Insel11e ppt23

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  • Figure 23-1 Sample living will
  • Figure 23-2 The need for organ donors
  • Insel11e ppt23

    1. 1. Chapter 23© 2010 McGraw-Hill Companies. All Rights Reserved.
    2. 2. Why Is There Death?  There is no completely satisfying answer to the question of why death exists  Death promotes variety through the evolution of species  From the perspective of species survival, the cycle of life and death makes sense  Death challenges our emotional and intellectual security© 2010 McGraw-Hill Companies. All Rights Reserved. 2
    3. 3. What is Death?  Defining death  Defined as cessation of the flow of vital bodily fluids ○ Cessations of the heart beating and breathing ○ Life-support systems  Brain death ○ Harvard medical school committee – death involves: 1. Lack of receptivity and response to external stimuli 2. Absence of spontaneous muscular movement and spontaneous breathing 3. Absence of observable reflexes 4. Absence of brain activity • Clinical death • Cellular death 3© 2010 McGraw-Hill Companies. All Rights Reserved. 3
    4. 4. Learning About Death  A child’s understanding of death evolves greatly from about age 5 to age 9  Most children cone to understand that death is final, universal, and inevitable  Mature understanding of death  Mark Speece and Sandor Brent’s facts about death, including four components: 1. Universality 2. Irreversibility 3. Nonfunctionality 4. Causality© 2010 McGraw-Hill Companies. All Rights Reserved. 4
    5. 5. Denying Versus Welcoming Death  Understanding death in a mature fashion does not imply that we never experience anxiety about the deaths of those we love or about the prospect of our own death© 2010 McGraw-Hill Companies. All Rights Reserved. 5
    6. 6. Planning For Death  Making a will  A legal instrument expressing a person’s intentions and wishes for the disposition of his or her property after death  Estate  Testator  Intestate  Testamentary letter ○ Document includes information about your personal affairs (bank statements, credit cards, documents etc.)© 2010 McGraw-Hill Companies. All Rights Reserved. 6
    7. 7. Considering Options for End-of- Life Care  Home care  Hospital-based palliative care  Focuses on controlling pain and relieving suffering by caring for the physical, psychological, spiritual, and existential needs of the patient  Hospice programs  Palliative care© 2010 McGraw-Hill Companies. All Rights Reserved. 7
    8. 8. Deciding to Prolong Life or Hasten Death  Withholding or withdrawing treatment  Assisted suicide and active euthanasia  Physician-assisted suicide (PAS) ○ Physician provides lethal drugs or other interventions  Active euthanasia ○ Intentional act of killing someone who would otherwise suffer from an incurable and painful disease© 2010 McGraw-Hill Companies. All Rights Reserved. 8
    9. 9. Completing an Advance Directive  Any statement made by a competent person about choices for medical treatment should he or she become unable to make such a decision  Two forms: 1. Living will 2. Health care proxy ○ Surrogate (the decision maker)© 2010 McGraw-Hill Companies. All Rights Reserved. 9
    10. 10. Figure 23.1 Sample living will© 2010 McGraw-Hill Companies. All Rights Reserved. 10
    11. 11. Becoming an Organ Donor  Each day about 77 people receive an organ transplant while another 19 people on the waiting list die because not enough organs are available  98,000 Americans wait for an organ transplant  Uniform donor card 11© 2010 McGraw-Hill Companies. All Rights Reserved. 11
    12. 12. Figure 23.2 The need for organ donors© 2010 McGraw-Hill Companies. All Rights Reserved. 12
    13. 13. Planning a Funeral or Memorial Service  Disposition of the body  Social, cultural, religious, psychological, and interpersonal considerations  Burial  Cremation  Embalming for a viewing or wake  Arranging a service© 2010 McGraw-Hill Companies. All Rights Reserved. 13
    14. 14. Coping With Dying  Awareness of dying  The tasks of coping  On Death and Dying by Elisabeth Kubler-Ross ○ 5 psychological stages in response to an awareness of imminent death: 1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance  Charles Corr’s four primary dimensions in coping with dying: 1. Physical 2. Psychological 3. Social 4. Spiritual© 2010 McGraw-Hill Companies. All Rights Reserved. 14
    15. 15. Coping With Dying  The trajectory of dying  Useful for understanding patients’ experiences as they near death  Supporting a dying person© 2010 McGraw-Hill Companies. All Rights Reserved. 15
    16. 16. Coping With Loss  Experiencing grief  Bereavement  Mourning  Tasks of mourning 1. Accepting reality 2. Working through the pain 3. Adjusting to a changed environment 4. Emotionally relocating the deceased and moving on with life  The course of grief  Supporting a grieving person  Helping children cope with loss© 2010 McGraw-Hill Companies. All Rights Reserved. 16
    17. 17. Chapter 23© 2010 McGraw-Hill Companies. All Rights Reserved. 17

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