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Psychology of Death > Final > Flashcards

Final Flashcards

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1
Q

modern dying is…

A

degenerative

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2
Q

modern dying - trajectory

A

slower, gradual (you can live for many years), death is a medical failure

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3
Q

modern dying - % dying in institutions

A

70-80%

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4
Q

cancer survival

A

for females, more preventative if caught early, only 5 (out of 25) types of cancer that dont survive for 5 years

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5
Q

Survival after first heart attack

A

24 hrs - 61%
28 days - 48%
5 years - 36% (lower than cancer)
10 years - 30%

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6
Q

Modern dying - treatment choices

A

hospital stressors, pain from treatment, body esteem threatened, medical compliance, patient role, anxious, chronic stress, lifestyle changes and losses

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7
Q

Psychological coping tasks (6)

A

seek treatment, integrate treatment with life, body changes, maintain self-esteem, coping with pain, prepare for death

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8
Q

Is there evidence that fighting helps?

A

No

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9
Q

Role of optimism and hope (3)

A

Optimism draws social support, hope correlates with self-esteem, but neither seems to prolong life

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10
Q

Additional coping factors (5)

A

concurrent stressors, coping resources, social network, emotional expressiveness, disclosure

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11
Q

Seeing what in death? Coping

A

Meaning, spirituality and illusions

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12
Q

Coping - What is ego transcendence?

A

Focus on post self or symbolic immortality

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13
Q

What are the 3 psychological states in reaction to death?

A

Bereavement, grief, mourning

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14
Q

What is bereavement?

A

Outer behavior. defined by society, acted out as a role

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15
Q

What is grief?

A

Inner behavior, sadness, pain, shock, confusion, guilt, anger, most intense in the first 30 days, death rate rises for 6 months, 1-2 years to be normal

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16
Q

What is mourning?

A

Behaviors used to adapt to loss, highly individualized, mourning with others may help

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17
Q

What does Freud say about mourning?

A

It does not equal depression. Mourning is normal, other-directed, and grief-work

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18
Q

Kubler-Ross: Stages of Dying

A

5 steps: denial, anger, bargaining, depressions, acceptance

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19
Q

Yale Bereavement Study (YBS) Stages

A

Disbelief (denial), anger, yearning (bargaining), depression, acceptance

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20
Q

YBS Key findings

A

All reactions occur simultaneously, regular but complex pattern

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21
Q

YBS - first 3 months

A

acceptance, yearning and disbelief

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22
Q

YBS - 4-8 months

A

worst period, less disbelief, rising anger and depression

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23
Q

YBS - 1 year

A

yearning and disbelief less, rise in anger and depression

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24
Q

YBS - 2 years

A

Depression still lingers, acceptance dominates

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25
Grief Work (3): Freud& Bowlby
Emotion-oriented view of grief, love energies blocked, reworking of attachments
26
Maggie
Movie: child is dead, but mom still visits the grave with her ghost
27
Task-based grieving: Worden
popular. Emhasize coping, accept loss, experience pain of loss, adjust roles and adapt to changes, withdraw and reinvest love in the living
28
Due-Process Model: Stroebe
2 stressors: grieving the loss, restoring one's life. Strong ambivilance. Approach-avoidance conflicts. Imbalance and conflict
29
Narrative Model: Walter
Grief is not just emotion, shift in thoughts and memories (my wedding will miss my dad), storytelling
30
Pennebaker writing experiments
Physical health better over next year with higher positive emotion, higher causes, reasons
31
Aspect of Complicated Grief - Idealization
Unusually positive distortion of memories
32
Aspect of Complicated Grief - mummification
attempts to preserving dea person's life
33
Aspect of complicated grief - memorialization
excessive effort at public recognition of loss
34
Aspect of complicated grief - chronic grieving
Lifestyle built around mourning behaviors
35
Aspect of complicated grief - Repression via busyness
Avoidance or normal grieving
36
Aspect of complicated grief - substance abuse
Repression via drug dependance
37
Aspect of complicated - Disenfranchised grief
Social stigmas block normal mourning
38
How is end-of-life care?
Far from ideal
39
Ideas to fix problems with end-of-care? (4)
Training for nurses, monitoring of patient needs, daily updates for doctor, care for family concerns
40
Problems with end-of-care? (3)
Doctors did not know patient wishes, patient choices are not implemented, families and patients are frustrated by pain
41
Reasons for problem with care?
Medicine is focused on treatment, avoidance and denial, legal concerns
42
AMA standard for medical futility?
When intervention to prolong life become futile, physicians are obligated to shift to intent of care for comfort and closure
43
Is futility scientifically objective?
No, values are involved
44
AMA - fair review process
5 steps for communication, alternatives and conflict resolution
45
Advanced directives
Incase you become crazy, your wishes can still be heard
46
Healthcare power of attorney
Living will, natural death declaration
47
California: Health Care Decisions Law
Designates a health care agent if incapable of making decisions
48
Palliative care
Alternative. Emphasis on comfort, social emotional and spiritual support, and pain management.
49
De-institutionalization of care (5)
Alien settings, legal constraints, under-medication of pain, family stress, expensive
50
Hospice
Good death is natural, comfortable
51
Hospice - requirements
6-month diagnosis, stopped curative
52
Reasons for late referral to Hospice
Lack of awareness, communication hurdles, physician reluctance, patient denial, fear of assisted death
53
CA - Right to know Act
Disclosure of all options, hospice info, right to refuse care, stop eating or drinking,
54
What does VSED stand for?
Voluntary stop eat and drink
55
Euthanasia - arguments for (4)
dying is lingering, suffering has no purpose, choice helps patients, we do it to animals
56
Passive Euthanasia
withdrawal of ususal treatment, DNR, removal of respiration, may take 2-3 weeks to die. Legal in US
57
Active Euthanasia
Action taken by some other person that causes death, voluntary or involuntary, injection of lethal drugs, only legal in Netherlands.
58
Who is Dr. Jack Kevorkian
Performed 130 assisted suicides, convicted of murder in 1998
59
Physician-assisted death (PAD)
Voluntray, patient takes acion, injection. Legal in Oregon, Washington, and Montana. 72% approval vote
60
Oregon Death with Dignity Act
15 days waiting period, first request to death=42 days, oral barbiturate, 25 minutes to die, 40-50 deaths per year

Psychology of Death (3 decks)

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