Psy Life Span W8D10
Lostcauseminka
psyc2314_ppt_ch20.pptxLIFE-SPAN DEVELOPMENT 18e
John W. Santrock
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Chapter 20
Death, Dying, and Grieving
© 2021 McGraw Hill. 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.
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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: Topics
The death system and its cultural variations.
Changing historical circumstances.
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(Left) Russell Underwood/Corbis/Getty Images; (right) Paul Almasy/Corbis/VCG/Getty Images
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The Death System and Its Cultural Variations 1
Robert Kastenbaum emphasizes that the death system in any culture comprises the following components:
People.
Places or contexts.
Times.
Objects.
Symbols.
Cultural variations characterize death and dying.
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.
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The Death System and Its Cultural Variations 2
FIGURE 1: A RITUAL ASSOCIATED WITH DEATH
Family memorial day at the national cemetery in Seoul, South Korea.
Ahn Young-joon/AP Images
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Changing Historical Circumstances
Two hundred years ago, almost one of every two children died before the age of 10, and one parent died before children grew up.
Today, death occurs most often among older adults.
Over 80% of deaths in the U.S. occur in institutions or hospitals.
This has minimized our exposure to death and its painful surroundings.
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Defining Death and Life/Death Issues
Issues in determining death.
Decisions regarding life, death, and health care.
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Issues in Determining Death
Brain death: a neurological death when all electrical activity of the brain has ceased for a specified period of time.
Flat E E G reading for a specified period of time is one criterion of brain death.
Includes both higher cortical functions and lower brain stem functions.
Paolo_Toffanin/Getty Images
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Decisions Regarding Life, Death, and Health Care 1
Advanced care planning:
Advanced care planning is the process of patients thinking about and communicating their preferences about end-of-life care.
Living will: a legal document that reflects the patient’s advance care planning.
Advance directive: a document such as a living will that indicates whether life-sustaining procedures should or should not be used to prolong an individual’s life when death is imminent.
Physician Orders for Life-Sustaining Treatment (P O L S T): a more specific document that translates treatment preferences into medical orders.
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Decisions Regarding Life, Death, and Health Care 2
Euthanasia:
Euthanasia is the act of painlessly ending the lives of individuals suffering from incurable diseases or severe disabilities.
Passive euthanasia: when treatment is withheld.
Active euthanasia: when death is deliberately induced.
Assisted suicide: a process that requires the patient to self-administer lethal medication and determine when and where to do this.
Widely publicized by Michigan physician Jack Kevorkian.
Legal in several countries and in an increasing number of U.S. states.
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Decisions Regarding Life, Death, and Health Care 3
Better care for dying individuals is needed:
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: the act of reducing pain and suffering, and helping individuals die with dignity.
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A Developmental Perspective on Death: Topics
Causes of death.
Attitudes toward death at different points in the life span.
Per-Anders Pettersson/Getty Images
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Causes of Death
Death can occur at any point in the human life span.
Miscarriages and stillborn births.
During the birth process or in the first few days after birth.
Sudden infant death syndrome (S I D S), the leading cause of infant death in the United States.
In childhood, most commonly accidents or illness.
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:
Children as young as 4 to 5 years of age can understand the irreversibility of death and the cessation of functions.
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 2
Adolescence:
Deaths of friends, siblings, parents, or grandparents bring death to the forefront of adolescents’ lives.
Adolescents develop more abstract conceptions about death than children do, and they may develop religious and philosophical views.
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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Attitudes Toward Death at Different Points in the Life Span 3
In old age, one’s own death may take on an appropriateness it lacked in earlier years.
Increased thinking and conversing about death.
Increased sense of integrity from a positive life review.
Less likely to have unfinished business.
Attitudes about death vary, however.
Fuse/Corbis/Getty Images
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Facing One’s Own Death: Topics
Kübler-Ross’ stages of dying.
Perceived control and denial.
The contexts in which people die.
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Facing One’s Own Death
Knowledge of death’s inevitability permits us to establish priorities and structure our time.
Most dying individuals want an opportunity to make some decisions regarding their own life and death.
Some want time to resolve problems and conflicts and to put their affairs in order.
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Kübler-Ross’ Stages of Dying 1
Denial and isolation: Elisabeth Kübler-Ross’ first stage of dying, in which a dying person denies she or he is really going to die.
Anger: a dying person’s denial gives way to anger, resentment, rage, envy.
Bargaining: a dying person develops hope that death can be postponed.
Depression: when the dying person comes to accept the certainty of her or his death, a period of depression or preparatory grief may appear.
