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Psychology of Aging > Chapter 13: Dying and Bereavement > Flashcards

Chapter 13: Dying and Bereavement Flashcards

1
Q

True or False. Death is a universal cultural experience

A

True. Every culture experiences death and each one has its own set of rituals for how to deal with the dead and grief.

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2
Q

What are the three signs that a person is experiencing whole-brain death?

A
  1. The person is in a coma and the cause of it is known
  2. All brainstem reflexes have permanently stopped working
  3. Breathing has permanently stopped.
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3
Q

True or False. The criteria for determining brain death is the same across all hospitals in the US.

A

False. Not all hospitals have adopted the same criteria for brain death so some hospitals may have different criteria. This can result in misdiagnosis, delays in organ transplants, and hard decisions for families.

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4
Q

What is a persistent vegetative state?

A

When a person’s cortical functioning ceases but brainstem activity continues.

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5
Q

What two things does bioethics emphasize?

A

The importance of individual choice and the minimization of harm over the maximization of good.

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5
Q

What is bioethics?

A

The study of the interface between human values and technological advances in health and life sciences.

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6
Q

What is euthanasia?

A

The practice of ending life for reasons of mercy.

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7
Q

What are the two forms of euthanasia?

A

Active euthanasia: The deliberate ending of someone’s life. Made based on a clear statement of a person’s wishes or by the decision of someone else who has legal authority. Ex. Administering a drug overdose

Passive euthanasia: The allowing of a person to die by withholding treatment. Ex. Disconnecting a ventilator.

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8
Q

How does opinions of euthanasia vary globally?

A

Western European countries view it more positively than Eastern European or Islamic countries.

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9
Q

What is physician-assisted suicide?

A

The process in which physicians provide dying patients with a fatal dose of medication that the patient self-administers.

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10
Q

What criteria must be met in the Netherlands before a terminally ill patient can request physician-assisted suicide?

A
  1. Patients condition is intolerable with no hope of improvement
  2. No relief is available
  3. The patient is competent
  4. The patient makes a request repeatedly over time
  5. Two physicians review the case and agree with the patient’s request
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11
Q

Which age group is the least anxious and most accepting of death? Why?

A

Older adults. This can be for many reasons like the achievement of ego integrity, the joy of living diminishing, and the feeling that the most important life tasks have been completed.

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12
Q
A
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13
Q

What are the five reactions that dying people experience according to Kubler Ross? In what order are they experienced?

A

Denial, anger, bargaining, depression, and acceptance. There is no universal order in which people experience these emotions. They often tend to overlap and be experienced in a different order.

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14
Q

What is terror management theory?

A

The theory of why people engage in certain behaviors to achieve a particular psychological state is based on their deeply rooted concerns about mortality. Ex. Getting cosmetic surgery so you don’t have to face the fact that you are aging.

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15
Q

What is death anxiety?

A

A people’s anxiety or even fear of death and dying

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15
Q

Concerning the context surrounding one’s death, what are the four dimensions of tasks that a dying person faces according to Corr?

A

Bodily needs, psychological security, interpersonal attachments, and spiritual energy and hope.

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16
Q

Do older or younger adults show lower death anxiety? Why?

A

Older adults. Their tendency to engage in life review, different perspectives of time, and higher levels of religious motivation.

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17
Q

How does death anxiety differ between men and women?

A

Men have a greater fear of the unknown but women have a more specific fear of the dying process.

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18
Q

What are some ways to alleviate death anxiety?

A

Writing your obituary and educating yourself about death.

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19
Q

What are end of life issues?

A

Issues about the management of the final phase of life, after-death disposition, memorial services, and distribution of assets.

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20
Q

How does the current generation of older adults differ from past generations in how they handle the final parts of their lives?

A

The current generation of older adults is planning out the final parts of their lives more than past generations.

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21
Q

What is a final scenario?

A

Making such choices about how they do and do not want their lives to end.

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22
Q

What is hospice?

A

An approach to assist dying people that emphasizes pain management, palliative care, and dying with dignity.

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22
Q

What is one of the most important parts of the final scenario?

A

The process of separation from family and friends. Involves affirming love, resolving conflicts, and providing peace for dying people.

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23
Q

What is the main objective of hospice?

A

To make the person as peaceful and comfortable as possible instead of delaying an inevitable death.

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24
Q

What are inpatient hospice?

A

Hospices that provide care to all clients regardless of where they are.

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24
Q

What is palliative care?

A

Care that is focused on providing relief from pain and other symptoms of disease at any point during the disease process.

25
Q

What are the two types of hospices?

A

Inpatient and outpatient

26
Q

What are outpatient hospices?

A

Hospices that provide services to clients who remain in their homes.

27
Q

How does hospice staff differ from medical staff?

A

Hospice staff are meant to just be with the client instead of treating them like how medical staff do.

28
Q

How do hospice and hospital patients differ in their physical and mental health?

A

Hospice clients are more mobile, less anxious, and less depressed. Spouses visit hospice clients more often and participate more in their care.

29
Q

What are death doulas?

A

People who help clients ease the passage of death. May perform actions like holding the client’s hand, playing music, and meditating with them.

30
Q

What is a living will?

A

A document where a person states his or her wishes about life support and other treatments.

31
Q

What is a healthcare power of attorney?

A

An individual appoints someone to act at his/her agent for healthcare decisions.

32
Q

What are some challenges that people may face with advanced care planning?

A
  • State laws vary relating to advanced directives.
  • Many fail to inform relatives and physicians about healthcare decisions
  • Some do not tell the person named in a durable power of attorney where the document is kept.
33
Q

What is a Do not resuscitate order (DNR)?

A

A medical order in which CPR is not started if one’s heart or breathing stops.

