L10: psychosocial factors in dying and aging, ch 15 Flashcards
what is our definition of death? when is it premature? what is a different definition that some people are arguing for?
- irreversible loss of circulation and respiration or irreversible loss of brain function
- < 75 or 70 age = premature
- some people argue that it should be put on a continuum
what is palliative care? what is it associated with?
- care that is focused on improving quality of life and reducing suffering in patients with chronic/terminal illness
- standard form of care in nursing homes
- associated with improved personal control and availability of support, though it can be problematic for family members
what are 5 goals in end-of-life care? what is the main goal?
- help patient achieve death with dignity
- informed consent (offer knowledge, encourage involvement)
- safe conduct (act as helpful guides for patient)
- significant survival (help patient make most of time)
- anticipatory grief (aid patient and family with sense of loss)
- timely and appropriate death (patient should be allowed to die when and how they
want, as much as possible)
what are some health disparities in end-of-life care?
- racialized individuals…
- lower use of palliative care services
- worse symptom control
- less likely to have end-of-life wishes documented or respected
- indigenous cultural needs and traditions related to death and dying often go unaccommodated in Canadian hospitals
what is medically assisted dying? how does it differ from euthanasia?
- euthanasia:
- administered by doctors
- MAiD
- materials provided by doctors, but administered by patient
- physicians knowingly and intentionally providing a person with the knowledge or means required to end their life
compare Bill C-14 with Bill C-7
- BILL C-14
- mentally competent adults with a serious and incurable illness or disability
- are in an advance state of irreversible decline
- face a reasonably foreseeable death
- written request in the presence of 2 independent witnesses
- minimum 10-day reflection period
- Bill C-7
- expanded access: death no longer needs to be reasonably foreseeable, meaning that anyone with chronic conditions with suffering can opt for MAiD
- 90-day waiting period and consultation with additional physician
what are current trends on assisted dying in Canada?
- increasing interest
- cancer, neurological disorders, respiratory diseases most common
- only small percentage of total MAID cases were for non-foreseeable deaths
what are 6 concerns and criticisms of MAiD?
- incompatibility with care provider’s ethics
- errors in diagnoses or prognoses
- coercion by family members of physicians
- suicide contagion
- disproportional impacts on vulnerable groups
though MAiD having a disproportionate impact on vulnerable groups is a criticism, why might it not be a huge concern?
- unlikely to be driven by social or economic vulnerability
- more likely to be taken up by higher-income canadians
- patients with lower socioeconomic status were less likely to receive medical assistnace
what is the impact of MAiD on the bereaved? Why?
- less impactful
- they know what to expect
- increased perceived control
- less intense grief response and lower posttraumatic stress
what are 2 main motivating factors for choosing MAiD? how might physical factors play a role?
- functional decline, leading to lowered quality of life
- inability to participate in meaningful activities
what are the stages of dying? it is, and isn’t scientifically valid in which ways?
- denial
- anger
- bargaining
- depression
- acceptance
- this isn’t based on empirical research
- no evidence supporting that these things happen in this order
- however, people do tend to experience these emotions, just not in this order
how is death denial contradictory at the end of life? what is its benefits?
- it involves 2 opposite views of death
- prevents us from being overwhelmed and aids in the acceptance of death
- denying death and minimizing the bleakness of a prognosis
- making plans for one’s death
name and describe 2 autobiographical activities. What are they similar to?
- reminiscence
- recollecting memories of one’s self in the past
- similar to rumination
- life review
- return of memories and past conflicts at end of life
- spontaneous or structured reconciliation of one’s lfie
- similar to reminiscence, but looking at life as a whole
what are 2 cross-generational methods of creating meaning?
- symbolic immortality: continuity/immortality obtained through symbolic means, being remembered in some way
- generativity
- concern for establishing and guiding the next generation
how does religion and spirituality play into personal meaning at end of life?
- religiosity
- endorsing or subscribing to an organized system of beliefs, practices, rituals, and symbols
- only intrinsic religiosity is significantly related to meaning in life
- spirituality
- personal questioner understanding answers to the ultimate questions about life, about meaning, and about relationship to the sacred or transcendent
what is death acceptance? how is it paradoxical? how is this paradox resolved? what is the alternative to death acceptance?
- giving in and realizing the inevitability of death
- paradox: perceived control AND acceptance are important during the end of life and terminal phase
- resolved by using acceptance as a form of control: by accepting death, you are chose to accept reality
how does the fear of death develop as one ages? why?
- young adult
- more likely to fear death
- due to fear of not seeing goals to fruition
- older adults
- experience mortality salience–more likely to think about death
- less likely to fear death due to more experience with loss and death and having lived a long life
- more likely to fear the dying process
