This document discusses various topics related to death, dying, and grieving. It defines death, including brain death criteria, and addresses issues around end-of-life decisions and euthanasia. Cultural and historical contexts of death are examined. Kübler-Ross' five stages of dying - denial, anger, bargaining, depression, acceptance - are summarized. Communicating with the dying, grieving processes, and coping with the death of a loved one are also outlined.

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DEATH, DYING, AND GRIEVING
17
ESSENTIALS OF LIFE-SPAN
DEVELOPMENT
JOHN W. SANTROCK
3e

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17-2
CHAPTER OUTLINE
• Defining death and life/death issues
• Death and sociohistorical, cultural contexts
• Facing one’s own death
• Coping with the death of someone else

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17-3
DEFINING DEATH AND LIFE/DEATH
ISSUES
• Determining death
• Decisions regarding life, death, and health care

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17-4
DEFINING DEATH AND LIFE/DEATH
ISSUES
• Determining death
• Brain death: A 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

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17-5
DEFINING DEATH AND LIFE/DEATH
ISSUES
• Decisions regarding life, death, and health care
• Natural death act and advance directive
• “Choice in Dying” created the living will, a legal document that
reflects the patient’s advance care planning

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17-6
DEFINING DEATH AND LIFE/DEATH
ISSUES
• Euthanasia: The act of painlessly ending the lives of
individuals who are suffering from an incurable disease or
severe disability
• Passive euthanasia: Treatment is withheld
• Active euthanasia: Death deliberately induced
• Recent cases - Terri Schiavo and Jack Kevorkian

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17-7
DEFINING DEATH AND LIFE/DEATH
ISSUES
• Needed: Better care for dying individuals
• Death in America is lonely, prolonged, and painful
• A “good death” involves physical comfort, support from loved
ones, acceptance, and appropriate medical care
• 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

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17-8
DEATH AND SOCIOHISTORICAL,
CULTURAL CONTEXTS
• Changing historical circumstances
• Death in different cultures

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17-9
DEATH AND SOCIOHISTORICAL,
CULTURAL CONTEXTS
• Changing historical circumstances
• The age group in which death most often occurs
• Life expectancy has increased from 47 years for a person
born in 1900 to 78 years for someone born today
• Location of death
• 80% of deaths in the U.S. today occur in institutions or hospitals

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17-10
DEATH AND SOCIOHISTORICAL,
CULTURAL CONTEXTS
• Death in different cultures
• Cultural variations characterize experience of death and
attitudes about death
• Individuals more conscious of death in times of war, famine,
and plague
• In most societies, death is not viewed as the end of
existence
• Spirit lives on
• Americans are death avoiders and death deniers

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17-11
FACING ONE’S OWN DEATH
• Kübler-Ross’ stages of dying
• Perceived control and denial

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17-12
FACING ONE’S OWN DEATH
• Kübler-Ross’ stages of dying
• Denial and isolation: Person denies that death is really
going to take place
• Anger: Person recognizes that denial can no longer be
maintained
• Bargaining: Person develops the hope that death can
somehow be postponed or delayed
• Depression: Dying person comes to accept the certainty of
death
• Acceptance: Person develops a sense of peace, an
acceptance of one’s fate, and in many cases, a desire to
be left alone

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17-13
FIGURE 17.2 - KÜBLER-ROSS’ STAGES OF
DYING

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17-14
FACING ONE’S OWN DEATH
• Perceived control and denial
• Perceived control may be an adaptive strategy for
remaining alert and cheerful
• Denial insulates and allows one to avoid coping with
intense feelings of anger and hurt
• Can be maladaptive depending on extent

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17-15
COPING WITH THE DEATH OF
SOMEONE ELSE
• Communicating with a dying person
• Grieving
• Making sense of the world
• Losing a life partner
• Forms of mourning

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17-16
COMMUNICATING WITH A DYING
PERSON
• Open communication with a dying person is 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

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17-17
GRIEVING
• Dimensions of grieving
• Grief: Emotional numbness, disbelief, separation anxiety,
despair, sadness, and loneliness that accompany the loss of
someone we love
• Pining or yearning reflects an intermittent, recurrent wish or
need o recover the lost person
• Most survivors experience normal or uncomplicated grief
reactions
• Include sadness and even disbelief or considerable anguish

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17-18
GRIEVING
• By six months after their loss, they accept it as a reality
• More optimistic about the future, function competently in their
everyday lives
• Prolonged grief disorder: Grief that involves enduring
despair and remains unresolved over an extended period
of time

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17-19
GRIEVING
• 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)

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17-20
GRIEVING
• 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

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17-21
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

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17-22
LOSING A LIFE PARTNER
• The death of an intimate partner brings profound
grief
• Many widows are lonely
• The poorer and less educated they are, the lonelier they
tend to be

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17-23
FORMS OF MOURNING
• Approximately 66% are buried and 34% are
cremated
• Funerals are an important aspect of mourning in
many cultures
• Cultures vary in how they practice mourning