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Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
LIFE-SPAN DEVELOPMENT
17
A Topical Approach to
John W. Santrock
Death and Grieving
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Death and GrievingThe Death System and Cultural
ContextsDefining Death and Life/Death IssuesA Developmental
Perspective on DeathFacing One’s Own Death Coping with the
Death of Someone Else
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Death in Different CulturesPerceptions of death vary; reflect
diverse values and philosophies
Individuals more conscious of death in times and places of war,
poverty, disease.
Most societies have Philosophical or religious beliefs about
death Rituals that deal with death View that death does not end
existence
Death and Cultural Contexts
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
U.S. Denial and Avoidance of DeathFuneral industry
emphasizes lifelike qualities
Euphemisms — softening language for death
Persistent search for “fountain of youth”
Rejection and isolation of aged
Concept of pleasant and rewarding afterlife
Medical emphasis — prolonging life, not easing suffering
Death and Cultural Contexts
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Changing Historical CircumstanceDeath becoming increasingly
complex When to determine death has occurred Life expectancy
has increased Most die apart from families Care for dying
shifted away from family Minimized exposure to death and its
pain
Death and Cultural Contexts
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Issues in Determining DeathBrain death — neurological
definition of death
All electrical activity of brain has ceased for a
specified period of time
Flat EEG recording
Some medical experts argue criteria for death
should include only higher cortical functioning
Defining Death and Life/Death Issues
*
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© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Decisions Regarding Life, Death, and Health CareNatural Death
Act and Advance Directive
Expresses person’s desires regarding extraordinary medical
procedures that might be used to sustain life when medical
situation becomes hopeless
Defining Death and Life/Death Issues
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
EuthanasiaPainlessly ending lives of persons suffering from
incurable diseases or severe disabilities
Passive euthanasia — withholding of available treatments,
allowing the person to die
Active euthanasia — death induced deliberately, as by injecting
a lethal dose of drug
Publicized controversy: assisted suicide
Defining Death and Life/Death Issues
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Needed: Better Care for Dying IndividualsDeath in U.S.: often
lonely, prolonged, painful
Plan for your death Make a living will Give someone power of
attorney Give your doctor specific instructions Discuss desires
with family and doctor Check insurance plan coverage
Defining Death and Life/Death Issues
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Needed: Better Care for
Dying Individuals
Hospice — humanized program committed to making the end of
life as free from pain, anxiety, and depression as possible
Palliative care — reducing pain and suffering and helping
individuals die with dignity
Defining Death and Life/Death Issues
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Causes of DeathDeath can occur at any point in human life span
Prenatal — miscarriage, stillborn
Childhood — accidents or illness
Adolescence — motor vehicle accidents, suicide,
and homicide
Older adults — chronic diseases
A Developmental Perspective of Death
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Death and ChildrenHonesty may be best way to discuss death
with children
Explained in simple physical or biological terms to
preschool children
Be sensitive and sympathetic, encouraging
feelings and questions
Not unusual for terminally ill children to distance
themselves in final stages, may be a result of
depression
A Developmental Perspective of Death
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Attitudes Toward Death at Different Points in the Life Span
Childhood
Adolescence
Adulthood
Infant has no concept of death; perceptions of death develop in
middle/late childhood; even very young children concerned
about separation and loss
Develop more abstract concepts of death; common to think they
are immune to death
Middle-aged adults fear death more than young adults or older
adults; older adults think about death more
A Developmental Perspective of Death
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Suicide
A Developmental Perspective of Death
Serious physical illnessFeelings of disparity, isolation, failure,
lossSerious financial problemsDrug use or prior suicide
attemptsAntidepressant links
Cultural and gender differences existRare in childhood, risk
increase in adolescenceMost adolescent attempts failLinked to
genetic and situational factorsGay or lesbian links not clear
Risk factors
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Suicide in U.S.
