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Dying And Death. Chapter 20. Why Is There Death?. Life span is long enough to allow reproduction and the linage of our species. Challenges our emotions and intellectual security. We know that everything alive eventually dies. Understanding Death and Dying. Defining death. - PowerPoint PPT Presentation

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  • Dying And DeathChapter 20

  • Why Is There Death?Life span is long enough to allow reproduction and the linage of our species.Challenges our emotions and intellectual security.We know that everything alive eventually dies.

  • Understanding Death and Dying Defining death. Defined as cessation of the flow of bodily fluids.Life-support systems.Brain death.Lack of receptivity and response to external stimuli.Absence of spontaneous muscular movement and breathing.Absence of observable reflexes.Absence of brain activity.Electroencephalogram (EEG).

  • Learning About DeathUnderstanding of death changes as we age.Mature understanding of death.Four components (Mark Speece).Universality.Irreversibility.Nonfunctionality.Causality.

  • Denying Versus Welcoming DeathAnxiety associated with death. Many seek to avoid any thought or mention of death.United states attitude is to death denying.

  • Planning For DeathMaking a will.Estate.Testator.Interstate.

  • Considering Options for End-of Life CareSpending your last days at home, cared for by relatives and friends?-OR-Access to the sophisticated medical technologies in the hospitals.Home care.Hospital-based palliative care.Hospice programs.

  • Deciding to Prolong Life or Hasten DeathModern medicine.Persistent vegetative state.Ethical questions about the right to die.U.S. Supreme Court in 1990.The right to refuse life sustaining treatment is constitutionally protected.

  • Deciding to Prolong Life or Hasten DeathWithholding or Withdrawing Treatment.Passive euthanasia.Assisted Suicide and Active Euthanasia.Physician-assisted suicide (PAS).Active euthanasia.

  • Completing an Advance DirectiveLiving will.Health care proxy.Surrogate.

  • Becoming an Organ DonorHuman body is a valuable resource.Each day 60 people receive an organ transplant.Each day 18 people on the waiting list die because not enough organs to assist.Uniform Donor Card.

  • Planning a Funeral or Memorial ServiceDisposition of the body.Arranging a Service.Non-profit memorial society.

  • Coping With DyingNo one right way to live or die of a life-threatening illness. Doctors treat diseases; people suffer from illness.Concerns with:Costly medical care.Loss of income.Repeated and lengthy hospitalization.Physical pain.

  • Awareness of DyingLiving-dying experience.Middle knowledge patients and family seek a balance between hope and reality.

  • The Tasks of CopingOn Death and Dying (Elisabeth Kubler-Ross).5 Psychological stages:Denial.Anger.Bargaining.Depression.Acceptance.

  • The Tasks of CopingCharles Corrs primary dimensions in coping with dying.Physical.Psychological.Social.Spiritual.

  • Patterns of CopingDefense mechanisms.Coping Strategies.Different strategies:Emotion-focused.Problem-focused.Meaning-based.The Trajectory of dying.Supporting a dying person.

  • Coping With LossExperiencing Grief.Bereavement.Mourning.Tasks of Mourning.Accepting the reality of the loss.Working through the pain and grief.Adjusting to a changed environment.Emotionally relocating the deceased and moving on.The Course of Grief.

  • Supporting a Grieving PersonGive kind and loving support.Be a good listener.Refrain from making judgments about the survivors feelings are good or bad.Social support is critical.

  • Helping Children Cope With LossChildren tend to cope with loss healthier fashion.Adults must share the news with the children.Natural curiosity.Sudden changes in the family environment.Keep the informational lines open for the childs questions.Be Honest.

  • Enjoy Your Day!

