Knowledge Of Foundation Of The Field


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Knowledge Of Foundation Of The Field

  1. 1. Assignment 8-2 1 Walter L Graboski October 19th, 2008 Developmental Psychology Shoshana Dayanim, PhD. Argosy University Knowledge of foundations of the field: 1
  2. 2. Assignment 8-2 2 The issue in determining death twenty-five years ago was simpler than it is today. Theend of certain biological functions, such as breathing and blood pressure, and the rigidity of thebody (rigor mortis) were clear signs of death, (Santrock, 2008,). However, in the past decades,defining death has become more complex, ( Corr, Nabe, and Others, 2003,). Therefore, one issueis brain dead, which is a neurological definition of death, which states that a person is brain deadwhen all electrical activity of the brain has ceased for a specific period of time. Furthermore, thedefinition of brain death currently followed by most physicians includes the death of both thehigher cortical functions and the lower brain stem functions, (Bernat, 2005, cited Santrock,2008,). The second type of death is euthanasia, (easy death) is the act of painlessly ending thelives of individuals who are suffering from an incurable disease or severe disability. Therefore,this disease is sometimes called “mercy killing” (Santrock, 2008,). However, there are two typesof euthanasia. First, passive euthanasia, occurs when a person is allowed to die by whit holdingavailable treatment, such as withdrawing a life-sustaining device. For example, this mightinvolve turning off a respirator or a heart –lung machine, (Santrock, 2008,). Second, is activeeuthanasia, occurs when death is deliberately induced, as when a lethal dose of drug is injected,(Santrock, 2008,). Therefore, questions like can a comatose persons life-support be disconnectedwhen the patient has written no instructions to that effect? Does the family of a comatose patienthave right to over rule the attending physician’s decision to continue life support systems? Thesequestions have no simple or universally agreed-upon answers, (Kelly, & McLoughlin, 2002,cited Santrock, 2008,). However, the most widely publicized cases of active euthanasia involveassisted suicide, ( Hicks, 2006, Wolf, 2005, cited Santrock, 2008,) Active euthanasia is a crimein most countries and in all states in the United States except Oregon, ( Hedberg, Hopkins, 2
  3. 3. Assignment 8-2 32003,). However, a survey of more than nine hundred physicians assessed their attitudes aboutactive euthanasia where most opposed and said, “ That adequate pain control often eliminates theneed for it, and commented that primary role of the physicians is to preserve life,” ( Walker,Gruman, & Blank, 1999, cited Santrock, 2008,). Needed better care for dying individuals: Death in America is often lonely, prolonged,and painful, (Institute of Medicine, 1997, cited Santrock, 2008,). However, scientific advancessometimes have made dying harder by delaying the inevitable, (Kaufaman, 2005, cited Santrock,2008, ) Also, even though painkillers are available, too many people experience severe painduring the last months of life, ( Fine, & Peterson, 2002,). Therefore, there are a few- safemeasures for avoiding pain at the end of life. First, making a living will, and be sure there issomeone who will draw your doctor’s attention to it. Secondly, give someone the power ofattorney and make sure this person knows your wishes regarding medical coverage. Thirdly, giveyour doctors specific instructions from “Do not resuscitate” to “Do everything possible” forspecific circumstances. Fourthly, if you want to die at home, talk it over with your family anddoctor. Finally, check to see whether your insurance plan covers home care and hospital care,( Cowley & Hager, 1995, cited Santrock, 2008,). On the other hand, there is a program calledhospice which is committed to making the end of life as free from pain, anxiety, and depressionas possible. Hospice movement began toward the end of the nine-teen sixties in London, when anew kind of medical institution, St. Christopher’s opened. The primary goal is to bring painunder control and to help dying patients face death in a physiologically healthy way. Hospicealso makes every effort to include the individuals’ family, (Reb, 2003, ; Johnson & Others, 2005,cited Satrock, 2008,). Whereas hospitals goals are to cure illness and prolong life, hospice 3