34
Q

What is the Patient Self-Determination Act? When was it passed?

A

A law that requires most healthcare facilities to provide information to patients in writing that they have the right to make their own healthcare decisions, accept or refuse medical treatment, and make an advance healthcare directive.

It was passed in 1990

35
Q

What is one major concern regarding the Patient Self Determination Act?

A

One major concern of the Self Determination Act is determining if the person is cognitively or legally able to make the decisions about end-of-life care.

36
Q

True or False. Research indicates that family members and other surrogate decision-makers are often right about what loved ones really want.

A

False. Family members and other decision-makers are often wrong about what their loved one wants so discussions about end-of-life issues must be done ahead of time advanced directives are put in place and key individuals are aware of them.

37
Q

What are four things that a person does while grieving?

A
  • They acknowledge the reality of the loss
  • Work through emotional turmoil
  • Adjust to the environment when the deceased is absent
  • Loosen ties to the deceased
38
Q

What are three important aspects of grief?

A
  • It is a highly individualistic experience (everyone goes through it differently).
  • People take different amounts of time to work through various emotional issues
  • There is no real “recovery”. We learn to live with the loss rather than recover from it.
39
Q

What is anticipatory grief?

A

Grief experienced before an expected death occurs. Is believed to act as a buffer for the impact of the loss when it does come and facilitate recovery.

40
Q

True or False. Survivors of an expected loss are able to recover better than survivors of an unexpected loss.

A

False. There is no evidence to support the notion that anticipatory grief alleviates bereavement.

41
Q

How does attachment style relate to the amount of grief a person feels?

A

The more attached a person is to the deceased, the greater the grief; however, secure attachments also lead to less depression after the loss because of less guilt over unresolved issues.

42
Q

How do men and women differ in the ways they express grief?

A

Men have higher mortality rates following bereavement but women have higher rates of depression and complicated grief.

43
Q

What is grief work?

A

The psychological side of coming to terms with bereavement.

44
Q

What are the five themes of grief that Muller and Thompson found?

A
  • Coping; What people do to help them deal with their loss
  • Affect: People’s emotional reactions to their loved one’s death
  • Change: The way survivor’s lives change as a result of loss
  • Narrative: The stories survivors tell about their deceased loved ones
  • Relationship: Who the deceased person was to the survivor and how close the deceased and survivor were.
45
Q

True or False. As well as psychological reactions, people also experience physiological reactions to grief.

A

True. A person’s sleep schedule may be disturbed, they may get sicker, or they experience circulatory problems.

46
Q

What is anniversary reaction?

A

The changes in behavior related to feelings of sadness on a certain date.

Ex. Someone seems gloomy on the anniversary of their spouse’s death.

47
Q

Research shows that grief tends to peak _______ months after the death of a loved one.

A

6

48
Q

What are three models that researchers have created to explain and understand the grieving process?

A

The four components model, the dual process model, and the model of adaptive grieving processes.

49
Q

What is the four-component model of dealing with grief?

A

This model states that there a four parts to understanding grief: the context of the loss, the continuation of subjective meaning from the loss, changing representations of the lost relationship over time, the role of coping and emotional regulation processes /

50
Q

What is the grief work as rumination hypothesis?

A

Is an alternative view to the four-component model. This approach rejects the necessity of grief process for recovery from loss and views extensive grief as a form of rumination that may increase distress.

51
Q

What is the dual process model of grief?

A

This model states that there are two types of stressors that a survivor experiences after the loss of a loved one: loss-orientated stressors (dealing with the loss itself) and restoration stressors (adaption to the new life situation). People tend to go back and forth between dealing with these stressors.

52
Q

What is the model of adaptive grieving dynamics?

A

That model is based on two pairs of adaptive grieving dynamics: lamenting/heartening and integrating/tempering.

53
Q

What is lamenting?

A

Experiencing/expressing grief responses that are distressful, disheartening, and painful.

54
Q

What is heartening?

A

Experiencing/expressing grieving responses that are gratifying, uplifting, and pleasurable

55
Q

What is integrating?

A

Assimilating internal and external changes and reconciling differences in past, present, and future realities in light of changes.

56
Q

What is tempering?

A

Avoiding chronic attempts to integrate changed realities impacted by loss that overwhelms a griever’s/ community’s resources and capacities to integrate such changes.

57
Q

What is ambiguous loss?

A

Situations of loss in which there is no resolution or closure.

58
Q

What are the two types of ambiguous loss?

A

When a person is missing but still present psychologically to family and friends (ex. victims of kidnappings or natural disasters).

When a person is physically present but psychologically absent. (ex. people with dementia).

59
Q

What is complicated grief?

A

Persistent and intrusive grief that lasts beyond the expected period of adaptation to loss. Is associated with separation distress and traumatic distress.

60
Q

What is separation distress?

A

Preoccupation with the deceased to the point it interferes with everyday functioning (ex. upsetting memories of the deceased, longing/searching for the deceased, and isolation after loss).

61
Q

What is traumatic distress?

A

Feelings of disbelief about the death. Mistrust, anger, and detachment from others, feeling shocked about the death, and the experience of the physical presence of the deceased.

62
Q

What effects does complicated grief have on an individual?

A

It causes high levels of separation distress, increased morbidity, increased smoking, increased substance abuse, and difficulties with family and other social relationships.

63
Q

According to Arizmendi and colleagues, how do people with complicated grief experience emotions differently?

A

They do not engage in areas of the brain that are involved with regulating emotions.

64
Q

What is disenfranchised grief?

A

A loss that appears insignificant to others that is highly consequential to the person who suffers the loss.

65
Q
A

Psychology of Aging (10 decks)

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