Chapter 16 - Death and Dying Flashcards
(130 cards)
1
Q
Biological Death
A
hard to define because it is not a single event but a complex process
Different systems of the body die at different rates
2
Q
total brain death
A
An irreversible loss of functioning in the entire brain, both the higher centers of the cerebral cortex that are involved in thought and the lower centers of the brain that control basic life processes such as breathing.
Determining total brain death requires extensive testing following specific guidelines that differ some from state to state in the United States
3
Q
Comas - total brain death
A
A person in a coma must be observed to be totally unresponsive to stimuli, show no movement in response to noxious stimuli, and have no reflexes such as a constriction of the eye’s pupils in response to light
An electroencephalogram (EEG) or other measures should indicate an absence of electrical activity in the cortex of the brain
This definition means that a coma patient whose heart and lungs are kept going only through artificial means such as a mechanical ventilator but who has no sign of functioning in the brain stem is dead.
4
Q
Euthanasia
A
Literally, “good death”; specifically, hastening, either actively or passively, the death of someone suffering from an incurable illness or injury.
5
Q
Active euthanasia
A
“mercy killing,” is deliberately and directly causing a person’s death—for example, by administering a lethal dose of drugs to a pain-racked patient in the late stages of cancer or smothering a spouse who has advanced Alzheimer’s disease
6
Q
Passive euthanasia
A
by contrast, means allowing a terminally ill person to die of natural causes—for example, by withholding extraordinary life-saving treatments (as when Terri Schiavo’s feeding tube was removed)
7
Q
assisted suicide
A
Making available to individuals who wish to commit suicide the means by which they may do so, such as when a physician provides a terminally ill patient who wants to die with enough medication to overdose
8
Q
Surveys tell us that there is overwhelming support among medical personnel and members of the general public for ____________ euthanasia
A
passive
9
Q
Who tends to be more supporting of the right to end life?
A
Attitudes tend to be most accepting among younger generations, men, and highly educated respondents
10
Q
Who tends to be less accepting of the right to end life?
A
African Americans and other minority group members tend to be less accepting of actions to hasten death than European Americans, whether because they do not trust the medical establishment or for religious or philosophical reasons
11
Q
the law and active euthanasia
A
still treated as murder in the United States and most countries
12
Q
the law and passive euthanasia
A
it is legal to withhold or withdraw extraordinary life-extending treatments from terminally ill patients when that is the wish of the dying person or when the immediate family can show that the individual had expressed a desire to reject life-support measures
13
Q
living will
A
A document, also called an advance directive, in which people state in advance that they do not wish to have extraordinary medical procedures applied if they are hopelessly ill.
14
Q
First state to legalize physician-assisted suicide
A
Oregon became the first state in the United States to legalize physician-assisted suicide - as patients in European countries such as the Netherlands, Belgium, Luxembourg, and Switzerland can do (when they have 6 or fewer months to live)
15
Q
denial of death
A
Since the late 19th century, Ariès argues, Western societies have engaged in a “denial of death.” - taken out of the home and put it in the hospital and funeral home to be managed by physicians and funeral directors; as a result, we have less direct experience with it than our ancestors did
16
Q
Is there a universal emotional response to death across cultures?
A
sadness is a common response, but there are no universal emotional responses to death
17
Q
average life expectancy for a newborn in the United States now?
in 1900?
males now?
females now?
A
almost 79 years
compared with 47 years in 1900
—76 for males, 81 for females
18
Q
Why do females tend to have longer lives?
A
Female hormones seem to protect women from high blood pressure and heart problems, and they are less exposed than men to violent deaths and accidents and to health hazards such as smoking and drinking
19
Q
Which ethnic group has the highest life expectancy in the US? Lowest?
A
highest for Hispanics, medium for non-Hispanic whites, and lowest for African Americans
20
Q
What is the average rate of infant mortality?
A
dropped to six out of 1,000 live births
21
Q
During which period of life do we have the lowest chance of dying?