Adolescence
3rd leading cause of death in ages10-19
19% of high school students seriously considered or tried
suicide in last 12 mos
Adulthood and Aging
Suicide rates increase in adulthood
Older adults use more lethal ways, are more successful
Racial and gender differences exist
A Developmental Perspective of Death
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Facing One’s Own Death Most dying individuals want to make
decisions regarding their life and death
Complete unfinished business
Resolve problems and conflicts
Put their affairs in order
Facing One’s Own Death
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Kubler-Ross’ Stages of Dying
Denial and isolation
Anger
Bargaining
Denies s/he is going to die
Denial gives way to anger, resentment, rage, and envy
Develops hope that death can somehow be postponed
Depression
Acceptance
Comes to accept the certainty of her or his death
Develops sense of peace and may desire to be left alone
Facing One’s Own Death
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Perceived Control and DenialWhen individuals believe they can
influence and control events, they may become more alert and
cheerful
Denial can be adaptive or maladaptive
Facing One’s Own Death
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
The Contexts in Which People DieContext of dying is important
for mostMost would rather die at home but worry over
Burden at home
Limited space
May alter relationships
Competency and availability of emergency
medical treatment
Facing One’s Own Death
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Communicating with
the Dying PersonEstablish your presence
Eliminate distraction
Limit visit time
Don’t insist on acceptance
Allow expressions of guilt or anger
Discuss alternatives, unfinished businessAsk if there is anyone
s/he would like to see
Encourage the dying individual to reminisce
Talk with the individual when s/he wishes to talk
Express your regard
Coping with the Death of Someone Else
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
GrievingGrief: emotional numbness; a complex emotional state
of… Disbelief Separation anxiety Despair Sadness Loneliness
Complicated griefDisenfranchised grief
Coping with the Death of Someone Else
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Model of GrievingDual-process model for effective copingLoss-
oriented stressorsRestoration-oriented stressorsCoping and type
of deathSudden or violent deaths have more intense and
prolonged effectsMany such deaths accompanied by PTSD
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Cultural Diversity in
Healthy GrievingPersistent holding on to deceased may be
therapeuticHopi of Arizona forget quicklyEgyptians dwell on
griefNetherlands: integrate loss into their livesHealthy coping
involves Growth Flexibility Appropriateness within the cultural
context
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Making Sense of the WorldGrieving stimulates many to try to
make sense of their world — positive themes linked to hopeful
future and better adjustment
Effort to make sense of it pursued more vigorously when caused
by an accident or disaster
Coping with the Death of Someone Else
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Losing a Life PartnerThose left behind after the death of an
intimate partner suffer profound grief and often endure
Financial loss Loneliness linked to poverty and education
Increased physical illness Psychological disorders, including
depression
Coping with the Death of Someone Else
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Adjustment to WidowhoodWomen live longerWidowed men
more likely to remarryMeasures of older women’s
healthPhysical and mental healthHealth behaviors and
outcomesOverall, women adjust better than menOlder widows
do better than younger widowsSupport programs aid adjustment
Coping with the Death of Someone Else
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
Forms of MourningApproximately 80 percent of corpses are
disposed of by burial, the remaining 20 percent by cremation
Funeral industry is source of controversy
Funeral is important aspect of mourning in many cultures
Cultures vary in how they practice mourning
Coping with the Death of Someone Else
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
The Amish, Traditional Judaism, and MourningAmish
Conservative group; family-oriented society Live same
unhurried pace as ancestors Time of death met with calm
acceptance Neighbors notify community; funeral at home High
level of support to family for one year
Coping with the Death of Someone Else
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
The Amish, Traditional Judaism, and MourningTraditional
JudaismMourning in graduated time periods; each with
appropriate practices
1st period: Aninut — between death and burial
2nd period: Avelut period — mourning properShivah period
— 7-day begins at burialSheloshim period — 30-day period
after burial
Mourning over for all but parents who mourn another 11
months
Coping with the Death of Someone Else
*
Slide *
© 2008 The McGraw-Hill Companies, Inc. All rights reserved.
