Death, Dying, and Terminal Illness

Question 1

Brain and Cortical Death

Answer 1

No longer any brain function or electrical activity in the brain cells

Question 2

Clinical Death

Answer 2

Heart stops beating or breathing stops for 10 min of more without intervention from another person

Question 3

Psychic Death

Answer 3

Loss of consciousness, but heart continues to beat normally until they die

Question 4

Social Death

Answer 4

Cease of interaction with others because they don’t want to be around others anymore or because others have stopped interacting with them socially for any reason

Question 5

*Age-based understanding of death

Answer 5

Under 3 YO: children don’t have the cognitive and linguistic ability to understand

3-5 YO: Children understand death means that someone is gone, but struggle to understand permanence

5-7 YO: Most understand that death is final but it is not understood biologically

7-9 YO: Most understand that death is final and irreversible; interested in the cause and may believe that thoughts can cause death

9+ YO: Approximate time that death is understood in similar ways to that of adults

Question 6

Life expectancy

Answer 6

An estimate of the average age that members of a particular population group will be when they die

See slide 7 and list out trends

Question 7

Trend in child and adolescent mortality rates in US between 2019 and 2021. Why?

Answer 7

20% increase - largest increase in the last 50 years.

Reason: homicide, accidental drug OD, MVAs, suicide (ages 10-19)

Question 8

Top three leading causes of death in all ages in the US (2020)

Answer 8

1. Heart disease
2. Malignant neoplasms
3. COVID-19

Question 9

Top three leading causes of death in ages 18-25 yo (2020)

Answer 9

1. Unintentional injury
2. Homicide
3. Suicide

Question 10

Indirect death impacts of COVID-19

Answer 10

Increases in mortality due to social isolations and reductions in access to and use of healthcare services. Increases in stress, depression, and substance-use —> increases in suicide

Question 11

Cultural factors that influence perspective of death

Answer 11

Values, religion, personal beliefs, community traditions

Question 12

Common factors of an acceptable or “good” death (4)

Answer 12

• Non-dramatic, disciplined, very little emotion
• Allows for social adjustments and personal preparation
• Not too early
• One dies in the service of their country or religion

Question 13

Premature death and 2 common causes

Answer 13

Dying before the average age of 79

Commonly due to heart attack or stroke

Question 14

Trend in premature deaths - Why?

Answer 14

Declining rate of premature dues mainly due to decreases in lung cancer rates

Question 15

Euthanasia

Answer 15

Ending a person’s life who is in pain or suffering

Question 16

Impact of long-term treatment of chronic illness on psychological well-being

Answer 16

Often extremely taxing and has high psychological costs

Question 17

Living Will

Answer 17

Document that details a person’s procedures and decisions that should be enacted if they incapacitated and unable to make a judgement in a timely fashion

Question 18

*Kubler Ross’ Stages of Death Theory

Answer 18

People spend varying times in each stage of grief. Can refer to one’s own death or a loved one

Shock, Denial, Frustration, Depression, Experiment, Decision, Integration

Question 19

Criticisms of Kubler Ross’ Theory

Answer 19

Procession from one reaction to another is often not in an orderly fashion.

Implies that the bereaved individual has to reach the end in order to achieve “acceptance”

Question 20

*Stroeb and Schuts Dual-Process Model of Grief

Answer 20

Oscillation between loss-oriented behaviors (direct) and restoration-oriented behaviors (indirect)

Question 21

*Bolby and Parker’s Four Phases of Grief

Answer 21

Based on research of children’s reactions to being separated from their caregivers

Phases: shock and disbelief, searching and yearning, disorganization and repair, rebuilding and healing

Question 22

__ in __ Americans who die each year die in a hospital

Answer 22

1 in 3

Question 23

Hospital staff members’ role in patients’ deaths

Answer 23

Depersonalized, yet full of experience - offers a unique perspective that family members often cannot

Question 24

Risks of terminal care for hospital staff (4)

Answer 24

1. Difficult for staff b/c care is often palliative not curative
2. Involves unpleasant custodial work like feeding, changing, and bathing the patient
3. Burnout from watching their patients die
4. Possible temptation to work in efficient, objective ways and not be warm/supportive to minimize their personal pain

Question 25

Palliative care

Answer 25

With terminal illness, this kind of care is designed for comfort, not curative measures

Question 26

Thanatologist

Answer 26

Those who study death and dying

Question 27

Guidelines for terminal care

Answer 27

Informed consent, safe conduct, significant survival, anticipatory grief, timely and appropriate death

Question 28

Hospice Care

Answer 28

May be residential or home-based. Aimed at providing warmth and emotional support to terminally ill patients

Question 29

Home Care

Answer 29

Run by family members. Similar goals to hospice care (warmth and emotional support), but more cost effective. Con: can be a large emotional burden for family members