  4. 4. Assignment 8-2 4emphasizes palliative care, which involves reducing pain and suffering and helping individualsdie with dignity, ( King & Quill, 2006, cited Santrock, 2008,). There are two subjects explained in death in cultural context. First, changing historicalcircumstances; Therefore, as explained earlier a historical change involving death is determiningwhen someone is truly dead. Another is change that involves the age group in which death mostoften strikes. Therefore, today, death occurs most often among older adults , ( Lamb, 2003, citedSantrock, 2008,). The life expectancy has increased from forty-seven years for a person born innine-teen hundred to seventy-eight years for someone born today, ( U.S. Bureau of Census,2006, cited Santrock, 2008,). However, in the nineteen hundreds most people died at home, caredby their family, whereas today as the population grows more people die away from theirfamilies. In the United States today, more than eighty percent of all deaths occur in institutions orhospitals, (Santrock, 2008,). The death in different cultures varies as the experience and attitudes vary. For example,to live a full live and die with glory was the prevailing goal of ancient Greeks, whereasAmericans are conditioned from early in life to live as though they were immortal, in much ofthe world this fiction cannot be maintained, (Santrock, 2008, ) Furthermore, most societiesthroughout history have had philosophical or religious beliefs about death, and most societieshave a ritual that deals with death, ( Lobar, Youngblut, & Brooten, 2006, cited Santrock, 2008,).Examples include the following, death may be a punishment for ones’ sins, an act of atonement,or a judgment of a just God. For some, death means loneliness; for others, death is a quest forhappiness. Others death represents redemption, a relief from the trials and tribulations of theearthly world. For those who welcome death, it may be seen as the fitting end to a fulfilled life,(Santrock, 2008,). However, in the United States, we are death avoiders and death deniers, 4
  5. 5. Assignment 8-2 5( Norouzieh, 2005, Taylor, 2003,). Therefore, this denial can take many forms including: Thetendency of the funeral industry to gloss over death and fashion lifelike qualities in the dead.Another, the adoption of euphemistic language for death- for example, exiting, passing on, neversay die, and good for life, which implies forever. Thirdly, the persistent search for a fountain ofyouth. Fourthly, the rejection and isolation of the aged, who may remind us of death. Finally, theadoption of the concept of a pleasant and rewarding afterlife, suggesting that we are immortal,(Santrock, 2008,). There are two issues that will be discussed in the developmental perspective on death.First, the causes of death can be at any point in a life span. In child hood death occurs most oftenbecause of accidents or illness; However, SIDS is the leading cause of death in the United States,(Santrock, 2008,) Compared with childhood, death in adolescence is more likely to occurbecause of motor vehicle accidents, suicide, and homicide. Finally, older adults are more likelyto die from diseases, such as heart and cancer, where as younger adults are more likely to diefrom accidents. Of course, younger adults can die of diseases and cancer too, ( Santrock, 2008,). The final issue is attitude toward death at different points in the life span. First,childhood, most researchers believe that infants do not have even a rudimentary concept ofdeath. Furthermore, even children ages three to five years of age are confused with death andmay ask, “Why is he or she sleeping?” On the other hand, sometime in the middle and latechildhood years more realistic perceptions of death develop. In one early investigation pfchildrens perception of death, children three to five years of age denied death exists, children sixto nine believed that death exists but only happens to some people, and children nine years of agerecognized death’s finality and universality, (Nage, 1948, cited Santrock, 2008,) In conclusion,the best strategies that can be adopted in discussing death with children are the following. First, 5
  6. 6. Assignment 8-2 6most psychologists consider honesty is the best concept. However, it also depends on the child’smaturity level. For example, the preschooler requires a less elaborate explanation than an olderchild. Actually, what young children need more than an elaborate explanation of death isreassurance that they are loved and will not be abandoned, (Santrock, 2008,) In adolescence, the prospect of death, like the prospect of aging is regarded as a notion soremote that it does not have much relevance. Therefore, the subject may be avoided, glossedover, kidded about, and controlled by a cool, spectator-like orientation. This perspective istypical of the adolescent’s self-conscious thought; however, some adolescents do show a concernfor death, both trying to fathom its meaning and in confronting the prospect of their own demise,( Baxter, Stuart, & Stewart, 1998, cited Santrock, 2004,) In addition, adolescents develop moreabstract conceptions of death than children do. For example, adolescents describe death in termsof darkness, light, transitions, or nothing less, ( Wenestam &Wass, 1987, cited Santrock, 2008,). In early adulthood there is no evidence