Week 12

Question	Answer
The study of death and dying.	Thanatology
True/False: Dying people benefit profoundly from social support in their last days/hours.	True
True/False: In reality, 80% of people die free of pain.	False (20% die free of pain)
Death is the accumulation of a straightforward...	biological process.
1 in 4 deaths are sudden. What % of these deaths are due to heart attacks?	80-90%
Irregular heart rhythm caused by uncontrolled twitching of the heart (during heart attack).	Fibrillation
Heart becomes scarred, no longer able to contract with the forces needed to deliver oxygen to tissues.	Congestive heart failure (Majority suffer this form of heart disease)
How long can a brain be oxygen-starved before it will suffer irreversible damage?	3-4 minutes
The spread of cancer to multiple organs.	Metastasis (Metastasized cancer)
Why do 3/4th of people die a long, drawn out death?	The help of life-saving medical technology.
What 3 traits are exhibited by a person in the last days/hours before death?	Decreased activity, less communication, and loss of interest in food and water.
What are the names of the 3 transition stages from life to death?	1. Agonal phase 2. Clinical death 3. Mortality
What occurs during the Agonal phase?	The gasps and muscle spasms during the first moments in which the regular heartbeat disintegrates.
What is Clinical death?	A short period in which heartbeat, circulation, breathing, and brain functioning stop, BUT resuscitation is still possible.
What is Mortality?	The passing of a person into permanent death.
True/False: Death is the result of the brain failing to function and occurs at a single point in time when the brain stops functioning.	False (Death is the result of multiple organs failing to function properly in a sequence that varies and does not happen at a single point in time)
Irreversible cessation of all activity in the brain and the brain stem.	Brain death
True/False: Brain death is the standard measure for death and is used for organ donations even if the intention of the deceased is not clear, as long as family consents.	True
The cerebral cortex no longer registers electrical activity, but the brain stem remains active.	Persistent vegetative state
The greatest dignity in death is the integrity of the life that precedes death. How can we foster integrity in death?	By the way wee communicate with and care for the dying person.
What 4 ways can we provide dignity in death?	1. Humane and compassionate care. 2. Be candid about death. 3. Educate the dying person about their disease. 4. Offer care, affection, companionship, autonomy, and esteem.
What is our culture's attitude towards death?	Reluctance to talk about death. We are in a death-denying culture (death = "passing away").
Our culture fosters an increase in death anxiety. What is death anxiety?	Fear and apprehension of death.
When and why does death anxiety decline?	Death anxiety declines in late adulthood due to better regulation of negative emotions.
Which of Erikson's psychosocial stages reduces death anxiety?	Ego integrity
What is symbolic immortality?	Belief that one will continue to live on through one's children or through work/personal influence.
True/False: People with a well-developed personal philosophy of death are more fearful of death.	False (less fearful of death)
True/False: Death anxiety can motivate one to live up to an internalized culture values (ie. be kinder to others).	True
Why do women appear to have more death anxiety than men?	Woman may be more admissive of feelings about death and women have greater emotional expressiveness throughout their life.
What 2 aspects of cognition reduce death anxiety?	Inhibition and Emotional self-regulation
What are the 5 sections of Kübler-Ross's Theory (about the thoughts and emotions of dying people)?	1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance
Ross did not intend for these sections of the Kübler-Ross's Theory to be fixed sequence. The use of which word caused this misinterpretation?	"Stages"
How should the stages of Kübler-Ross's Theory be viewed?	As coping strategies
What is Appropriate death?	Death that makes sense in terms of the individual's pattern of living and values and, at the same time, preserves or restores significant relationships and is as free of suffering as possible.
What proportion of cancer patients experience severe depression? Why is this important?	1/3 of cancer patients. Higher depression = Lower survival rate
True/False: In many nations in Europe, South America, Asia and the Middle East, terminally ill patients are seldom told the truth about their condition, since it disrupts important interdependent relationships.	True (ex. Japan)
What are the steps in a Hope Trajectory for a dying patient?	1. Hope for a cure 2. Hope to prolong life 3. Hope for peaceful death
True/False: Terminally ill patients who score higher in spiritual well-being experience less end-of-life despair.	True
In the past, most deaths occurred at home. What is the percentage of deaths that take place in hospitals? In LTC facilities?	40% of deaths occur in hospitals 20% of deaths occur in LTC facilities
What percentage of people prefer to die at home? What percentage actually die at home?	80-90% prefer to die at home, but only 25% actually die at home.
True/False: Family members of people who die at home experience less psychological stress than family members of people who died elsewhere.	False (After 10 months, they continue to report more psychological stress)
Why is there more a depersonalized experience for people dying in hospitals? (From doctor's perspective)	Doctors need to be able to efficiently care for patient, but not become so emotionally drained by repeated attachment and separations.
What programs in hospitals aim to ease physical, emotional, and spiritual suffering at end-of-life?	Hospital comprehensive treatment programs (only 1/3 of hospitals have them)
What 2 things do patients in nursing homes report about their experience?	Suffering from inattention to their needs High levels of untreated pain.