A
dying during childhood or adolescence
22
Q
Main causes of infant mortality
A
mainly associated with congenital abnormalities that infants bring with them to life, low birth weight or short gestation, and complications of pregnancy
23
Q
Main causes of childhood death
A
leading cause of death among preschool and school-age children is unintentional injuries or accidents (especially car accidents but also poisonings, falls, fires, drownings, and so on)
24
Q
Main causes of death of adolescent/emerging adult
A
Accidents (especially car accidents), suicides, and homicides are the leading killers
25
Main causes of adult deaths
Accidents continue to kill young adults, but cancers and heart diseases also begin to take a toll
45–54 age group, cancers have become the leading cause of death, followed by heart diseases, which then competes with cancer for the top spot thereafter, with chronic lower respiratory diseases often in third place - These and other chronic illnesses become more likely causes of death as age increases
adults age 65 and older, heart diseases lead the list, followed by cancers and chronic respiratory diseases
26
Two main categories of theories of aging/dying
programmed theories
damage theories
27
programmed theories
emphasize the systematic genetic control of aging processes
assume that aging will unfold according to a species-specific genetic program - a predictable genetic timetable
28
maximum life span - what is it? what is it for humans?
A ceiling on the number of years that any member of a species lives; 120 years for humans. (Among land mammals, humans have the longest maximum life span, estimated at around 125 years) - the maximum life span has changed very little over the past century
29
Genetic differences account for how much variation among us in age at death
about a third
30
a fairly good way to estimate how long you will live is to average the longevity of...
your parents and grandparents
31
Leonard Hayflick
discovered that cells from human embryos could divide only a certain number of times
32
Hayflick limit
The estimate that human cells can double/divide only 50 times, plus or minus 10, and then will die.
33
the maximum life span of a species is related to the Hayflick limit for that species: The long-lived Galapagos tortoise’s cells can divide _____ times whereas the cells of the short-lived fruit fly can divide far less than this
90–125
34
Telomeres
A stretch of DNA that forms the tip of a chromosome and that shortens after each cell division, serving as an aging clock and timing the death of cells
the mechanism behind the “cellular aging clock” suggested by the Hayflick limit on cell division
35
telomere length is a yardstick of...
biological age
36
What determines how long your telomeres are?
both genes and environment
differences in telomere length at birth that are partly genetic in origin but can also be influenced by the prenatal environment
chronic stress later in life is linked to shorter-than-average telomeres
shorter telomeres are associated with diseases of aging such as heart disease and diabetes, as well as with psychological disorders such as depression and anxiety
lack of exercise, smoking, obesity, and low socioeconomic status (SES)—all risk factors for age-related diseases—are also associated with short telomeres
37
Epigenetic aging clock
A measure of patterns of DNA methylation that are closely associated with aging
Based on analysis of DNA methylation patterns, a person’s biological age can be estimated
38
What influences a person's epigenetic aging clock?
highly genetically influenced and can also be affected by environmental risk factors such as stress, unhealthy lifestyles, and low SES
Having an epigenetic biological age that is greater than one’s chronological age turns out to be correlated with a number of environmental risk factors known to be associated with chronic diseases of aging, including cardiovascular disease and Alzheimer’s disease
39
Damage Theories
generally propose that wear and tear—an accumulation of random damage to cells and organs over the years—ultimately causes death
maintain that biological aging is more about random damage than genetically programmed change
40
Free radicals
a damage theory
Chemically unstable byproducts of metabolism that have an unpaired electron and react with other molecules to produce toxic substances that damage cells and contribute to aging.
toxic and chemically unstable by-products of metabolism, or everyday chemical reactions in cells such as those involved in the breakdown of food - produced when oxygen reacts with certain molecules in the cells
They have an unpaired, or “free,” electron and are highly reactive with and damaging to other molecules in the body, including DNA
Meanwhile, the body’s mechanisms for repairing genetic and epigenetic damage are also becoming more impaired with age and cannot keep up with the chaos - causes aging and eventual death
41
a visible sign of the damage that can result from free radicals
Age spots
42
free radicals have also been implicated in which of the major diseases that become more common with age
cardiovascular diseases, cancer, and Alzheimer’s disease
43
what is the damage of most concern from free radicals?
damage to DNA because the result is more defective cells replicating themselves
44
Antioxidants
such as vitamins E and C (or foods high in them such as raisins, spinach, and blueberries) or resveratrol (a natural substance in grapes, red wine, and peanuts)
can donate one of their electrons to chemically unstable free radicals, thereby reducing their damage to the body
45
what casts doubt on the value of the free radical theory as a major explanation of basic aging?
