1) The Death System and Cultural Contexts
2) Defining Death and Life/Death Issues
3) A Developmental Perspective on Death
4) Facing One's Own Death
5) Coping with the Death of Someone Else
Review of the latest research in the field on grief therapy and practice tips for practitioners. Topics include:
• The difference between normal grief and complicated or prolonged grief
• Research and issues involved in the inclusion of “Prolonged Grief Disorder” in DSM-V
• Cognitive behavioral techniques to treat prolonged grief
• The importance of self-awareness and the necessity of self-care when providing grief counseling
• Different cultural views of death
Presented by Susan Stuber, Ph.D. at the Philadelphia Society of Clinical Psychologists continuing education conference at the Philadelphia College of Osteopathic Medicine, March 22, 2013. A copy of the full presentation notes accompanying these slides may be obtained by contacting Dr. Stuber at sstuber@susanstuberphd.com.
Review of the latest research in the field on grief therapy and practice tips for practitioners. Topics include:
• The difference between normal grief and complicated or prolonged grief
• Research and issues involved in the inclusion of “Prolonged Grief Disorder” in DSM-V
• Cognitive behavioral techniques to treat prolonged grief
• The importance of self-awareness and the necessity of self-care when providing grief counseling
• Different cultural views of death
Presented by Susan Stuber, Ph.D. at the Philadelphia Society of Clinical Psychologists continuing education conference at the Philadelphia College of Osteopathic Medicine, March 22, 2013. A copy of the full presentation notes accompanying these slides may be obtained by contacting Dr. Stuber at sstuber@susanstuberphd.com.
'Loss, Grief and Bereavement Coping with Loss and Grief'Dr Wango Geoffrey
A new dawn has come in our lives in which we must be willing to face the reality of our lives. Part of that reality is the imminence of death. Death can be confusing especially with the advancement of medicine, science and technology and various attempts to make meaning and sense of our world. Ultimately, when death occurs, persons may oscillate between feelings of sadness and anticipation, especially when there is a lot of pain and suffering and hence our love and commitment to our loves ones is juxtaposed with relieve from pain. The interrelationships in our lives affect us all. The fact that death takes away our loved ones can be a panacea for disaster. The purpose of this presentation is to assist persons cope with loss and grief.
Theory lecture for first semester RN students about the special needs of older adults. We have a growing older adult population.. we need education patients and family members how to adapt to this aging changes.
Dr. Elizabeth Paulk gives an excellent review of palliative care topics including end of life discussions, hospice, pain management, and family counseling.
'Loss, Grief and Bereavement Coping with Loss and Grief'Dr Wango Geoffrey
A new dawn has come in our lives in which we must be willing to face the reality of our lives. Part of that reality is the imminence of death. Death can be confusing especially with the advancement of medicine, science and technology and various attempts to make meaning and sense of our world. Ultimately, when death occurs, persons may oscillate between feelings of sadness and anticipation, especially when there is a lot of pain and suffering and hence our love and commitment to our loves ones is juxtaposed with relieve from pain. The interrelationships in our lives affect us all. The fact that death takes away our loved ones can be a panacea for disaster. The purpose of this presentation is to assist persons cope with loss and grief.
Theory lecture for first semester RN students about the special needs of older adults. We have a growing older adult population.. we need education patients and family members how to adapt to this aging changes.
Dr. Elizabeth Paulk gives an excellent review of palliative care topics including end of life discussions, hospice, pain management, and family counseling.
http://positivetranceformations.com.au/blog/the-five-stages-of-grief-2/ According to Dr Kübler-Ross, there are five well-defined stages in the grief process, all of which are important parts of the way that we react to the inevitable loss that life brings. If we are unable to express grief during any stage of the process, the grief can become blocked or bottled up, and will need to be released later.
Identifying, Understanding and Working with Grieving Parents in the NICUKirsti Dyer MD, MS
This lecture was prepared and given at the First Annual Perinatal Conference held by the March of Dimes Valley Division in Modesto California in November 2005. I was one of the speakers invited to present as a former NICU Parent and a Grief, Loss and Bereavement expert.
Contact me if you are interested in using this lecture.
Note: This lecture is copyright under Attribution-Non-Commercial-NoDerivs license.
کازمتیک - مراقبت های پوستی برای بیماران شیمی درمانیMohammad Baghaei
دارو های شیمی درمانی موجب بروز خشکی در پوست می گردد لذا برای مدیریت و کنترل این نوع عوارض لام است تا مراقبتهای خاصی برای پوست این بیماران صورت پذیرد که در این اسلاید ها به آن می پردازم
This webinar educates professionals on strategies for recognizing and addressing the unique physical, emotional, and behavioral manifestations of grief and loss among healthcare and other helping professionals.
