Ch.12: Dying

Question 1

Death Anxiety

Answer 1

the apprehensive, uneasy, or nervous feeling brought on by the awareness of death

Question 2

Before WWII, people are dying at _______ while after WWII, half die in the __________

Answer 2

home, hospital

Question 3

3 Aspects of Death (These can happen ay different times)

Answer 3

• Biological
• Psychological
• Social

Question 4

Biological aspect of death

Answer 4

• body shuts down and ceases to function
• sleep more, digestion slows, breathing slows, circulation slows, brain no longer functions

(you’re clinically dead when your brain is no longer functioning)

Question 5

Psychological aspect of death

Answer 5

• we have a bit of control
• accept death
• less interest in the world, socializing, engagement in activities
• you can decide when you die (can hold on)

Question 6

Social aspect of death

Answer 6

• people know you’re dying and they stop visiting, they stop calling
• become invisible to others and lose social connectedness
• treated as if they were dead or not persons

Question 7

Elisabeth Kubler-Ross’ five stages of death

• recognize the stages
• cope better
• prevent social death

Answer 7

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance

Question 8

________ adults report a sense of being cheated by death

Answer 8

Young

Question 9

______________ adults begin to confront their own mortality and undergo a change in their sense of time lived and time until death

Answer 9

Middle-aged

Question 10

_________ adults are more accepting of death

Answer 10

Older

Question 11

WHO defines this as an approach that improves quality of life of patients and their families who are facing the problems associated with life-threatening associated with life-threatening illnesses

Answer 11

palliative care

Question 12

Palliative care team involves

Answer 12

• specially trained physicians
• nurses
• social workers
• spiritual counsellors
  pharmacists

Question 13

Around 70% of palliative and end-of-like care in Canada is still provided within a ___________ environment

Answer 13

hospital

Question 14

Characteristics of a good death

Answer 14

• preference for the dying process
• pain-free status
• emotional well-being
• life completion
• treatment preferences
• dignity
• family
• quality of life
• relationship with healthcare professional
• religiosity and spirituality- can give you purpose & meaning in life

Question 15

This is the most important bioethical issue

Answer 15

Euthanasia

Question 16

Active Euthanasia

Answer 16

• it is when death is brought by an act. For example, taking a high dose of drugs
• to end a person’s life by use of drugs, either by oneself or by the aid of physician

Question 17

Passive Euthanasia

Answer 17

• when death is brought by an omission. For example, when someone lets the person die, this can be done by withdrawing or withholding treatment

Withdrawing treatment: switching off a machine that keeps the person alive
Withholding treatment: not carrying out a surgery that will extend life of the patient for a short time

Question 18

In 2015, the Canadian federal government passed legislation that allows eligible adults in Canada to request physician-assisted suicide or “_____________________________”

Answer 18

medical assistance in dying (MAID)

Question 19

Medically Assisted Suicide

Answer 19

• a physician or nurse practitioner prescribes a drug that is self-administered to cause death
• also referred to as physician-assisted death

Question 20

Eligibility criteria for MAID

Answer 20

• be eligible for federal or provincial healthcare services
• be at least 18 years old and mentally competent
• have a grievous irremediable medical condition
• make a request for MAID that is not the result of outside pressure and influence
• give informed consent to receive MAID

Question 21

Motivation for wishing to die in older adults

Answer 21

• Aside from irremediable medical conditions, older adults may experience a wish to die if they experience declines in mobility, vision, hearing, speaking, and cognition; loss of connection to public life, and feelings that life has no meaning anymore

Question 22

Advance directives

Answer 22

• directions given by a competent individual concerning what and/or how and/or by whom decisions should be made in the event that, at some time in the future, the individual becomes incompetent to make certain decisions

When patient’s wishes are met, both patients and their families experience less strain and improved quality of life

Question 23

Bereavement

Answer 23

a period of mourning following the loss of a loved one or a close friend through death

experienced more by older people than younger people

Question 24

This is the natural response to the loss of someone or something that is very dear to a person, which may or may not involve death

e.g., the death of a pet, the loss of a job or a home

Answer 24

Grief

Question 25

Bereavement is best understood from a ______________ perspective

Answer 25

biopsychosocial Biological: stress on body, trouble sleeping, low energy Psychological: range of negative emotions, impaired attention and memory Sociocultural: altered position in family and community, financial burden, change in support network

Question 26

Complicated/Prolonged Grief

Answer 26

- occurs in about 10-12% of bereaved individuals - suffer adverse health effects, and become incapacitated by grief to the exclusion of other interests and concerns - ruminate about the death - long for reunion with the deceased - inability to accept the loss - inability to feel pleasure - bitterness - difficulty trusting others - feeling of being stuck in the grieving process

Question 27

Factors associated with the development of complicated/prolonged grief

Answer 27

- first-degree relationship to the deceased - a poorly functioning marriage or insecure attachment style prior to widowhood - emotional dependency on the deceased - lack of preparation for the death (i.e., "off-time" losses such as traumatic or unexpected deaths) ex: loss of child - in-hospital death of the loved one

Question 28

Strategies that can help in the process of grieving

Answer 28

- talk about the death of your loved one - accept your feelings - take care of yourself and your family - reach out and help others dealing with the loss - remember and celebrate the lives of your loved ones