that a special orientation toward death develops inearly adulthood. Researchers have found that middle aged adults actually fear death more thando younger adults (Kalish & Reynolds, 1976, cited Santrock, 2008,). Furthermore, older adults,though, think about death more and talk about it more in conversations with others than domiddle aged and young adults. They also have more direct experiences with death as their friendsand relatives become ill and die, ( Hayslip & Hansson, 2003,). Younger adults who are dyingoften feel cheated more than do older adults who are dying, (Kaylish, 1987, cited Santrock,2008,). Where as older adults are less likely to have unfinished business than younger adults.They usually do not have children who need to be guided to maturity, their spouses are morelikely to be dead, and they are less likely to have work related projects that require completion,(Santrock, 2008,). 6
  7. 7. Assignment 8-2 7Facing one’s own death: Knowledge of death’s inevitability permits us to establish priorities and structure our timeaccordingly. As we age, these priorities and structures change in recognition of diminishingfuture time. Furthermore, values concerning the most important uses of time also change. Forexample, when asked how they would spend six remaining months of life, younger adultsdescribed such activities as traveling and accomplishing things they previously had not done yet;older adults described more inner focused activities contemplation and meditation , ( Kalish &Reynolds, cited Santrock, 2008,).Kubler Ross Stages of Dying: The five stages of dying according to Kubler Ross are the following: First, denial andisolation, in which the person denies that death is really going to take place. The person may say,“No it can’t be me. It’s not possible.” This is common reaction to terminal illness. However,denial is usually a temporary defense. Therefore, it is eventually replaced with increasedawareness when the person is confronted with such matters as financial considerations,unfinished business, and worrying about surviving family members, (Santrock, 2008,). Secondstage is anger, in which the dying person recognizes that denial can no longer be maintained.Denial often gives way to anger, resentment, rage, and envy. The dying persons question is,“Why me?” At this point, the person becomes more increasingly difficult to care for as angermay become displaced and projected onto physicians, nurses, family members, and even God,(Santrock, 2008,). The third stage is bargaining, in which the person develops the hope that deathcan somehow be postponed or delayed. Some people enter into a bargaining or negotiation oftenwith God, as they try to delay their death, (Santrock, 2008,). The fourth stage is depression, inwhich the dying person comes to accept the certainty of death. At this point, a period of 7
  8. 8. Assignment 8-2 8depression or preparatory grief may appear. The dying person may become silent, refuse visitors,and spend much of the time crying or grieving. This behavior is normal and is an effort todisconnect the self from love objects, (Santrock, 2008,). The final stage is acceptance, in whichthe person develops a sense of peace, an acceptance of one’s fate, and in many cases, a desire tobe left alone. In this stage, feelings and physical pain may be virtually absent. The current evaluation of Kubler approach according to Robert Kasterbaum, (2004,) isthere are some problems with Ross’ approach. First, the existence of the five stage sequence hasnot been demonstrated by either Ross’ or independent research. Secondly, the stageinterpretation neglected the patients’ situations, including relationships support, specific effectsof illness, family obligations, and institutional climate in which they were interviewed,(Santrock, 2008,). In conclusion, the effective strategies for communicating with a dying person include thefollowing. First, establish your presence, be at the same eye level; don’t be afraid to touch thedying person. Second, eliminate distraction; thirdly, if the dying person is frail you may not wantto visit. Fourthly, don’t insist that the dying person feel acceptance about death if the dyingperson wants to deny the reality of the situation. Another, allow the dying person to expressguilt, or anger; encourage the expression of feelings. Don’t be afraid to ask the person what theexpected outcome for the illness is. Discuss alternatives, unfinished business. Encourage thedying individual to reminisce, especially if you have memories in common. Talk with theindividual when she or he wishes to talk. If possible, make an appointment and keep it. Finally,express your regard for the dying individual. Don’t be afraid to express love, and don’t be afraidto say good-bye, (Santrock, 2008,). 8
  9. 9. Assignment 8-2 9References:Santrock, J. W. (2008). Life-Span Development. New York: McGraw Hill. 9