Chapter 19

• Death is a biological fact; but it also has social, cultural, historical, religious, legal, psychological, developmental, medical, and ethical aspects, and often these are closely intertwined.
• Thanatology - Study of death and dying.
• Hospice care - Personal, patient- and family-centered care for a person with a terminal illness.
• Palliative care - Care aimed at relieving pain and suffering and allowing the terminally ill to die in peace, comfort, and dignity.
• Terminal drop - A frequently observed decline in cognitive abilities near the end of life. Also called terminal decline.
• Kübler-Ross (1969, 1970) outlined five stages in coming to terms with death: denial, anger, bargaining, depression, acceptance
• First, there is grief, the emotional response that generally follows closely on the heels of death.
• Bereavement is a response to the loss of someone to whom a person feels close. But bereavement is not just an event, and it is not just grief—it is also a process of adjustment.
• 1. Shock and disbelief. This first stage may last several weeks, especially after a sudden or unexpected death.
• 2. Preoccupation with the memory of the dead person. In the second stage, which may last 6 months to 2 years or so, the survivor tries to come to terms with the death but cannot yet accept it.
• 3. Resolution. The final stage has arrived when the bereaved person renews interest in everyday activities.
• At about the same age, children realize two other important concepts about death: first, that it is universal (all living things die) and therefore inevitable; and second, that a dead person is nonfunctional (all life functions end at death).
• For adolescents. In their urge to discover and express their identity, they tend to focus more on how they live than on how long they are likely to live.
• Survivors of people who take their own lives have been called “suicide’s other victims.”
• Euthanasia means “good death” and is intended to end suffering or to allow a terminally ill person to die with dignity.
• Passive euthanasia withholding or discontinuation of life prolonging treatment of a terminally ill person in order to end suffering or allow death with dignity.
• Active euthanasia deliberate action taken to shorten the life of a terminally ill person in order to end suffering or to allow death with dignity; also called mercy killing.
• Advance directive (living will) Document specifying the type of care wanted by the maker in the event of an incapacitating or terminal illness.
• Durable power of attorney Legal instrument that appoints an individual to make decisions in the event of another person’s incapacitation.
• Assisted suicide - Suicide in which a physician or someone else helps a person take his or her own life.
• Life review - Reminiscence about one’s life in order to see its significance.
• Life review can, of course, occur at any time. However, it may have special meaning in old age, when it can foster ego integrity—according to Erikson, the final critical task of the life span.