1. To understand the circumstances and consequences of terminal illness and death.
2. To understand grief in the context of impending death- both in the aware patient, the caregiver and loved ones
3. To explore the understanding of death across cultures
4. To develop relevant skills in dealing with death in clinical situations, with specific reference to dementia
Module 3 Death & Dying Death in Childhood Adult Assu.docxkendalfarrier
Module 3 Death & Dying
Death in Childhood
Adult Assumptions
About Children and Death
• Children are seldom given the opportunity in
family discussions to talk about death-related
topics
• Adults often have their own fears, doubts, and
conflicts, which often get communicated to their
children
• Freud thought that parents wanted to believe
that their children live in a fairy-tale world safe
from the reality of death
Lessons from the
Research Case Histories
• It is the death of particular people or animals that
enlists the child’s concern
• Death-related experiences, attitudes and
behaviors are part of the intimate flow of life
between children and their parents
• There may be several different orientations
toward death within the same household
Lessons from the
Research Case Histories
• Parents whose own discomfort interferes with
their responses to their children’s death-related
curiosity are likely to perpetuate these anxieties
for another generation
• There is now a transitional generation of parents
who are trying to communicate in an open
manner with their children, although their own
experience was of family silence about death
Stages of Death Comprehension
in Childhood (Nagy)
• Research conducted in 1948/1969, involving
378 children, ages 3 to 10
• Stage 1, ages 3 to 5, Focus on Absence
• Very curious about death and death-related items, like
coffins, the cemetery, and also the funeral
• Death is a continuation of life but in a diminished form
(such as diminished sight or hearing)
• Death is temporary
• Death is departure and separation
• Death aroused anxiety
Stages of Death Comprehension
in Childhood (Nagy)
• Stage 2, ages 5 to 9, Focus on Finality
• Death is represented as a person
• Death is dangerous, invisible, like a skeleton, and
comes out in the dark
• Death has mysterious power
• Belief that death might still be eluded (for example,
you might get killed crossing the street, but not if you
look both ways and be careful about crossing the
street)
• Death is not recognized as universal and personal
Stages of Death Comprehension
in Childhood (Nagy)
• Stage 3, beginning about age 9, Focus on
Personal, Universal, and Inevitable
• Realizes that death is final
• Realizes that death will come to him or her as well
• Discussion of death has a more adult quality
• May add a moral, poetic, or religious dimension
Additional Research Findings
• Children with superior intellectual and verbal ability
demonstrated more advanced death concepts than
others their same age
• No difference in death concepts based on SES
• Gender: boys are more likely to depict violent deaths
than girls
• Younger children seem to focus on separation anxiety
• Older children see death as scary and begin to use
symbols to represent death concepts
Cultural Influences on Children’s
Concepts of Death
• U.S. ch.
Transitions: How can we help?
Wendy Duggleby
Persons receiving palliative care services and their families experience multiple, complex and concurrent significant changes which impact their hope and quality of life. This presentation will focus on the findings from several research studies on transitions and quality of life. An online “Changes Toolkit” developed for persons receiving palliative care and their families will also be presented.
The goal of this webinar is to educate professionals on strategies for recognizing and addressing the unique physical, emotional, and behavioral manifestations of grief and loss among healthcare and other helping professionals.
A warm welcome to CRESTBD's webinar slides for "Stigma123 & Bipolar Disorder"! An idea readily accepted in academic literature, the three levels of stigma is not yet a robust part of the mainstream discussion about stigma. We'll share both the lived experience and research perspectives of our team.
The Ties that Bind: Depression and DisabilityEsserHealth
The Disability status of an individual and their risk of concomitant mental health needs is linked. If you or a loved one are considering going out on " disability" be sure you have the tools to deal with depression and the like. Reach out, find support and be proactive.
Disability and Mental Health: The Ties that BindEsserHealth
Depression and Disability: The Ties That Bind. See how Disability and Depression work hand in hand. Learn the most recent statistics in disability science and how essential it is to tackle the whole picture to help the whole patient.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
2. 20 - 2
Chapter Outline
• What is the death system and what is its
cultural & historical context?
• How can death be defined?
• What is the developmental perspective on
death?
• How do people face their own death?
• How do we cope with the death of someone
else?
