DEATH AND DYING THE CULTURAL CONTEXT ● Cultural aspects of death include care of and behavior toward the dying and the dead, the setting where death usually takes place, and mourning customs and rituals ● Expressions of grief, anger, and fear are common across cultures ● Most cultures have socially sanctioned ways of expressing these emotions within the context of mourning or funeral practices THE MORTALITY REVOLUTION ● Advances in medicine and sanitation, new treatments for many once-fatal illnesses, and a better-educated, more health conscious population have brought about a mortality revolution ● Top causes of deaths in 1900s are: Pneumonia, Influenza, Tuberculosis, Diarrhea, and Enteritis ● Today, the most common are heart disease and cancer ● As death increasingly became a phenomenon of late adulthood, it became “invisible and abstract” \ ● Thanatology: study of death and dying CARE OF THE DYING ● Hospice Care: personal, patient- and family-centered, compassionate care for the terminally ill ○ Hospice facilities offer a specialized type of palliative care for people whose life expectancy is 6 months or less ○ The goal is to allow the person to die in peace and dignity, while minimizing any pain and suffering ○ Hospice care may take place at home, but such care can be given in a hospital or another institution, or at a hospice center ● Palliative Care: includes relief of pain and suffering, controlling of symptoms, alleviation of stress, and attempts to maintain a satisfactory quality of life FACING DEATH AND LOSS PHYSICAL AND COGNITIVE CHANGES PRECEDING DEATH ● Terminal Drop: specifically to a widely observed decline in cognitive abilities shortly before death ○ Also called Terminal Decline ○ Losses of perceptual speed have been found to predict death nearly 15 years later, although most declines start about 7.7 years before death occurs ● Near-Death Experience: often involving a sense of being out of the body or sucked into a tunnel and visions of bright lights or mystical encounters ○ Linked to stimulation or damage of various brain areas, most notably in bilateral frontal and occipital areas ○ Generally experienced as positive as a result of the release of endorphins ● While more highly educated people generally perform better on cognitive tests, they show similar rates of decline as do less educated people ● Dementia accelerates the rate of decline in all people ● Areas of decline include memory capacity, perceptual speed, visuospatial abilities, and everyday cognition CONFRONTING ONE’S OWN DEATH ● Kübler-Ross outlined five stages in coming to terms with death ● She also proposed a similar progression in the feelings of people facing imminent bereavement ● Although the emotions she described are common, not everyone goes through all five stages and not necessarily in the same sequence KUBLER-ROSS’ STAGES OF DEATH Denial “This can’t be happening to me!” Anger “Why me?” Bargaining Bargaining for extra time “If I can only live to see my daughter married, I won’t ask for anything more” Depression Acceptance 1 | @studywithky
PATTERNS OF GRIEVING ● Grief: emotional response that generally follows closely on the heels of death ● Bereavement: response to the loss of some whom a person feels close ● Grief Work: the working out of psychological issues connected with grief GRIEF WORK MODEL Shock & Disbelief Immediately following a death, survivors often feel lost and confused The initial numbness gives way to overwhelming feelings of sadness and frequent crying May last several weeks, especially after a sudden or unexpected death Preoccupation with the Memory of the Dead Person May last 6 months to 2 years Survivor tries to come to terms with the death but cannot yet accept it Resolution 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 Multiple Variations of Grieving ● Recovery Pattern: mourner goes high to low distress ● Delayed Grief: moderate or elevated initial grief, and symptoms worsen over time ● Chronic Grief: distressed for a long time ● Resilience: the mourner shows a low and gradually diminishing level of grief in response to the death of a loved one ATTITUDES ABOUT DEATH AND DYING ACROSS THE LIFESPAN ● By age 4, children build a partial understanding of the biological nature of death ● Adjusting to loss is more difficult if a child had a troubled relationship with the person who died ● They do not understand death, but they understand loss ● Often, teens turn to peers for support ● Young adults will find their entire world collapsing at once when they knew they are dying instead of dealing with other issues ● Middle-Aged and Older adults are more prepared with death ● Terror Management Theory: human’s unique understanding of death, in concert with self-preservation needs and capacity for fear, results in common emotional and psychological responses when mortality, or thoughts of death are made salient ATTITUDES TOWARDS DEATH Infants No concept of death Preschool Little concept of death Do not develop until age 5 Believe that death = sleep Elementary More realistic orientation towards death Accept universality of death by age 9 May feel responsible for death Adolescence More abstract, philosophical views of death Unrealistic (personal fable) May react negatively to the likelihood of death due to illness Early Adulthood No evidence for special orientation towards death Believe that death is unfair Middle Adulthood Heightened consciousness about death and death anxiety Fear of death is greater Older Adults Less death anxiety but more experience and converse about it Realistic and reflective about death SIGNIFICANT LOSSES SIGNIFICANT LOSSES ● Bereavement for women can lead to headaches, memory problems, difficulty with concentration, dizziness, indigestion, loss of appetite, or chest pain ● Distress of loss can be catalyst for introspection and growth ● Losing a parent can push adults into resolving important developmental issues ○ Achieving a stronger sense of self and more pressing, realistic awareness of their own morality ○ Along with greater sense of purpose, responsibility, commitment, and interconnectedness to others ● After death of a parent, siblings tends to be closer ● Losing a child weakens and destroys the marriage if the marriage is not strong MEDICAL, LEGAL, AND ETHICAL ISSUES: THE “RIGHT TO DIE” 2 | @studywithky
SUICIDE ● A growing number of people consider a mature adult’s deliberate choice of a time to end his or her life a rational decision and a right to be defended ● Suicide rates are highest in the elderly in almost all areas of the world ● Men also commit suicide at higher rates than do women HASTENING DEATH ● Brain Death: neurological condition which states the person is brain dead when all electrical activity of the brain has ceased for a specific period of time ○ Higher portions of the brains dies sooner than lower parts which facilitates breathing and heartbeat ○ That is why your brain could be dead but you still have heartbeat for the meantime ● Euthanasia: good death, intended to end suffering or to allow terminally ill person to die with dignity ○ Passive: involves withholding or discontinuing treatment that might extend the life of a terminally ill patient such as life support ○ Active: “mercy killing” involves action taken directly or deliberate to shorten life ● Advance Directive: contains instructions for when and how to discontinue futile medical care ○ Living will or a more formal legal document called a durable power of attorney ○ Durable Power of Attorney: appoints another person if the maker of the document becomes incompetent to do so ● Assisted Suicide: physician or someone else helps a person bring about a self-inflicted death SCHNEIDMAN'S TYPES OF SUICIDE SEEKERS Death Seekers Clearly wants to end their life State of mind changes often Some may be set on suicide and an hour later be uncertain Death Initiators Hurrying the inevitable Clearly intent on ending their life Usually someone who is ill or elderly Believe that death is already coming Death Ignorers Do not think that death will be the end of them Believe that death will bring a happier existence Common in children who lose a parent Death Darers Unsure about suicide Risk-taking behavior may not ensure death May think ahead for ways to be stopped by others FINDING MEANING AND PURPOSE IN LIFE AND DEATH FINDING MEANING ● Life Review: a process of reminisce that enables a person to see the significance of his or her life ● Within a limited life span, no person can realize all capabilities, gratify all desires, explore all interest, or experience all the richness that life has to offer REFERENCES Papalia, D., & Martorell, G. (2015). Experience human development (13th ed.). McGraw Hill Education. Santrock, J. W. (2019). Life-span development (17th ed.). McGraw-Hill Education. 3 | @studywithky