Death and Dying

Chapter Seventeen Accepting Dying and Death

Definitions of Death
Clinical determinants of death
Medical death certificate
Criteria to establish death
Lack of heartbeat and breathing
Lack of central nervous system function
Presence of rigor mortis

Psychological Stages of Dying
Denial
Anger
Bargaining
Depression
Acceptance

Near-Death Experiences
Acknowledgement of death
Out-of-body experience
Extreme blackness
Encountering love ones who have died
Intense light
Sense of well-being and peace
Decision whether to enter into the light
Return to the body

Interacting with Dying People
Be genuine and honest
Provide emotional support
Allow people to express their feelings

Talking with Children about Death
Use straightforward, age-appropriate language
Avoid shielding
Make certain the child understands
Provide simple, direct answers
The person will never come back
The body has been buried or burned to ashes

End-of-Life Options and Decisions
Hospice care for the terminally ill
Goal is to maximize quality of life
Strategies
Pain control
Family involvement
Multidisciplinary approach
Patient decisions
Follow-up and care for survivors

Euthanasia
Indirect or passive euthanasia
Allowing to die (“do not resuscitate”)
Direct or active euthanasia
Giving a patient a lethal dose of drugs
Physician-assisted suicide
Prescribing a patient a lethal dose of drugs
Oregon Death with Dignity Act

End-of-Life Options and Decisions
Advance Healthcare Directives
Living will
Durable power of attorney for health care

Living Will

Organ Donation
Intention to donate can be stated on driver’s license, but next-of-kin must consent at time of death
Significant shortage of donor organs
Every day:
77 people receive a transplant
110 people join waiting list for a transplant
19 people die waiting for a transplant

Planning an Organ Donation

Grief and Coping: The Experience of Grief
Physical discomfort
Sense of numbness
Feeling of detachment from others
Preoccupation with the image of the deceased
Guilt
Hostility
Disruption in daily schedule
Delayed grief

Coping with Death from Specific Causes
Terminal illness
Accidental death
Natural disasters
Terrorism
Suicide
Murder

Coping with the Death of a Loved One
Child
Miscarriage
Lost after birth
Grieving
Parent
Spouse
Sibling

Rituals of Death
Cultural differences
Full funeral services
Embalming
Calling hours
Funeral service
Memorial service
Disposition of the body
Ground burial
Entombment
Cremation
Anatomical donation
Costs

Personal Preparation for Death
Will
Life insurance
Funeral prearrangements
Anatomical or organ donation
Eulogy
Epitaph

Chapter Seventeen Accepting Dying and Death

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Death and Dying

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