bargaining (let's make a deal for extending things, often to "higher" power, make a deal with god, doctors, nurses)
depression (realizing you can no longer deny or prevent the outcome, mourning over loss of relationships and own life)
acceptance (being at peace, serenity with idea of death; depression lifts/goes away)
Which stage of death lingers the longest according to the research?
Who were the studies of death performed on?
young to middle age cancer patients
What is missing in the experiences of death?
farewells (how you are saying goodbye to people) written letter, gifts to family members, conversation (most common farewell)
What is the greatest contribution of the death stages?
sensitization of healthcare workers and others to the complexity involved in the process of dying
What are the reasons for reminiscing?
pleasure: enhance mood and improve self-image; most common reason for reminiscing
self-understanding: most positive mental health in combination with negative (realistic) reminiscence (balancing)
solving present problems and coping with losses: how did I deal with similar things in the past and how can I use those coping strategies now
What are the types of reminiscences?
integrative: acceptance of self and resolving old conflicts/grudges (attempting to integrate ideal version of self with real version of self) most beneficial to successful aging
instrumental: drawing on past memories to solve current problems
escapist: "glorifying" the past (no other better time than the past) escaping the past memories (past is better)
obsessive: thoughts focus on (negative emotions) regret, dispair, bitterness
What is involved in the grieving process?
bereavement: condition/mental state you are in due to loss from death
grieving: emotional state you are in during early phases of bereavement (responses: sorrow, hurt, anger, guilt, confusion(senseless death), emptiness, relief/peace)
Mourning: behavior expression of grief (actions can involve crying) heavily culturally influenced (rituals: provide sense of control and meaning to the death)
Grieving process is very individualized
What are the patterns of grieving?
expected: leading to low death anxiety
unexpected: leading to high death anxiety
anniversary reaction: anniversary of the death (6 months since death, 2 years since death etc.)
emotional response is equally intense if death is expected or unexpected
What is the most common reaction to the death of a loved one?
resilience (keep going on with life in spite of death)
How does relationship to deceased reflect grief experienced?
experience of grief does not reflect one's bond with the deceased
What is finitude?
coming to grips with one's eventual death (occurs over time and at many levels)
What is reminiscence?
reviewing memories in preparations of death (writing a memoir/autobiography, seeking out old friends/relatives to talk with about the past)
What is said about a life review?
it is an important aspect of "writing the final chapter" or legitimizing one's life in some fashion
What is a living will?
document that takes effect if you are no longer able to express your wishes about end-of-life decisions
What is an organ transplant donor?
agreeing that at the time of death, their usable organs and other tissue can be transplanted to people who have been approved to receive them
What are the stages of cancer/severe illness diagnosis?
positive avoidance (denial): rejection of evidence about diagnosis; insistence that surgery was just precautionary
fighting spirit: an optimistic attitude, accompanied by a search for more information about the disease; they often saw their disease as a challenge and planned to fight it with every method available
stoic acceptance (fatalism): acknowledgment of the diagnosis but without seeking any further information; ignoring the diagnosis and carrying on their normal life as much as possible
helplessness/hopelessness: overwhelmed by diagnosis; saw themselves as dying or gravely ill; devoid of hope
anxious preoccupation: response to the diagnosis was strong, persistent anxiety; if they sought information, they interpreted it pessimistically; they monitored their body sensations carefully, interpreting each ache or pain as a possible recurrence
How does social support affect the dying process?
high levels are linked to lower levels of pain, less depressive symptoms, and longer survival times
What is hospice care?
care focused on pain relief, emotional support, and spiritual comfort for the dying person and his/her family
What is a good death?
death with dignity, maximum consciousness and minimum pain, and with the patient and patient's family having full information and control over the process
What are the aspects of the hospice approach?
death viewed as normal, inevitable, not to be avoided but faced and accepted
patient and family preparing for death by examining their feelings and planning for later life
family involved in care to full extent possible allowing for each family member to come to some sort of resolution with their relationship with dying person
control over care and care-receiving setting should belong to patient and family
medical care is palliative, pain should be alleviated and comfort maximized, but a minimum of invasive or life-prolonging measures should be undertaken