Ethical considerations Living Will Available online Durable Power of Attorney For you to fill out in the even that you would become mentally incompetent to make decisions for them Naming who is allowed to make decisions DNR medical order Generally for CPR, do not perform Patient Self- Determination Act Any health care facility that is receiving medical funds, must have these papers on file Personal Aspects of Death Life course approach to studying death Thoughts and emotions associated with dying Differences seen between older and younger adults Kubler- Ross?s Stage Theory We progress through a series of stages when thinking about death and grieving over lost loved ones Five stages cycle through many times, can be in more than one stage at a time, may not necessarily go through them in order Denial Younger people think they are invincible mid- life writing will and such diagnosed with disease coping mechanism Anger Hostility, anger, envy of people that are healthy Bargaining Try to find another way out? God or yourself Despair Complete raw emotion, grief Realize that the person you love is really gone Acceptance Often appear emotionless Older adults are generally more open to it, younger people have a since of invincibility Other theories what they have to deal with while they die Bodily needs Psychological security Need to feel some control Interpersonal attachments Spiritual energy and hope Death Anxiety Reflection of own concern for dying Fear of death Lower level of religiousness Less social support Being rejected as they die Body malfunctions When people die, they pee and poop Interruption of other peoples life?s? spouse, family Manifestations Avoidance Challenging death doing dare devil things Day dreaming Humor Fear of loosing something permanent (loosing your teeth) Dealing with anxiety Living fulfilling life Personal reflection Death education End of life Issues Creating a final scenario Making choices about the end of life Planning for disposition of body Memorial service Distribution of assets Hospice Assistance for dying persons emphasizing pain management, dying with dignity Let their death as open or closed as they wish Principles behind hospice Clients and families are viewed as a unit Client should be kept free of pain Emotional and social impoverishments must be minimal Encouraged to maintain competencies Try to help with conflict resolution Client must be free to begin or end relationships Staff members must seek to alleviate pain and fear There as a friend and a guide Research on hospice Hospice patients are more mobile, less anxious and less depressed Spouses visit more often and participate in their care Hospice staff are perceived as more accessible Other considerations regarding hospice care Families must be supportive Supportive follow- up services Doctor approved in a timely fashion Survivors and the grieving process Bereavement period after person has died Include context and meaning of the loss Changing in representation of the loss Coping and emotional regulation Grief Mourning The way we express our grief Cultural constructed For our culture, its 12 months Experiencing grief Active process with choices in coping Acknowledge the reality of the loss Work through emotional turmoil Adjust to the environment without deceased Loosen ties with the deceased Not feeling guilty when you start enjoying things again Normal Grief Sadness, denial, anger, loneliness, guilt Grief work Psychological coming to terms with bereavement Anniversary reactions Changes in behavior related to feelings of sadness on the date of the loss Grief over time As long as 50 years later, loss is still felt Continues to evoke emotion Anticipatory grief and coping Abnormal grief Intensity distinguishes it from normal grief Excessive guilt and self- blame Depression can become severe Interferes with daily life Types of loss and grief BLACK BOARD!!! Death of parent (6 months to year) Reminds us of own mortality Loss of an important person The more stress preceding the death Death of child Most dramatic, not supposed to happen Mothers grieve for child, fathers grieve generally for the mother?s loss Death of spouse Death of sibling In older age can be more devastating that spouse
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