While antioxidants can promote healthier aging with less frailty in later life, they do little to actually lengthen life
46
A technique demonstrated to extend the life span of laboratory animals
a highly nutritious but severely calorie-restricted diet
caloric restriction reducing intake by 30–40% extends both the average longevity and the maximum life span of a species and that it delays or slows the progression of many age-related diseases
reduces the number of free radicals and other toxic products of metabolism - also appears to alter gene expression and trigger the release of hormones that slow metabolism and therefore decrease oxidative damage
47
KÜBLER-ROSS’ STAGES OF DYING
denial
anger
bargaining
depression
acceptance
48
Kübler-Ross emphasized a sixth response that runs throughout the stages:
hope. She believed that it is essential for terminally ill patients to retain some sense of hope, even if it is only the hope that they can die with dignity
49
four problems with the Kübler-Ross stages
emotional responses to dying are not stagelike
the nature and course of an illness affects reactions to it
individuals differ widely in their responses
dying people focus on living, not just dying
50
terminal decline
Many dying patients display symptoms of depression and other signs of decreased well-being as part of a deterioration in functioning and emotional well-being shortly before death
51
Bereavement
A state of loss that provides the occasion for grief and mourning
52
Grief
The emotional response to loss.
53
Mourning
Culturally prescribed ways of displaying reactions to a loss.
54
Anticipatory grief
Grieving before death for what is happening and for what lies ahead.
55
Parkes/Bowlby attachment model of bereavement
Model of grieving describing four predominant reactions to loss of an attachment figure: numbness, yearning, disorganization and despair, and reorganization.
56
Numbness:
first few hours or days after the death
sense of unreality and disbelief and almost empty of feelings
57
Yearning:
a time of acute separation anxiety, which motivates efforts to reunite with the lost loved one
Grief comes in pangs or waves that typically are most severe from 5 to 14 days after the death
panic, bouts of uncontrollable weeping, and physical aches and pains
pines and yearns and searches for the loved one, longing to be reunited - may sense a presence or smell articles of clothing, etc.
anger and guilt are common during these early weeks and months
58
Disorganization and despair:
depression, despair, and apathy increasingly predominate
most of the first year after the death, and longer in many cases, bereaved individuals often feel apathetic and may have difficulty managing and taking interest in their lives
pangs of intense grief and yearning become less frequent, although they still occur
59
Reorganization:
invest less emotional energy in their attachment to the deceased and more in their attachments to the living. If they have lost a spouse, they begin to make the transition from being a wife or husband to being a widow or widower, revising their identities
60
Typical grief for widows and widowers:
the worst of the grieving process for widows and widowers is typically during the first 6 months after the loss
the process of overcoming depression symptoms may take a year or so for widows and longer for widowers
61
Dual-process model of bereavement
A theory of coping with bereavement in which the bereaved oscillate between loss-oriented coping in which they deal with their emotions, restoration-oriented coping in which they try to manage practical tasks and reorganize their lives, and periods of respite from coping.
Both loss- and restoration-oriented issues need to be confronted, but they also need to be avoided at times or they would exhaust us - have to strike a balance between confrontation and avoidance of coping challenges and between loss-oriented and restoration-oriented coping
Over time, emphasis shifts from loss-oriented to restoration-oriented coping and from more negative to more positive thoughts and emotions
62
Loss-oriented coping
coping focused on dealing with one’s emotions and reconciling oneself to the loss.
63
Restoration-oriented coping
coping focused on managing daily living, rethinking one’s life, and mastering new roles and challenges
64
Most researchers agree that bereavement is a...
