This chapter discusses various topics related to dying and death including: 1) The psychological stages of dying including denial, anger, bargaining, depression, and acceptance. 2) Near-death experiences and common phenomena reported like out-of-body experiences and seeing deceased loved ones. 3) Interacting with dying people by being honest, providing support, and allowing expression of feelings. 4) End-of-life options like hospice care, euthanasia, physician-assisted suicide, and advance healthcare directives.

1. Chapter Seventeen Accepting Dying and Death

2. 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

3. Psychological Stages of Dying Denial Anger Bargaining Depression Acceptance

4. 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

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

6. 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

7. 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

8. 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

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

10. Living Will

11. 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

12. Planning an Organ Donation

13. 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

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

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

16. 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

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

18. Chapter Seventeen Accepting Dying and Death