3. 20 - 3
Components of the Death System
Kastenbaum (2012)
• People: everyone (at some point of time);
those in funeral industry; policemen; firemen
• Places or contexts: e.g. hospitals, funeral
homes,
• Times: anniversaries & memorial events
• Objects: e.g. caskets, armbands
• Symbols: e.g. religious ceremonies connected
to death
4. 20 - 4
Cultural Variations of the Death System
• Ancient Greeks – to live a full life and die with glory
• Most societies have rituals that deal with death
• In times of war, famine, natural disasters: individual
consciousness of death increases
• In most societies, death is not viewed as the end of
existence as the spiritual body is believed to live on
• Norouzieh (2005): Americans tend to be death
avoiders & death deniers; in some societies – daily
overdisplay of death in crowded city streets &
impoverished segments of society
5. 20 - 5
Changing Historical Circumstances
• Age group in which death most often occurs:
– 1800: children before age 10 – ratio 1:2; one
parent would have died before children grew up
– Now: older adults
• Life expectancy:
– 1900 - 47 years; now - 78 years
• Location of death:
– USA today: 80% of deaths occur in institutions or
hospitals, away from family
6. 20 - 6
Issues in Determining Death
• Recent decades: not easy to determine death
• Brain death: neurological definition:
– Person is brain dead when all electrical activity of
the brain has ceased for a specified period of time
– A flat EEG reading for a specified period of time is
one criterion of brain death
• Includes both the higher cortical functions and the
lower brain-stem functions
– Issue: Some medical experts argue criteria for
death should include only higher cortical
functioning (eg. Intelligence, personality)
associated with making us human
7. 20 - 7
Advanced Care Planning
• Process of patients thinking about & communicating
their preferences about end-of-life care
• “Choice in Dying” created the living will , a legal
document that reflects the patient’s advance care
planning
– Must be signed while individual is still able to think clearly
– Accepted in all 50 states of USA
• Recently: POLST (Physician Orders for Life Sustaining
Treatment):
– Must involve health care professional & patient or
surrogate conferring to determine & state patient’s wishes
8. 20 - 8
Euthanasia (mercy killing):
• Act of painlessly ending lives of individuals who are suffering
from an incurable disease or severe disability; 2 types:
– Passive euthanasia – Available treatment is withheld; preferred type
– Active euthanasia - Death deliberately induced, considered a crime in
most countries & in USA (except for Oregon & Washington)
• Well-publicized cases:
– Terri Schiavo: in vegetative state for 15 years; finally passive
euthanasia applied March 18, 2005, died 13 days later
– Dr. Jack Kevorkian: convicted of 2nd
degree murder for using active
euthanasia involving “assisted suicide” of terminally ill patients
• Issue of whether:
– a patient’s life-support system be disconnected if patient has left no
written instructions
– Family of comatose patient can overrule attending doctors’ decision
to continue life-support systems
9. 20 - 9
Needed: Better care for dying individuals
• Death in America: lonely, prolonged, and painful
• A “good death” involves physical comfort, support from loved
ones, acceptance, and appropriate medical care
• Cowley & Hager (1995): suggested fail-safe measures for
avoiding pain at end of life:
– Make a living will
– Give someone power of attorney
– Give doctors specific instructions
– Discuss with family whether or not you want to die at home
– Check insurance to see if it covers home care or hospice care
10. 20 - 10
Hospice
• A program committed to making the end of life as
free from pain, anxiety, and depression as possible
– Emphasizes palliative care
• Reducing pain and suffering, helping individuals die with dignity
• Hospice movement started late 1960s in London,
now spread world-wide
• Hospice more likely to serve those with terminal
cancer than those with other life-threatening
conditions
• Can be home-based, community-based, or
11. 20 - 11
Causes of Death
• Death can occur at any point in the life span
• Prenatal stage: miscarriage
• During birth process & soon after birth: Birth defects
• Infancy: SIDS leading cause of infant death in the
U.S.
• Childhood Years: Accidents or illness
• Adolescence and young adulthood: deaths result
from suicide, homicide, or motor vehicle accidents
• Middle-age and older adult deaths usually result
from chronic diseases
12. 20 - 12
Attitudes Toward Death
at Different Points in the Life Span
Childhood
•Young children (3 -5 years) believe the dead can be brought
back to life
•Around 9 years of age, children view death as universal and
irreversible
•Death of parent is especially difficult for children
•Honesty is the best strategy in discussing death with children
– Elaboration of explanation depends on child’s maturity level
•Most dying children know they have a terminal illness
– How well they cope depends on their developmental level, social
support & coping skills
13. 20 - 13
Attitudes Toward Death
at Different Points in the Life Span
Adolescence
•Death may be regarded as remote and may be avoided, glossed
over, or kidded about. (Personal Fable)
•Death of friends, siblings, parents, or grandparents bring death
to the forefront of adolescents’ lives
•Develop more abstract conceptions about death than children
14. 20 - 14
Attitudes Toward Death
at Different Points in the Life Span
Adulthood
•Middle-aged adults actually fear death more than young adults
or older adults
•Older adults are forced to examine the meanings of life and
death more frequently than younger & middle-aged adults
– Older adults have more direct experience with death (of friends &
relatives)
•Older adults who are dying feel less cheated & more
emotionally calm than younger adults who are dying
15. 20 - 15
Facing One’s Own Death:
Kübler-Ross’ stages of dying (1969)
• Behavior & thinking of dying persons go through 5 stages:
– Denial and isolation: “It can’t be!”
