Terminal Illness Flashcards
How has adulthood become more stressful? what shows this difference?
pre vs post recession differences in adult samples have shown that financial stability and income have decreased even tho people are more educated. THey also have more chronic heath conditions, BMI physical symptoms etc. The only thing that is higher is environmental mastery.
What are the 5 stages of dying?
Elizabeth Ross
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
Are there really stages in dying? Pros and cons of stage model.
- describes patients reactions
- points out counselling needs
- breaking the taboo of the topic
BUT - no universal stages to greif
- no mention of anxiety which is important factor
- not everyone goes through those stages, different for every person and is a complex process.
How do children understand death?
- don’t understand. DOn’t think its final, but can sense that it makes adults upset. May describe it as “passing on or gone to heaven”
ages 5-9: death is a bad thing (devil/angel) that takes away a loved one, no biological understanding
ages 9 and up: more undertsanding of biology and physical processes and rituals.
How do adults adjust to illness and dying?
Adolescents/young adults: angry, scared or lonely. THey feel its unfair and that they’re being robbed.
Worried about children fairing without them** which one is this??
Middle aged adults: death is more common (parents, friends)
People are less afraid of death as they age.
What is end of life care and why do we need it?
What do patients want?
pain and symptom management, avoid prolonged dying, have a sense of control, relieve family burden and strengthen relationships with loved ones.
They get: death in hospitals (70% of the time) and with suffering and higher healthcare costs. Less opprotunities for closure and enjoyment of last few days of life.
There is a disparity between what people want and what they get.
SOLUTION
palliative care: improving quality of life.
What are the 4 parts of palliative care?
- Managing symptoms/pain
- Supporting the caregivers
- Psychological social and spiritual well being
- Supporting the bereaved.
Can be pursued without medical interventioned aimed at treating disease.
What is hospice care?
Compassionate care at final stages of life. (6monthts-days before)
Team provides care, family is involved and provides support and recieves support before and after death.
What are end of life decisions?
Advance care planning, written wishes about what one wants and who can make decisions for them. should be of sound mind when making these decsions.
DNR: do not resuscitate, instructions to medical peoples
Who is Dr. Jack Kevorkian?
Dr Death
Advocated for physican assisted dying. Conducted extensive interviews with patients who were of sound mind who all said they wanted to die with dignity. He videoed all this and then gave euthanasia to a patient (he administerd) and was locked up for murder lol.
What is medically assistance in dying?
Criteria need to be met: must be terminally ill (seriously), irreversible/untreatable/unbearable suffering, natural death in near future.
- Clinically administered (euthanasia)
- Self administered (assisted suicide)
How do children respond to dying? How do adults respond to it?
Children don’t really understand and react in a variety of ways.
Survivors routine: return to former routine and take on new tasks (household duties)
Acute grief: numbness, disbelief, saness, missing dead person. last months to years
Complicated grief: severe symptoms causing problems after 6 months (social issues and whatnot)
How is bereavement related to health?
Impaired immune functioning Higher HPA axis acitivity (higher cortisol) SNS actiivty (adrenaline)
Bereaved have a higher risk of death after 1st year of loss, due to cancers, heart issues, accidents and suicide.
Higher mortiatily for men who’ve lost wives than the other way around.