The End
17
*
Slide © 2008 The McGraw-Hill Companies, Inc. All rights r.docx

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Slide © 2008 The McGraw-Hill Companies, Inc. All rights r.docx

  • 1. Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. LIFE-SPAN DEVELOPMENT 17 A Topical Approach to John W. Santrock Death and Grieving * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Death and GrievingThe Death System and Cultural ContextsDefining Death and Life/Death IssuesA Developmental Perspective on DeathFacing One’s Own Death Coping with the Death of Someone Else * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved.
  • 2. Death in Different CulturesPerceptions of death vary; reflect diverse values and philosophies Individuals more conscious of death in times and places of war, poverty, disease. Most societies have Philosophical or religious beliefs about death Rituals that deal with death View that death does not end existence Death and Cultural Contexts * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. U.S. Denial and Avoidance of DeathFuneral industry emphasizes lifelike qualities Euphemisms — softening language for death Persistent search for “fountain of youth” Rejection and isolation of aged Concept of pleasant and rewarding afterlife Medical emphasis — prolonging life, not easing suffering Death and Cultural Contexts * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Changing Historical CircumstanceDeath becoming increasingly
  • 3. complex When to determine death has occurred Life expectancy has increased Most die apart from families Care for dying shifted away from family Minimized exposure to death and its pain Death and Cultural Contexts * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Issues in Determining DeathBrain death — neurological definition of death All electrical activity of brain has ceased for a specified period of time Flat EEG recording Some medical experts argue criteria for death should include only higher cortical functioning Defining Death and Life/Death Issues * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Decisions Regarding Life, Death, and Health CareNatural Death Act and Advance Directive Expresses person’s desires regarding extraordinary medical procedures that might be used to sustain life when medical situation becomes hopeless
  • 4. Defining Death and Life/Death Issues * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. EuthanasiaPainlessly ending lives of persons suffering from incurable diseases or severe disabilities Passive euthanasia — withholding of available treatments, allowing the person to die Active euthanasia — death induced deliberately, as by injecting a lethal dose of drug Publicized controversy: assisted suicide Defining Death and Life/Death Issues * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Needed: Better Care for Dying IndividualsDeath in U.S.: often lonely, prolonged, painful Plan for your death Make a living will Give someone power of attorney Give your doctor specific instructions Discuss desires with family and doctor Check insurance plan coverage Defining Death and Life/Death Issues *
  • 5. Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Needed: Better Care for Dying Individuals Hospice — humanized program committed to making the end of life as free from pain, anxiety, and depression as possible Palliative care — reducing pain and suffering and helping individuals die with dignity Defining Death and Life/Death Issues * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Causes of DeathDeath can occur at any point in human life span Prenatal — miscarriage, stillborn Childhood — accidents or illness Adolescence — motor vehicle accidents, suicide, and homicide Older adults — chronic diseases A Developmental Perspective of Death *
  • 6. Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Death and ChildrenHonesty may be best way to discuss death with children Explained in simple physical or biological terms to preschool children Be sensitive and sympathetic, encouraging feelings and questions Not unusual for terminally ill children to distance themselves in final stages, may be a result of depression A Developmental Perspective of Death * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Attitudes Toward Death at Different Points in the Life Span Childhood Adolescence Adulthood Infant has no concept of death; perceptions of death develop in middle/late childhood; even very young children concerned about separation and loss Develop more abstract concepts of death; common to think they are immune to death Middle-aged adults fear death more than young adults or older adults; older adults think about death more A Developmental Perspective of Death
  • 7. * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Suicide A Developmental Perspective of Death Serious physical illnessFeelings of disparity, isolation, failure, lossSerious financial problemsDrug use or prior suicide attemptsAntidepressant links Cultural and gender differences existRare in childhood, risk increase in adolescenceMost adolescent attempts failLinked to genetic and situational factorsGay or lesbian links not clear Risk factors * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Suicide in U.S. Adolescence 3rd leading cause of death in ages10-19