complex, phaselike, but not-very-stagelike process
65
Infant understanding of death
Possibly, infants first form a global category of things that are “all gone” and later divide it into subcategories, one of which is “dead”
they lack the cognitive capacity to interpret what has happened when someone in the family dies
66
Bowlby’s attachment theory for infants:
Only after infants form their first attachments around 6 or 7 months do they display separation anxiety when their beloved caregivers leave them
67
Bowlby’s stages for infants reacting to death:
first engage in vigorous protest—yearning and searching for the loved one and expressing outrage when they fail
after some hours or days of protest, an infant has not succeeded in finding the loved one, he begins to despair, displaying depression-like symptoms - may be reflected in a poor appetite, a change in sleeping patterns, excessive clinginess, or regression to less mature behavior
After some days—longer in some cases—the bereaved infant may enter a detachment phase, in which he gives up and takes renewed interest in toys and companions
68
Child's understanding of death
young children are highly curious about death; think about it with some frequency; build it into their play, rhymes, and songs; and talk about it
their beliefs about death often differ considerably from those of adults
69
In Western societies, a “mature” understanding of death has four components
Finality - the cessation of life and of all life processes, such as movement, sensation, and thought
Irreversibility
Universality - inevitable and happens to all living beings
Biological causality - the result of natural processes internal to the organism, even if external causes set off these internal changes
70
Children between age 3 and 5 - understanding of the four components of death
have some understanding of death, especially of its universality
any of them picture the dead as living under altered circumstances and retaining at least some of their capacities (no finality)
Some preschool-age children also view death as reversible rather than irreversible
young children think death is caused by one external agent or another - do not grasp the ultimate biological cause of death
71
Children between age 5 and 7 - understanding of the four components of death
make considerable progress in acquiring a mature concept of death (when, according to Jean Piaget’s theory of cognitive development, children progress from the preoperational stage of cognitive development to the concrete-operational stage)
understand that death is characterized by finality (cessation of life functions), irreversibility, and universality
Understanding the biological causality of death is the hardest concept of death for children to master
72
Children’s understandings of death are influenced by:
cognitive development, cultural socialization, and individual experiences
73
Four major messages have emerged from studies of bereaved children:
children grieve,
they express their grief differently than adults do,
they lack some of the coping resources that adults command, and
some experience long-term negative effects of bereavement
74
Young children have mainly _________________coping strategies at their disposal for grieving
behavioural - 2-year-old Reed found comfort by taking out a picture of his mother and putting it on his pillow at night
75
Older children are able to use ___________ coping strategies for grieving
cognitive - such as conjuring up mental representations of their lost parents
76
children who lose their father to death have...
16% shorter telomeres than children who have not lost their father
77
How many children who had lost a parent had serious adjustment problems 2 years after the death
1/5
78
The adolescent's understanding of death
able to think in more abstract ways about death, consistent with the shift from Piaget’s concrete-operational stage to his formal-operational stage
79
dying adolescents may be acutely disturbed if their illness brings...
hair loss, weight gain, amputation, loss of sexual attractiveness and responsiveness, or other such physical changes
Wanting to be accepted by peers, they may feel like “freaks” or become upset when friends who do not know what to say or do avoid them
80
adolescents who lose a parent may express their grief in what way?
may express their anguish instead through delinquent behavior and somatic ailments
reluctant to express their grief for fear of seeming abnormal, out of control, or overdependent
81
responses to the sudden loss of a parent through suicide, accident, or sudden natural causes like a heart attack were studied closely by David Brent and his colleagues - ranged in age from 7 to 18 at the time of the death and were assessed periodically until 5 years after the death:
About 30% experienced significant grief reactions in the first year that then gradually diminished, while another 10% continued to experience significant grief reactions even 3 years later - The remainder (almost 60%) had milder grief reactions.
more likely than nonbereaved comparison youth to suffer from major depression, alcohol and substance abuse, and, in the first year, posttraumatic stress disorder
cortisol levels were higher
disrupted the completion of key developmental tasks of adolescence
outcomes were poorest for those who lost their mothers
82
how many adolescents ages 12–17 experienced the death of a close friend in the past year
1/5
83
how did death of a friend impact a teenager?
32% of teenagers who lost a friend to suicide experienced clinical levels of depression after the suicide
experiencing such a death was associated with higher rates of substance abuse
84
Do most bereaved adult partners become clinically depressed?
No, most bereaved partners do not become clinically depressed, but many feel lonely and experience symptoms of depression in the year after the death
85
widows and widowers as a group experience what kinds of physiological changes?
chronic inflammation and cardiovascular disease and have a higher-than-average risk of death
86
widows and widowers often experience what types of disruptions in functioning and for how long?
disruptions in physical, cognitive, and emotional functioning are common, usually lasting for a year; less severe, recurring grief reactions may then continue for several years
87
George Bonanno found what five patterns of adjustment in bereaved adults?
resilient pattern in which distress is at low levels all along
Common grief, a recovery pattern with heightened and then diminishing distress after the loss within a year or so
Chronic grief in which loss brings distress and the distress lingers
Chronic depression in which individuals were depressed before the loss and remained so after it
A depressed–improved pattern in which individuals who were depressed before the loss become less depressed after the death; many of these individuals were likely experiencing caregiver burden before the death and felt relieved of stress after the death
88
resilience
a low level of depression all along—is the most common response, characterizing almost half the sample. This result runs counter to our belief that all bereaved people must go through a period of significant distress.