    From a personal standpoint, death may challenge our emotional, spiritual, and intellectual, social security. Dying and death are more than biological events, they have multidimensional effects. For example, our beliefs, can be a key to how we relate to the thought of our own death and that of others.Defining death Traditionally, death has been defined as cessation of the flow of vital bodily fluids. However, more specific definitions of death are required today.Brain death is a medical determination as the cessation of brain activity. It has four characteristics: 1.) Lack of receptivity and response to external stimuli, 2.) Absence of spontaneous muscular movement or breathing, 3.) Absence of observable reflexes, and 4.) Absence of brain activity indicated by a flat EEG.Clinical death is a medical determination of death that includes brain death or the cessation of heartbeat and breathing.Cellular death is the breakdown of metabolic processes at the cellular level.Learning about death Our understanding of and attitudes about death change as we grow and mature. A childs understanding of death develops greatly from about age 5-9. Speece and Brent have identified four empirical (observable) facts about death. They are: 1.) Universality all living things eventually die, 2.) Irreversibility organisms that die cannot be made alive again, 3.) Nonfunctionality death involves the cessation of all physiological functioning or signs of life, and 4.) Causality There are biological reasons for the occurrence of death. Many people also hold non-empirical (not subject to scientific proof) ideas, such as faith, that address issues like life after death. Speece and Brent term this as noncorporeal continuity.

    Denying versus welcoming death Some people seek to avoid any thought or mention of death. Few people avoid or wholly welcome death. Problems can occur, however, when avoidance or denial fosters the idea that death only happens to others and not me.

    Acknowledging the inevitability of death allows us to plan for it. Adequate planning can help ensure that a sudden, unexpected death or a long debilitating illness wont be more difficult the survivors than it has to be. Although some decisions cannot be made until one is actually in a particular situation, many decisions related to death and dying can be anticipated, considered, and discussed with close relatives and friends while one is young. Issues in planned include:Making a will Seven out of ten Americans die without a will. A will is a legal instrument expressing a persons intentions and wishes for the disposition of his or her estate after death. Estate is the money, property, and other possessions belonging to a person. A testator is the person who has the will made and can have the will changed at any point until he or she dies. When a person dies without having made a legal will the term used to describe the situation is intestate. In this situation, the estate is distributed according to the rules of the state which may not be the same as the wishes of the deceased or his or her heirs. For this reason, its advisable to involved close family members in the decisions to prevent future problems.Considering options for end-of-life care Slide three provides a more detailed discussion of these considerations. They include home care, hospital-based programs, and hospice programs.Deciding to prolong life or hasten death The issues involved with making the difficult decision as to whether to prolong life or to hasten death are described on slides eight and nine. Completing an advance directive An advanced directive is a written legal document that is used to express ones wishes about the use of life-sustaining treatment. The two types are a living will and a health care proxy. A living will enables individuals to provide instructions about the kind of medical care they wish to receive if they become incapacitated or otherwise unable to participate in treatment decisions. A health care proxy is also know as a durable power of attorney for health care. This document makes it possible to appoint another person (surrogate) to make decisions on your behalf , based on your wishes, about medical treatment if you become unable to do so.Becoming an organ donor A human body is a valuable resource. You can donate your body or specific organs for transplantation and other medical uses after death. If you decide to become an organ donor, the first step is to indicate your intent by completing a Uniform Donor Card or you can indicate your wish on the back of your drivers license.Planning a funeral or memorial service The stages of planning funerals or memorial services are addressed on slide twelve.

    By becoming aware of your choices regarding end-of-life care, we and our families are empowered to make informed and meaningful decisions. The decision may involve a combination of home, hospital, and hospice care.Home care Many people choose to spend their last days at home because it is a familiar and comfortable place and may be the most satisfying option when feasible. Home care is a full time job and is not always possible because sometimes appropriate care requires trained professionals or specialized equipment. However, sometimes these professionals can be hired to come to the home and equipment may be rented.Hospital-based care Although a hospitals primary function is to provide short-term intensity treatment for acute injuries and illnesses, many are adopting the principle of palliative care for terminally ill individuals. Palliative care is a form of medical care aimed at reducing the intensity or severity of a disease by controlling pain and other discomforting symptoms. The goal of this care is to achieve the best possible quality of life for the patients and their families.Hospice programs A hospice is a comprehensive program of care for dying patients and their families and is a form of palliative care. This team-oriented approach seeks to provide state-of the-art care to prevent or relieve pain and other distressing symptoms, as well as to offer emotional and spiritual support to both the patient and family. Generally, hospice care requires a