Four dimensions of death education?
Cognitive, affective, behavioral, valuational
Cognitive dimension of death education
Factual information about death related experiences including facts about death, cultural patterns etc.
Important because: identifies new ways to organize or interpret data- for example learning of a new diseases and causes of death
Affective dimension of death education
Education regarding emotions, feelings, and attitudes, understanding response
Important because: Gives us the awareness of appropriate grief reactions and responses
Behavioral dimension of death education
explaining the why of the way people behave regarding death-related situations
Important because: Points out the great value in what individual and social organizations can do-the importance of human presence
Valuational dimension of death education
helps to identify and articulate the basic values that govern human lives
Important because: Gives us perspective on the value we place on our lives and also assisting children with death
Hospice care
- Team approach
- for all ages
- focus on comfort
- covered by insurance
- goal: improve quality of life
- Patient must have a terminal diagnosis of a 6 months or less
- Patients forgo aggressive treatment
Palliative care
- Team approach
- for all ages
- focus on comfort
- covered by insurance
- goal: improve quality of life
- can be established at any time during the illness
- done in an institutional setting
Pre-active Phase of dying
- 7 to 14 days before death
- Weakness and fatigue
- Increased dependence on caregivers
- Bed bound status in formerly active patients Increased sleep
- Progressive disorientation
- Limited attention span
- Restlessness
- Decreased interest in food and fluid Difficulty swallowing
- Loss of bladder and/or bowel control
Active phase of dying
- 2 to 3 days before death
- Decreased responsiveness
- Eyes glassy, pupils unfocused
- No interest in food or fluid
- Lowered blood pressure
- Abnormal respiratory pattern
- Blood pressure and pulse difficult to obtain
- Progressive cooling and mottling of extremities
- Excess secretions/ terminal congestion
- Lowered skin temperature (skin cool, clammy or damp)
Anticipatory grief
- Grief felt by the family or the person dying before the actual death
- same symptoms of grief after a loss
5 Stages of grief
Established by Elisabeth Kubler Ross:
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
Complicated grief: Inhibited/absent grief
A pattern in which persons show little evidence of the
expected separation distress, seeking, yearning, or other characteristics of normal
grief.
Complicated grief: Delayed grief
A pattern in which symptoms of distress, seeking, yearning, etc., occur at a much later time than is typical
Complicated grief: Chronic grief
A pattern emphasizing prolonged duration of grief symptoms
Complicated grief: Distorted grief
A pattern characterized by extremely intense or atypical symptoms
Children grief: infancy - 2yrs
Not able to understand death, Separation from mother causes changes
Response: Quietness, crankiness, poor sleep, weight loss
Children grief: 2- 6yrs
Death is temporary, not final, Dead person can come back to life
Response: Asks many questions(How does she eat?)
Problems in eating, sleeping, regression, tantrums/Magical Thinking
Children grief: 6- 9yrs
Death is often thought of as a person or spirit, Death is final and frightening
Response: Curious about death, asks specific questions. Some concerns about imaginary illnesses. May feel abandoned
Children grief: 9 and older
Death is final and cannot be changed, Everyone will die
Response: Heightened emotions, sleeping problems, increased anxiety over own death
Euthanasia
- involves a physician or another third party administering the medication
- is illegal in all states of the United States
Physician assisted suicide
Requires the patient to administer the medication and to determine when and where to do this
Legal in the states of Washington, Oregon, and Montana, and most recently Vermont
Depression and the terminally ill
many caregivers suffer from depressive symptoms, chances of depression are greater in women
Women and caregiving
Women comprise two-thirds of all unpaid caregivers
The Four Things that Matter Most
Forgiveness, Thank You, I love you, Goodbye