89
What type of people are more likely to be resilient?
before the death they seemed to be well-adjusted and happily married people with good coping resources
experienced emotional pangs in the first months after the death, but they were more comforted than most by positive thoughts of their partners and simply coped effectively with their loss
90
Frank Infurna and Suniya Luthar - five measures of adjustment
life satisfaction, negative affect, positive affect, self-perceived health, and physical functioning (ability to carry out activities of daily living)
The percentage of people judged to be resilient varied considerably depending on which indicator was used
few showed a resilience across all five measures
91
Complicated grief
An emotional response to a death that is unusually prolonged or intense and that impairs functioning; pathological grief
persists for 6 months or longer and may involve intense distress over separation from the deceased, as well as a sense of meaninglessness, bitterness over the loss, difficulty getting past the loss, and difficulty functioning
92
how many people experience complicated grief?
a minority of bereaved individuals, up to about 15% or so
93
what are some people who are experiencing complicated grief sometimes diagnosed with?
sometimes diagnosed as having a depressive disorder or, if the death was traumatic, posttraumatic stress disorder (PTSD)
some experts have concluded that complicated grief, also called prolonged grief disorder, has unique symptoms, is distinct from these other conditions, and should be viewed as a distinct psychological disorder
DSM-5 recognizes complicated grief as worthy of further study as a distinct disorder but does not define it as one
94
Most of what we know about same-sex partner grief comes from what?
studies of the partners of gay men who were infected with HIV and died of AIDS
Many of these men not only experienced the burden of caring for their dying partners but were also HIV infected themselves and therefore stressed by their own illness and possible death. They also had to contend with the stigma surrounding both AIDS and homosexuality
95
disenfranchised grief
Grief that is not fully recognized or appreciated by other people and therefore may not receive much sympathy and support, as in the loss of a gay partner
Losses of ex-spouses, extramarital lovers, foster children, pets, and fetuses can also result in disenfranchised grief
generally harder to cope with than socially supported grief
96
How many parents of an adolescent or young adult child died of an accident, suicide, or homicide said they had found meaning in the death 1 year later? 5 years later?
12%
57%
97
years after their loss, bereaved parents tend to be less ___________ than adults who have not lost a child
happy
98
The age of the child who dies has what type of relation to the severity of the grief?
little relation
parents grieve for an adult child as much as for a younger child or adolescent
99
death of a child does what to the family system?
rattles the whole family system, affecting the marital relationship, parenting, and the well-being of surviving siblings, grandparents, and other relatives
100
Siblings of a child who dies are more likely to face what?
often remain deeply affected and may struggle in school and develop behavior and mental health problems
101
loss of a parent is what type of life experience?
a normative life transition that most of us will experience - most of us do not have to face this event until we are in middle age
102
Which type of loss is usually not as difficult to adjust to?
adjusting to the death of a parent is usually not as difficult as adjusting to the death of a romantic partner or child
103
The Grief Work Perspective
The view commonly held, but now challenged, that to cope adaptively with death bereaved people must confront their loss, experience painful emotions, work through these emotions, and move toward a detachment from the deceased.
grew out of Freudian psychoanalytic theory
104
What perspective is commonly held in our society about grief?
The Grief Work Perspective - among both therapists and members of the general public, and it influences what we view as an “abnormal” reaction to death
105
Challenges to the Grief Work Perspective
may be culturally biased
little support for the grief work perspective’s assumption that bereaved individuals must confront their loss and experience painful emotions to cope successfully - Delayed grief is extremely rare
growing evidence that too much “grief work" may backfire and prolong psychological distress
view that we must break our attachment bonds to the deceased to overcome our grief is flawed
106
continuing bonds
Maintenance of attachment to a loved one after the person’s death through reminiscence, use of the person’s possessions, consultation with the deceased, and the like.
Bereavement rituals in some cultures are actually designed to ensure a continued bond between the living and the dead
107
internalized continuing bonds
involve keeping the loved one psychologically close through mental images and memories,
tend to aid adjustment
108
Externalized continuing bonds
involve seeking physical proximity and may depend on illusions and hallucinations—for instance, seeking comfort from the loved one’s possessions or visiting the grave every day—reflect continued efforts to reunite
associated with difficulty coping
109
What factors affect coping well with grief?
