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Death and the Dying Process


Diagnosis of death based on the cessation of all signs of brain activity. ... Defined: The practice of assisting people who are terminally ill to die more quickly. ... – PowerPoint PPT presentation

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Title: Death and the Dying Process

Death and the Dying Process
  • Types of Death
  • Basic Statistics
  • Social Aspects of Death
  • Do Not Resuscitate
  • Euthanasia

Types of Death
  • Thanatologists People who study death and dying.
  • Two types of death
  • Functional Death
  • Absence of a heart-beat and breathing.
  • Brain Death
  • Diagnosis of death based on the cessation of all
    signs of brain activity.
  • Measured by electrical brain waves.

Basic Statistics
  • America has a very high infant mortality rate
  • Ranks behind 35 other countries
  • Why is this?
  • Accurate statistics on our part
  • More drug use than almost any other country
  • In early adulthood the leading cause of death is
  • This is followed by Suicide, Homicide, AIDS, and

Basic Statistics
  • Death has changed historically
  • 200 years ago, 1 out of every 2 children died
    before age 10, and one parent usually died before
    a child grew up
  • Today, death occurs mostly among the elderly
  • Life expectancy has increased from 47 years for
    a person born in 1900 to 77 years for a person
    born today
  • Over 80 of all U.S. deaths occur in hospitals

Basic Statistics
  • Causes of death vary across the life span
  • Prenatal death through miscarriage
  • Death during birth or shortly afterwards
  • Accidents or illness cause most childhood deaths
  • Most adolescent deaths result from suicide,
    homicide, or motor vehicle accident
  • Deaths among young adults are increasing due to
  • Middle-age and older adult deaths usually result
    from chronic diseases

Social Aspects of Death
  • Attitudes toward death vary at different points
    in the life span
  • Young children use illogical reasoning to
    explain death, believing magic or treatment can
    return life
  • Others claim separation anxiety is an indicator
    of a childs awareness of separation and loss
  • Those in middle and late childhood have more
    realistic perceptions of death that it is a

Social Aspects of Death
  • Concerns about death increase as one ages
  • Awareness usually intensifies in middle age
  • Older adults are more often preoccupied by it
    and want to talk about it more
  • Ones own death usually seems more appropriate in
    old age, possibly a welcomed event, and there is
    an increased sense of urgency to attend to
    unfinished business

Social Aspects of Death
  • Elisabeth Kubler-Ross
  • Made many observations and interviews with people
    who were dying and with those who cared for them.
    Based on her observations, she suggested that
    people pass through five basic steps as they move
    toward death.

Social Aspects of Death
  • 1. Denial People resist the idea that they are
    going to die.
  • They may argue that their test results have been
    mixed up, that an X-ray has been read
    incorrectly, or that their physician does not
    know what he or she is talking about.
  • A patient can flatly reject the diagnosis
  • Sometimes memories of weeks in the hospital are

Social Aspects of Death
  • 2. Anger A dying person may be angry at everyone
  • They may be angry at people who are in good
    health, their spouses and other family, those who
    are caring for them, and their children.
  • They can lash out at others and get loud.
  • Many become very angry with God.
  • Questions Asked Why are the bad people not
    dieing and why am I? This can lead to the next

Social Aspects of Death
  • 3. Bargaining Dying people try to negotiate
    their way out of death.
  • They may declare that they will dedicate their
    lives to the poor if God saves them.
  • Maybe if they can live just long enough to see a
    son married, or a child born, they will willingly
    accept death.
  • If you are good, you will be rewarded
  • The reward for being good is to live

Social Aspects of Death
  • 4. Depression Realizing that the issue is set in
    stone and that bargaining will not stop this,
    they become overwhelmed with a huge sense of
  • Reactive depression Feelings of sadness are
    based on events that have already occurred
  • Loss of dignity that may accompany medical
  • End of a job
  • Knowledge that one will never return from the
  • Preparatory depression Sadness over future
  • Death will bring an end to their relationships
    with others and that they will never see future

Social Aspects of Death
  • 5. Acceptance Final stage of dying is
  • Once acceptance has arrived they are fully aware
    that death is impending.
  • They will have virtually no feelings, positive or
    negative, about the present or future.
  • In essence, they have made peace with themselves
    and may wish to be left alone.

Social Aspects of Death
  • Denial and isolation It cant be!
  • Anger Why me?
  • Bargaining Just let me do this first!
  • Depression withdrawal, crying, and grieving
  • Acceptance a sense of peace comes

Social Aspects of Death
  • The quality of ones life is linked to how death
    will be approached
  • Meaning and purpose bring peaceful acceptance
  • An unfulfilled life brings distress and despair.
  • Perceived control and denial may be adaptive
    strategies for remaining alert and cheerful.
  • Denial insulates and allows one to avoid coping
    with intense feelings of anger and hurt.
  • In the U.S., most people die in hospitals (80),
    and fewer die in nursing homes or a hospice.

Social Aspects of Death
  • Women feel the loss of a life partner more than
    men because
  • They live longer than men
  • A widowed man is more likely to remarry
  • They usually marry older men
  • Cross-culturally, many widows fall into poverty
    after the loss of a life partner
  • Impact on ones physical and psychological health
    is linked to how long one grieves and remains

Do Not Resuscitate
  • Written order from a doctor that resuscitation
    should not be attempted if a person suffers
    cardiac or respiratory arrest.
  • Sometimes known as a no-code order.
  • Such an order may be instituted on the basis of
    an advance directive from a person.
  • Or from someone entitled to make decisions on
    their behalf, such as a health care proxy.
  • In some jurisdictions, such orders can also be
    instituted on the basis of a physician's own
    initiative, usually when resuscitation would not
    alter the ultimate outcome of a disease.
  • DNR is more commonly done when a person who has
    an inevitably fatal illness wishes to have a more
    natural death without painful or invasive medical
  • DNR order came into being in the U.S. in the
    1960s when defibrillation allowed the reversal of
    cardiac arrest, but this may prolong the life of
    the patient for only a short time.

  • Defined The practice of assisting people who are
    terminally ill to die more quickly.
  • There are three types of euthanasia
  • 1. Passive Euthanasia
  • Withholding common treatments (Antibiotics,
    drugs, or surgery) or giving a medication
    (Morphine) to relieve pain, knowing that it may
    also result in death.
  • Passive euthanasia is currently the most accepted
    form as it is currently common practice in most
  • 2. Non-aggressive Euthanasia The practice of
    withdrawing life support
  • Quite controversial
  • 3. Aggressive Euthanasia Using lethal substances
    or force to kill
  • Extremely controversial
  • Physician-Assisted Suicide Term for aggressive
    voluntary euthanasia.