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physical death is rebirth (reincarnation) ... Dying Process. Stages of Death and Dying (Elizabeth Kubler-Ross, 1960: 200 terminally ill ) ... – PowerPoint PPT presentation

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Title: Death

Death Dying Lecture 9 Chapter 19
I dont mind dying, I just dont want to be
there when it happens. Woody Allen
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Death Aint What it Use to Be… in the US at
Theory of Population Change Stage I Hi BR Hi
DR Preindustrial
  • The final stage of growth
  • Experienced by everyone
  • The young ignore its existence
  • The old begin to think of their own

  • Death imposes two kinds of burdens
  • 1. Preparing oneself for ones own death
  • 2. Deal with the interpersonal aspects of death
    that will affect ones loved ones
  • grief, anguish, anger, anxiety, denial

Societal Meanings of Death
  • Modern American
  • Medical failure
  • More traditional societies
  • Natural part of life cycle

US Societal Changes early 1900s and now
  • Early 1900s….
  • Focus was on comfort
  • Died of infection
  • Died at home
  • Family was caregiver
  • Death was short and sudden
  • 2005……
  • Focus is on cure
  • Die of chronic illness
  • Die in institutions
  • Institution staff are caregivers
  • Death is prolonged

Cross Cultural Views on Death
  • Eastern philosophies-death is natural
  • Buddhists Hindus
  • physical death is rebirth (reincarnation)
  • end of rebirths that is their goal, not the
    end of death,
  • …which is the goal of Christianity
  • Western-death is to be postponed, threat

oneness with the universe Focus is not on the
The Issue of Dying Across the Life Span
  • Childhood
  • Until around 5-7 dont understand the permanence,
    universality, and lack of functioning in death
  • Age 12 accurately perceive
  • Parent euphemisms (just went to sleep)
  • attending funerals, etc?

Would you want children under 10 to attend your
funeral? YES White 47.9 African American
68.4 Hispanic 57.6 Asian 40.4 Age NO?20-39
(7.4), 40-59 (7.4), 60 (21.9) (Kalish
Reynolds, 1976)
The Issue of Dying Across the Life Span
Adolescence - More experienced with
death and grief - Loss of sibling, friend or
parent (survivors guilt) - Positive outcome
includes greater appreciation for life
The Issue of Dying Across the Life Span
  • Middle-aged
  • understand next in line to die
  • change in perception of time
  • (lived vs amount left)
  • death of a parent
  • death of a child - violates the natural order
  • Transition to being the oldest generation

Late Adulthood- Older adults
  • Least concerned with dying
  • Loss of a partner
  • Loss of child or grandchild
  • although think about death more
  • In recent survey (AARP)
  • 2,000 Americans age 45 and older were questioned
    about their
  • fear of dying.
  • ? 30 of those 45-49 expressed fear of dying
  • 15 of those 75 and older expressed fear of dying
  • More women overall (24) than men overall (18 )
    were afraid of dying

Late Adulthood- Older adults
  • (Cicerilli, 1999)
  • N388, Young Old
  • Old think about death more
  • Old less afraid about death
  • Old more fearful vs
  • Old fear more pain artificial life
  • (Cicerilli, 2002)
  • Meaning of Death?
  • Eventually meeting with God or nonexistence
  • Preparation to leave a legacy
  • Limited time to do things

WHY not afraid?
  • goals have been fulfilled
  • living longer than expected
  • coming to terms with finitude
  • dealing with the deaths of friends

Dying Process
  • Stages of Death and Dying (Elizabeth Kubler-Ross,
    1960 200 terminally ill )
  • Denial Not me!
  • Anger Why me??? ?Why now??
  • Bargaining Yes, me…but!
  • Depression Yes…me…
  • Acceptance Yes, me.

Emotional stages
Have to have all stages to accept death?
Bereavement State of having sustained a loss
  • Older adults undergo much bereavement
  • Widowed men (up to age 75) are almost twice as
  • likely to die than married men
  • Grief reaction to loss (Lindemann, 1944)
  • upset stomach
  • shortness of breath
  • tightness in throat
  • sighing
  • decreased muscular strength
  • Grieving practices vary (Rituals)
  • By culture weeping/partying
  • By ethnicity wake/Shiva

Rituals - Jewish
Reaction to loss Grieving Practices
Funeral begins with cutting away (black ribbon
or garment) Shiva (7 days after burial)
parents, children, spouses and siblings of the
deceased, preferably all together in the
deceased's home Mourners sit on low stools or
the floor instead of chairs do not wear leather
shoes do not shave or cut their hair do not
wear cosmetics do not work do not do things for
comfort or pleasure (bathe, have sex, put on
fresh clothing) Mourners wear the clothes that
they tore at the time of learning of the death or
at the funeral Mirrors in the house are
covered "Baruch dayan emet," Blessed be the one
true Judge
  • Wakes / Visitations
  • Viewing of body (70-80)
  • Social gathering
  • Reading a will and executing it
  • Wearing black

Reaction to loss (Grief)
Reaction to loss
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Where We Die
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Fantasy Death Exercise
  • What are your criteria for a good death?
  • The only hitch, as in life, is that you have to
  • Imagine you are there right now
  • Notice where you are, what your are doing, who is
    with you, what it is like, perhaps sounds,
    smells, other sensory specifics…

Common Ideal Death Scenarios
  • Sudden death in sleep (Older Adults too)
  • Dying at home
  • Dying engaged in meaningful activity

Themes for a Good Death
  • Home
  • Comfort
  • Sense of completion (tasks accomplished)
  • Saying goodbye
  • Life-review
  • Love