Acceptance: the dying person develops a sense of peace, an acceptance of his or her fate, and in many cases, a desire to be left alone.
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Kübler-Ross’ Stages of Dying 2
FIGURE 2: KÜBLER-ROSS’ STAGES OF DYING
According to Elisabeth Kübler-Ross, we go through five stages of dying: denial and isolation, anger, bargaining, depression, and acceptance.
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Science Photo Library/Getty Images
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Kübler-Ross’ Stages of Dying 3
Some problems with Kübler-Ross’ approach:
The existence of the five-stage sequence has not been demonstrated by research.
The five-stage interpretation fails to consider variations in patients’ situations.
Some psychologists prefer to describe the stages as potential reactions to dying; emotions may wax and wane.
The extent to which people have found meaning and purpose in their lives is linked with how they approach death.
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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 the extent of the denial.
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The Contexts in Which People Die
More than 50% of Americans die in hospitals.
Nearly 20% of Americans die in nursing homes.
Hospitals offer many important advantages, including:
Professional staff members.
Technology that may prolong life.
Hospitals may not be the best place for many; and most people say they would rather die at home.
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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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Communicating with a Dying Person
Most psychologists argue it is best for dying individuals to know they are dying.
Dying individuals can close their lives in accord with their own ideas about proper dying.
They may be able to complete plans and projects, make arrangements for survivors, and participate in decisions about a funeral and burial.
They have the opportunity to reminisce and converse with others.
They will have a better understanding of what is happening to them and what medical staff are doing.
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Grieving 1
Dimensions of grieving:
Grief: the 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: grief that involves enduring despair and remains unresolved over an extended period of time.
Individuals who lose someone on whom they were emotionally dependent are often at greatest risk.
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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.
For example, death of an ex-spouse.
Lisay/Getty Images
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Grieving 3
Dual-process model of coping with bereavement: a model of coping with bereavement that emphasizes oscillation between two main dimensions.
Loss-oriented stressors.
Restoration-oriented stressors.
Coping and type of death:
Death’s impact on survivors is strongly influenced by the death’s circumstances.
Sudden deaths are likely to have more intense and prolonged effects on survivors.
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Grieving 4
Cultural diversity in healthy grieving:
Some cultures emphasize the importance of breaking bonds with the deceased; others, that such bonds should be maintained.
There is no one right, ideal way to grieve.
Xinhua/eyevine/Redux
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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.
Thomas Hinton/Splash News/Newscom
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Losing a Life Partner 1
Approximately three times as many women as men are widowed.
Those left behind after the death of an intimate partner often:
Suffer profound grief.
Die earlier than expected.
Endure financial loss, loneliness, increased physical illness, and psychological disorders.
Peter Power/Toronto Star/Getty Images
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Losing a Life Partner 2
Surviving spouses seek to cope with the loss in various ways.
Some intensify their religious and spiritual beliefs.
Widows may be more likely to use positive reframing, active distraction, help-seeking, and turning to God for strength.
Widowers may be more likely to use avoidant strategies and seek connection with their late spouse.
Finding meaning in the death of a spouse is linked to a lower level of anger in bereavement.
For both widows and widowers, social support helps them adjust.
Widow-to-Widow programs provide support for newly widowed women.
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Forms of Mourning 1
One decision facing the bereaved is what to do with the body.
In the United States, over half elect cremation.
The funeral is an important aspect of mourning in many cultures.
In the United States, the current trend is a private funeral followed by a memorial ceremony.
The funeral industry is a source of some controversy.
Funeral directors argue the funeral provides a form of closure.
Critics claim funeral directors are just trying to make money and that embalming is grotesque.
Cultures vary in how they practice mourning.
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Forms of Mourning 2
Among the Amish, the community handles virtually all aspects of the funeral.
In traditional Judaism, the program of mourning is divided into graduated time periods, each with its appropriate practices.
The seven-day period of the shivah is especially important.
(Left) Glenn Fawcett/Baltimore Sun; (right) Robert Mulder/Corbis/Getty Images
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End of Main Content
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Accessibility Content: Text Alternatives for Images
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The Death System and Cultural Contexts: Topics – Text Alternative
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Two images displaying cultural difference. The first image shows a funeral procession where the attendees are wearing black dress. A woman wearing a feather hat walks in front and a group of people carrying the coffin follow her. The second image shows women along with their kids standing side by side in casual attire holding colorful baskets on their heads.
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Kübler-Ross’ Stages of Dying 2 – Text Alternative
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An old man sitting with his hand supporting the head. A downward arrow representing stages of dying from top to bottom as denial and isolation, anger, bargaining, depression, and acceptance.
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