Personal Resources
Nature of the loss
Supports and Stressors
110
What are Personal Resources?
personality and coping style
Attachment style
111
personality and coping style - how does it affect grief?
individuals who are emotionally stable cope well, whereas those who score high on the Big Five personality dimension of neuroticism have more difficulty coping
Many also rely on ineffective coping strategies such as denial or avoidance, escape through alcohol and drugs, or unproductive rumination about their loss
people who are optimistic, look for and find positive ways of interpreting their loss, and use active coping strategies experience less intense grief reactions and are more likely to report personal growth after their losses
112
Bowlby’s 4 attachment styles
secure attachment style
resistant (or preoccupied) attachment style - being highly anxious about being abandoned
avoidant (or dismissing) attachment style - difficulty expressing emotions or seeking comfort
disorganized (or fearful) attachment style - rooted in unpredictable and anxiety-arousing parenting
113
Bowlby’s attachment theory - coping with death
emphasizes that early experiences in attachment relationships influence whether one has a secure or insecure attachment style - systematically related to reactions to death
114
How do each of the 4 attachment styles typically relate to coping with death?
secure attachment style - associated with coping relatively well
resistant (or preoccupied) attachment style - linked to being overly dependent and displaying prolonged grief and anxiety after a loss, ruminating about the death, and clinging to the lost loved one
avoidant (or dismissing) attachment style - may do little visible grieving and may minimize how much they miss their loved one
disorganized (or fearful) attachment style - associated with being especially ill-equipped to cope with loss; these individuals may turn inward, harm themselves, or abuse alcohol or drugs
115
How does the nature of the loss relate to ability to cope? what is the key factor?
closeness of the person’s relationship to the deceased is a key factor
cause of death can also matter:
advantages of being forewarned of death when a loved one is terminally ill may be offset by the strains of caregiver burden during the illness
sudden deaths that are violent or traumatic, such as suicides, homicides, motor-vehicle crashes, and terrorist attacks, appear to be especially difficult to bear and are more likely than deaths from natural causes to result in prolonged or complicated grief
sudden deaths like heart attacks are not necessarily harder to cope with in the long run than expected deaths from illnesses, although the initial grief reaction may be more intense
116
especially important for the child or adolescent whose parent dies to receive...
supportive parenting
117
outcomes tend to be poor for widows and widowers who must cope with...
financial problems after bereavement, manage household tasks they are not used to managing, single-handedly raise young children, find new jobs, or move
118
Posttraumatic growth
Positive psychological change resulting from highly challenging experiences such as being diagnosed with a life-threatening illness or losing a loved one
nearly half of people who have experienced traumas of various kinds report such growth, with the numbers varying from 10 to 77% across studies
119
Hospice
A program that supports dying persons and their families through a philosophy of caring rather than curing, either in a facility or at home.
Participants typically must be judged to be within 6 months of death
120
palliative care
Care aimed not at curing but at meeting the physical, psychological, and spiritual needs of dying patients even while their illnesses are still being treated
121
Key features of hospice care:
dying person and his family—not the “experts”—decide what support they need and want
Attempts to cure the patient or prolong his life are deemphasized (but death is not hastened either)
Pain control and comfort are emphasized
setting for care is as normal as possible
Bereavement counseling is provided to the family before and after the death
122
Results of hospice care:
Patients have less interest in physician-assisted suicide because their pain is better controlled
they spend more of their last days without pain, undergoing fewer medical interventions and operations
the relatives of dying people rate the quality of the death experience more positively and display fewer symptoms of grief
123
The Family Bereavement Program
a well-studied intervention for families in which a parent has died
A behavioral approach involving modeling and role-playing of target skills and homework assignments to apply skills was used
124
A group of 10 parents who suddenly lost their children is meeting to acknowledge the anniversary of their loss. How many of these parents have come to terms and see meaning in their children's death within one year of the event?
1
125
Jasmine just delivered a baby girl. What is the average life expectancy of her new daughter?
81 years
126
what term best reflects the grief work perspective regarding people's approaches to bereavement?
judgmental
127
what intervention will likely be most successful in helping parents Thom and Kelly effectively support their son Caleb in the death of his twin sister Holly?
family therapy
128
In Texas last year, 3,000 babies were delivered. About how many of them likely did not survive infancy?
18
129
According to the Parkes/Bowlby model, a toddler whose mother leaves the room and a man whose wife has passed away will both feel which of the following?
yearning
130
what is a biological impact adolescents who are grieving the loss of a parent may experience?
Higher levels of cortisol