  • 8. 19% of high school students seriously considered or tried suicide in last 12 mos Adulthood and Aging Suicide rates increase in adulthood Older adults use more lethal ways, are more successful Racial and gender differences exist A Developmental Perspective of Death * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Facing One’s Own Death Most dying individuals want to make decisions regarding their life and death Complete unfinished business Resolve problems and conflicts Put their affairs in order Facing One’s Own Death * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Kubler-Ross’ Stages of Dying Denial and isolation Anger Bargaining
  • 9. Denies s/he is going to die Denial gives way to anger, resentment, rage, and envy Develops hope that death can somehow be postponed Depression Acceptance Comes to accept the certainty of her or his death Develops sense of peace and may desire to be left alone Facing One’s Own Death * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Perceived Control and DenialWhen individuals believe they can influence and control events, they may become more alert and cheerful Denial can be adaptive or maladaptive Facing One’s Own Death * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. The Contexts in Which People DieContext of dying is important for mostMost would rather die at home but worry over Burden at home Limited space May alter relationships
  • 10. Competency and availability of emergency medical treatment Facing One’s Own Death * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Communicating with the Dying PersonEstablish your presence Eliminate distraction Limit visit time Don’t insist on acceptance Allow expressions of guilt or anger Discuss alternatives, unfinished businessAsk if there is anyone s/he would like to see Encourage the dying individual to reminisce Talk with the individual when s/he wishes to talk Express your regard Coping with the Death of Someone Else * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. GrievingGrief: emotional numbness; a complex emotional state of… Disbelief Separation anxiety Despair Sadness Loneliness
  • 11. Complicated griefDisenfranchised grief Coping with the Death of Someone Else * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Model of GrievingDual-process model for effective copingLoss- oriented stressorsRestoration-oriented stressorsCoping and type of deathSudden or violent deaths have more intense and prolonged effectsMany such deaths accompanied by PTSD * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Cultural Diversity in Healthy GrievingPersistent holding on to deceased may be therapeuticHopi of Arizona forget quicklyEgyptians dwell on griefNetherlands: integrate loss into their livesHealthy coping involves Growth Flexibility Appropriateness within the cultural context *
  • 12. Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Making Sense of the WorldGrieving stimulates many to try to make sense of their world — positive themes linked to hopeful future and better adjustment Effort to make sense of it pursued more vigorously when caused by an accident or disaster Coping with the Death of Someone Else * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Losing a Life PartnerThose left behind after the death of an intimate partner suffer profound grief and often endure Financial loss Loneliness linked to poverty and education Increased physical illness Psychological disorders, including depression Coping with the Death of Someone Else * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Adjustment to WidowhoodWomen live longerWidowed men more likely to remarryMeasures of older women’s
  • 13. healthPhysical and mental healthHealth behaviors and outcomesOverall, women adjust better than menOlder widows do better than younger widowsSupport programs aid adjustment Coping with the Death of Someone Else * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. Forms of MourningApproximately 80 percent of corpses are disposed of by burial, the remaining 20 percent by cremation Funeral industry is source of controversy Funeral is important aspect of mourning in many cultures Cultures vary in how they practice mourning Coping with the Death of Someone Else * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. The Amish, Traditional Judaism, and MourningAmish Conservative group; family-oriented society Live same unhurried pace as ancestors Time of death met with calm acceptance Neighbors notify community; funeral at home High level of support to family for one year Coping with the Death of Someone Else
  • 14. * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. The Amish, Traditional Judaism, and MourningTraditional JudaismMourning in graduated time periods; each with appropriate practices 1st period: Aninut — between death and burial 2nd period: Avelut period — mourning properShivah period — 7-day begins at burialSheloshim period — 30-day period after burial Mourning over for all but parents who mourn another 11 months Coping with the Death of Someone Else * Slide * © 2008 The McGraw-Hill Companies, Inc. All rights reserved. The End 17 *