A comprehensive program of support services for terminally ill people and their families. Provides care community, so they can prepare for an appropriate death.	Hospice
True/False: Hospices encompass at-home care and inpatient care options.	True
What are the main focuses of hospice care? (7 focuses)	1. Patient & family as a unit of care 2. Meeting physical, emotional, social, and spiritual needs 3. Interdisciplinary care team 4. Home-like atmosphere 5. Palliative or comfort care 6. Regular visits + 24/7 services 7. Bereavement help for the family
The practice of ending the life of a person suffering from an incurable condition.	Euthanasia
What is the difference between Passive and Active Euthanasia?	Passive - withhold or withdraw treatment Active - act directly to end life
True/False: Passive euthanasia is widely practiced as part of ordinary medical procedure.	True
True/False: Majority of Catholics favour euthanasia while African American favour euthanasia less.	True
A written statement of desired medical treatment should they become incurably ill.	Advanced medical directive
Living will is a type of AMD in which a patient had specified treatments they want or do not want. For which cases are living wills written?	Terminal illness, coma, or other near death situations.
Durable power of attorney for health care authorizes another person to make treatment decisions on their behalf. What is the main advantage of this over a Living Will?	More flexible than a living will. (Also not limited to terminally ill patients and can deal with unexpected situations)
What proportion of adults 65+ have an advance medical directive?	~2/3 of adults over age 65
What is an important mean of covering children and adolescents who cannot legally execute advance medical directives?	Proxies or Substitute decision makers
What is the type of euthanasia in which the doctor acts directly to end a suffering patient's life at their request?	Voluntary active euthanasia
What percentage of people in Western nations approve of voluntary active euthanasia?	70-90%
What is the difference between assisted suicide and voluntary active euthanasia?	Assisted suicide - Patient kills themself Voluntary active euthanasia - Doctor kill the patient
What is the legal status of assisted suicide in Canada?	Illegal in Canada
What proportion of patients say that they would consider assisted suicide in particular circumstances?	1/3 patients
Public opinion favours assisted suicide or voluntary active euthanasia?	Voluntary active euthanasia over assisted suicide.
Why would the possibility of coercion be reduced in assisted suicide when compared to voluntary active euthanasia?	The final act is the patient's responsibility.
What is the type of euthanasia that occurs when the doctor ends a patient's life without their permission or consent?	Involuntary active euthanasia
Intense physical and psychological distress (grief) felt when we have lost a loved one.	Bereavement
Culturally specified expression of the bereaved person's thoughts and feelings. (Aim is to help people cope with the grief)	Mourning
What is the grieving process compared to?	A roller coaster ride with many ups and downs.
What are the 4 necessary tasks of grief?	1. Accept reality of the death. 2. Work through the pain of grief. 3. Adjust to a world with the loved one. 4. Develop an inner bond with the deceased and move on with your life.
Avoidance of the reality of death results in shock, then disbelief. How long may this disbelief last?	May last for hours to weeks.
What is the term used to describe the numbing feeling experienced as you accept the reality of your loss?	Emotional "anesthesia"
What stage of grieving involves reviewing the circumstances of death to find meaning in their death?	Confrontation
In what stage of grieving must a person deal with stressors that are secondary outcomes of death?	Restoration
Effective coping requires people to oscillate between dealing with the emotional consequences of loss and attending to life changes, which have restorative or healing effects.	Dual-process of coping with loss
True/False: There is no set timeline for grieving, as it is different for everyone.	True
Why is there a much higher mortality rate in bereaved men than women?	Men typically express less distress and depression directly, and seek social support less.
Which results in more pronounced avoidance and highly traumatic confrontation: Sudden, unanticipated death or Prolonged, expected death?	Sudden, unanticipated death
In prolonged dying, the bereaved person has time to engage in what type of grieving that acknowledges loss as inevitable and prepares them emotionally for the loss?	Anticipatory grieving
True/False: People grieving a suicide are more likely to believe that they contributed or could have prevented it.	True
Parents experience the most difficult loss when who dies?	Their children (whether it is sudden or foreseen)
How should parents' reestablish a sense of life's meaning after their child's death?	Through valuing the child's impact on their lives and investing in other children and activities.
Cognitive development allows for grieving, thus an immature understanding of death may cause the child of a deceased parent to think what about their parent's death?	The child may think the deceased parent voluntarily left or was angry and left them.
What is the major difference in the grieving process between adolescents and younger children?	Adolescents tend to keep grieving to themselves and not confide in others.
True/False: Older widows eventually fare well, while younger widows display more negative outcomes.	True
A sense of loss without the opportunity to mourn publicly and benefit from others' support.	Disenfranchised grief (Seen in lesbian/gay couples)
Several deaths at once or in close succession, which causes depletion of coping resources, leaving you emotionally overwhelmed and unable to resolve your grief.	Bereavement overload
When is bereavement overload more likely to occur?	In late life and those who experienced natural disaster, terrorist attacks, etc.
What are the 5 suggestion for resolving grief?	1. Give yourself permission to feel the loss 2. Accept social support 3. Be realistic about the course of grieving 4. Remember the deceased 5. When ready, invest in new activities and new relationships.
What type of interventions encourage people to draw on their existing social network, while providing additional social support through group or individual counselling?	Bereavement interventions
In bereavement interventions, individually-tailored approach is best suited for which type of coping: Loss-oriented or Restoration-oriented?	Restoration-oriented coping
In bereavement interventions, support groups are best suited for which type of coping: Loss-oriented or Restoration-oriented?	Loss-oriented coping
What percentage of people use bereavement interventions?	30-50%
What are the goals of death education? (4 main goals)	1. Understanding of physical and psychological changes with dying. 2. How to cope with the death of a loved one. 3. Prepare to be informed consumers of medical and funeral services. 4. Understanding of social and ethical issues involving death.
Which are better at decreasing death anxiety: educational programs or experimental programs?	Experimental programs

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