Assignment 7.1: Community and the Aging Adult
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Chapter20PowerPoint.pptxLIFE-SPAN DEVELOPMENT 17e
John W. Santrock
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Chapter 20
Death, Dying, and Grieving
© 2020 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom.
No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education.
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Chapter Outline
The Death System and Cultural Contexts
Defining Death and Life/Death Issues
A Developmental Perspective on Death
Facing One’s Own Death
Coping with the Death of Someone Else
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The Death System and Cultural Contexts
The death system and its cultural variations
Changing historical circumstances
Components comprising the death system:
People.
Places or contexts.
Times.
Objects.
Symbols.
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The Death System and Its Cultural Variations
Cultural variations in the death system
Ancient Greeks: live a full life and die with glory.
Most societies have a ritual that deals with death.
In most societies, death is not viewed as the end of existence because the spiritual body is believed to live on.
©Ahn Young-joon/AP Images
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Changing Historical Circumstances
Life expectancy increased from 47 years for a person born in 1900 to 78 years for someone born today.
Location of death: over 80 percent of deaths in the United States occur in institutions or hospitals.
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Issues in Determining Death 1
Issues in determining death
Decisions regarding life, death, and health care
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Issues in Determining Death 2
Brain death: when all electrical activity of the brain has ceased for a specified period of time
Flat EEG reading for a specified period of time is one criterion of brain death.
Includes both higher cortical functions and lower brain stem functions.
©Stringer/Getty Images
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Decisions Regarding Life, Death, and Health Care 1
Advanced care planning: process of patients thinking about and communicating their preferences about end-of-life care
Choice in Dying: create a living will.
Living will: legal document reflects the patient’s advance care planning.
Advance directive: indicates whether life-sustaining procedures should or should not be used to prolong an individual’s life when death is imminent.
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Decisions Regarding Life, Death, and Health Care 2
Euthanasia: the act of painlessly ending the lives of individuals suffering from incurable diseases or severe disabilities
Passive euthanasia: treatment is withheld.
Active euthanasia: death deliberately induced.
Terri Schiavo.
Assisted suicide: patient self-administers lethal medication and determines when and where to do this.
Jack Kevorkian.
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Decisions Regarding Life, Death, and Health Care 3
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 end of life as free from pain, anxiety, and depression as possible.
Palliative care: reducing pain and suffering, helping individuals die with dignity.
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A Developmental Perspective on Death
Causes of death
Attitudes toward death at different points in the life span
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Causes of Death 1
Prenatal death through miscarriage
Birth defects
Sudden infant death syndrome (SIDS) leading cause of infant death in the United States
Accidents or illness cause most childhood deaths
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Causes of Death 2
Most adolescent and young adult deaths result from suicide, homicide, or motor vehicle accidents.
Middle-age and older adult deaths usually result from chronic diseases.
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Attitudes Toward Death at Different Points in the Life Span 1
Childhood
Some young children believe the dead can be brought back to life through medicine or magic.
Children as young as 4 to 5 years of age can understand the irreversibility of death and the cessation of functions.
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Attitudes Toward Death at Different Points in the Life Span 2
At some point in the middle and late childhood years, many children develop more realistic and accurate perceptions of death.
Honesty is the best strategy in discussing death with children.
Support programs for parentally bereaved children and their caregivers can be beneficial.
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Attitudes Toward Death at Different Points in the Life Span 3
Adolescence
Death regarded as remote and may be avoided, glossed over, or kidded about.
Deaths of friends, siblings, parents, or grandparents bring death to the forefront of adolescents’ lives.
Develop more abstract conceptions about death than children.
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Attitudes Toward Death at Different Points in the Life Span 4
Adulthood
Middle-aged adults fear death more than young adults do.
Older adults are forced to examine the meanings of life and death more frequently than younger adults.