– Anger: “Why me?”
– Bargaining: “Just let me do this first!”
– Depression: withdrawal, crying, and grieving
– Acceptance: a sense of peace comes
• Criticisms:
– Existence of 5 stages not demonstrated by Kubler-Ross herself and
independent research
– Neglected to consider patient’s situations (relationship support, type
of illness, family obligations, institutional climate in which they were
interviewed)
• Some psychologsits prefer to describe them as potential
reactions to dying
16. 20 - 16
Perceived Control and Denial
• Perceived control may be an adaptive strategy for
remaining alert and cheerful
• Denial can insulate and allows one to avoid coping
with intense feelings of anger and hurt
– Can be maladaptive if e.g. keeps person from having a lif-
saving operation
17. 20 - 17
Contexts in Which People Die
• Important for the dying person
• More than 50% of Americans die in hospitals and nearly 20%
die in nursing homes
• Increasing no prefer the hospice
• Hospitals offer no. of important advantages:
– Professional staff members readily available
– Availability of medical technology to prolong life
• Many prefer to die at home but may feel:
– They will be a burden at home
– Limited space at home
– Dying at home may alter relationships
– Competency & availability of emergency medical treatment
18. 20 - 18
Communicating with a Dying Person
• Open communication very important because:
– They can close their lives in accord with their own ideas
about proper dying
– They may be able to complete plans and projects, and
make arrangements and decisions
– They have the opportunity to reminisce and converse with
others
– They have more understanding of what is happening to
them
– See p. 636 Connecting development to life: Effective
strategies for communicating with a dying person
19. 20 - 19
Grieving
Dimensions of Grieving
•Grief: complex, evolving process with multiple
dimensions - Emotional numbness, disbelief, separation
anxiety, despair, sadness, and loneliness that
accompany the loss of someone we love
•Cognitive factors are involved in the severity of grief –
if more negative beliefs & self-blame, more severe the
grief
•Good family communications can help reduce the
incidence of depression and suicidal thoughts
20. 20 - 20
Grieving
• Prolonged grief disorder: Grief that involves
enduring despair and remains unresolved over an
extended period of time
– Has negative consequences for physical & mental health
• Disenfranchised grief - an individual’s grief involving
a deceased person that is a socially ambiguous loss
that can’t be openly mourned or supported
– Examples: Ex-spouse, abortion, stigmatized death (such as
AIDS)
21. 20 - 21
Grieving
Dual-Process model of Coping and Bereavement
•Two main dimensions:
– Loss-oriented stressors: focus on deceased individual; can include
positive & negative reappraisals of the loss
– Restoration-oriented stressors: involve secondary stressors as indirect
outcome of breavement e.g. identity change (wife -> widow) &
mastering skills
•Effective coping involves oscillation between coping with loss
and coping with restoration
Coping and Type of Death
•Impact of death on surviving individuals is strongly influenced by the
circumstances under which the death occurs
•Sudden deaths are likely to have more intense and prolonged effects on
surviving individuals
22. 20 - 22
Cultural Diversity in Healthy Grieving
• Some cultures emphasize the importance of breaking
bonds with the deceased and returning quickly to
autonomous lifestyles
• Non-Western cultures suggest that beliefs about
continuing bonds with the deceased vary extensively
• There is no one right, ideal way to grieve
23. 20 - 23
Making Sense of the World
• Grieving stimulates individuals to try to make sense
of their world
• A reliving of the events leading to the death is
common
• When a death is caused by an accident or a disaster,
the effort to make sense of it is often pursued more
vigorously e.g. MH370
24. 20 - 24
Losing a Life Partner
• Death of an intimate partner brings profound grief
• Widows outnumber widowers because women live longer
than men
• Widowed women are probably the poorest group in America
• Many widows are lonely & benefit considerably from social
support
• Optimal adjustment depends on several factors:
– Women do better than men
– Older widows do better than younger widows
– Widowers more likely to have money & to remarry than widows
– Social support benefits both widows & widowers
– Religiosity & coping skills are related to optimal adjustment
25. 20 - 25
Forms of Mourning
• USA: 2007 - Approximately 66% are buried and 34%
are cremated; cremation expected to increase to
44% in 2015
• Funerals are an important aspect of mourning in
many cultures
• Cultures vary in how they practice mourning
-end-