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Facing One’s Own Death 1
Kübler-Ross’ stages of dying
Perceived control and denial
The contexts in which people die
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Facing One’s Own Death 2
Knowledge of death’s inevitability permits us to establish priorities and structure our time.
Three areas of concern
Privacy and autonomy in regard to their families.
Inadequate information about physical changes and medication as death approached.
Motivation to shorten their life.
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Facing One’s Own Death 3
Kübler-Ross’ stages of dying
Denial and isolation: dying person denies she or he is really going to die.
Anger: dying person’s denial gives way to anger, resentment, rage, envy.
Bargaining: dying person develops hope that death can be postponed.
Depression: withdrawal, crying, and grieving.
Dying person comes to accept the certainty of death.
Acceptance: sense of peace.
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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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The Contexts in Which People Die
More than 50 percent of Americans die in hospitals.
Nearly 20 percent of Americans die in nursing homes.
Hospitals offer many important advantages.
Professional staff members.
Technology helps prolong life.
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Communicating with a Dying Person
Open communication with dying people is important because they can
Close their lives in accord with their own ideas about proper dying.
May be able to complete plans and projects and make arrangements and decisions.
Have the opportunity to reminisce and converse with others.
Have better understanding of what is happening to them.
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Grieving 1
Dimensions of Grieving
Grief: emotional numbness, disbelief, separation anxiety, despair, sadness, and loneliness accompanying the loss of someone loved.
Pining or yearning reflects an intermittent, recurrent wish or need to recover the lost person.
Cognitive factors are involved in the severity of grief.
Prolonged grief disorder.
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Grieving 2
Disenfranchised grief: an individual’s grief involving a deceased person that is a socially ambiguous loss and cannot be openly mourned or supported
Examples: spouse, abortion, stigmatized death such as a death due to AIDS
Dual-process model: model of coping with bereavement that emphasizes oscillation between
Loss-oriented stressors and
Restoration-oriented stressors
Oscillation model: oscillation between coping with loss and coping with restoration
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Coping and Type of Death
Death’s impact on survivors strongly influenced by the death’s circumstances
Sudden deaths likely have more intense and prolonged effects on survivors
Survivors may develop Post-Traumatic Stress Disorder.
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Cultural Diversity in Healthy Grieving
Some cultures emphasize importance of breaking bonds with the deceased and returning quickly to autonomous lifestyles.
Non-Western cultures suggest beliefs about continuing bonds with the deceased vary extensively.
There is no one right, ideal way to grieve.
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Making Sense of the World
Grieving stimulates individuals to try to make sense of their world.
Reliving events leading to the death is common.
When death is caused by an accident or a disaster, the effort to make sense of it is often more vigorous.
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Losing a Life Partner 1
The death of an intimate partner brings profound grief.
Widows outnumber widowers because women live longer than men.
Age groups and percent of widows
14 percent of 65 to 74 years old.
31 percent of 75 to 84 years old.
59 percent of those 85 years old and over.
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Losing a Life Partner 2
Widowed women are probably the poorest group in America.
Many widows are lonely and benefit considerably from social support.
Cross-cultural study of widowed men and women
Study in the United States, England, Europe, Korea, and China: depression peaked in the first year of widowhood for men and women
Widowed women recovered to levels compared to married individuals in all countries.
Widowed men continued to have high levels of depression 6 to 10 years post-widowed everywhere except in Europe.
Becoming widowed is associated with a 48 percent increase in having an earlier death.
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Forms of Mourning 1
Funerals are an important aspect of mourning.
Cultures vary in how they practice mourning.
In the United States, funerals are conducted privately and are followed by a memorial ceremony.
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Forms of Mourning 2
In some cultures, a ceremonial meal is shared after a death, while in others a black armband is worn by bereaved family members for 1 year following a death.
Amish culture: community handles virtually all aspects of the funeral
Traditional Judaism: 7-day period of shivah is especially important
Designed to promote personal growth and to reintegrate bereaved individuals into the community.
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