AGING, DEATH, AND DYING
AGING, DEATH, AND DYING
AGING
Ways to measure a person’s age
1. Chronological Age1. # of years a person has lived
2. Biological Age1. How well a person’s body systems are
functioning
3. Social Age1. Measure of the activity level engaged on a
daily basis
STAGES OF DEATH Elizabeth Kubler-Ross
I believe they should be called stages of lossA person may experience these for any type of
loss, such as: divorce, a pet, moving, going away to college, a relationship ending….
People tend to go through a series of stages, they may go back and forth, skip about or have periods where the stages seem to overlap, this is all according to their needs.
Stage One: DENIAL
Usually the first reaction: NOT MEPeople are in shock Unable to admit to themselves that the
patient might die and/or they will suffer the loss death represents
The best thing to do is just listen to what they are saying, you don’t need to come up with the correct response to fix the situation
Stage Two: ANGER
“WHY ME”
May be angry at the situation, not at you
The pain of loss is projected onto others
Try not to take it personally
Stage Three: BARGAINING
Last attempt to correct situation and avoid the inevitable
Pray to God, promise to reform their life
STAGE FOUR: DEPRESSIONThey are losing everything and may feel
hopeless and helplessUnfinished businessWhen the full impact of imminent death
strikes themFeel bad for the people they will leave behindThe best thing to do is just listen and be there
for them
STAGE FIVE: ACCEPTANCE
Learning to say goodbyeAccept the reality of deathMay get personal affairs in order, by way of
will and/or living willTry to live the rest of their life to the fullestListen to their wishes and be there for them
TERMSGrief
Intense emotional suffering caused by a loss, disaster, or misfortune
Empathy Ability to share in another person’s emotions or
feelings
Coping Dealing successfully with difficult changes in your life
Mourning the act of showing sorrow or grief
Ways to help a Grieving Person
Express your sympathy as a sign of respect
Feelings of guilt, despair, and similar feelings are normal
Listen to, hold (hug), and touch a grieving person. Allow the person to share their feelings with you.
Randy Pausch (2008)
• http://video.stumbleupon.com/#p=ithct48cqw
Diseases of the Elderly:Alzheimer’s Disease- more than 5 million
Is a fatal brain disorder that causes physical and chemical changes in the brain.
An incurable illness characterized by a gradual and permanent loss of memory.
Dementia deterioration of intellectual faculties
(memory/content)
Arthritis inflammation of the joints/ breakdown of
cartilage
Diseases of the Elderly:
ALS (Amyotrophic Lateral Sclerosis) Lou Gehrig Disease Progressive disorder of the nervous system
Cataracts lens become cloudy, impaired vision, causes
blindness
Glaucoma fluid inside the eye builds up, may cause
blindness
Diseases of the Elderly:
Osteoporosis- more common in women Brittle bones, which may lead to a broken bone. Due to the lack of calcium in developmental
years
Geriatrician a physician who specializes in caring for the
elderly
Death & Dying Terms:
Funeral The observances held for a dead person usually before burial or
cremation Embalming
Removing Blood and other fluids from a body that prevents deterioration of the body (formaldehyde, methanol, ethanol )
Cremation Complete reduction of a body to ashes by intense heat
EpitaphAn inscription on a tomb or at a grave in memory of the dead person
EulogyA prepared speech or writing extolling the virtues & services of a person
ObituaryA notice of the death of a person, usually published in a newspaper and includes a short biography
Death & Dying Terms:
Probate Establishing a will to settle your estate
Power of Attorney A legal instrument allowing one person to act
as the agent of another person (living will)Living Will (see handout)
A document enabling individuals to provide instructions about the kind of medical care they wish to receive or refuse if they can no longer make decisions
Defining DeathHarvard Medical School Criteria: brain death
Unreceptiveness/Unresponsiveness• Patient does not respond to painful stimuli
Absence of muscular movement and breathing• No breathing for over an hour
Lack of Reflexes• Knee Reflex is absent. Pupils will not respond to
light Absence of brain activity (EEG-Electroencephalograph)
• For 20 min, the brain does not generate electrical impulses
Death & Dying Terms: Palliative Care
Measures taken to reduce the intensity of a disease Hospice
An agency that assists people with a terminal illness May be in the house or in an area of a hospital Gives them more control over their death and how they want to die Medications are freely administered for pain Family members receive counseling to work through grief (better
prepared to interact w/ the dying person) Life Support Systems
Medical technologies used to keep patients alive that would otherwise die
Karen Ann Quinlan – Nancy Cruzan – Terri Schiavo
Death & Dying Terms:• Passive Euthanasia
– The practice of withholding or withdrawing life-prolonging treatment,allow for the terminally person to die naturally
• Active Euthanasia– The practice of intentionally hastening the death of
a person who requests it to avoid painful or prolonged living
– Dr. Jack Kevorkian – http://www.nndb.com/people/272/0000232
03/• Lethal Injection
– Injecting a drug that will result in death
Karen Ann Quinlan 1975- 21 yr. old ingested alcohol and sedatives Cardiopulmonary arrest and fell into a persistent
vegetative state Parents wanted to remove respirator Hospital said no Parents’ lost the first case Parents’ won the second case and turned the respirator off Karen continued to breath without life support and lived
for 10 years This case:
led to hospital and hospice ethics committees Led to advance directives (living wills)
Nancy Cruzan
1983 automobile accidentPermanently unconscious, no higher brain
functionKept alive by feeding tubeParents’ lost the first caseLater showed evidence and wonRemoved the feeding tube in December
1990 and later died that month
Terri Schiavo Feb. 1990- 26 yr. old severe brain damage from respiratory
and cardiac arrest and her heart stopped for 5 minutes 1998- husband filed to get the feeding tube removed
(saying wife told him that she didn’t want artificial respirator if she were ever put on one)
Parents fought 2000- Husband could discontinue life support The feeding tube was removed in 2003 and then reinserted
six days later “Terri’s Law” “Terri’s Law”- gave the governor authority to order the reinsertion
of the feeding tube, which had been removed six days earlier in compliance with a court order.
2005- Tube was removed again, after two weeks of no food and water, she died March 2005
Death With Dignity – Oregon, Washington, Netherlands, Belgium,
Switzerland, Thailand, Luxembourg
Allows patient to gain control over their death• Plan their funeral or memorial service• Want to decide who their doctors will be, type of
treatment, and who can visit them.• 18 years old or parent consent if under 18• 2 Doctors must diagnose & 6 months terminal illness• Mentally capable of making the decision on your own• Resident of the state• Patient makes three requests; two oral and one written• Patient drinks a strong Barbiturate potion (9g Pentobarbital)• Time from ingestion to unconsciousness is 1 to 20 minutes (avg. 4 minutes)• Time from ingestion to death 5 minutes to 48 hours (avg. 20 minutes)
http://www.deathwithdignity.org/media/uploads/OregonYear12Table.pdf
SuicideThe act of intentionally taking one’s own
life.Third leading cause of death among people
between the ages of 15-24 years of age lack of family support sense of isolation Guilt, low self-esteem, sense of worthlessness Increased use of drugs and alcohol
People who attempt suicide give warning signs that are a cry for help.
Many suicidal people reach out for help repeatedly before taking their own life.
Cluster Suicide A series of suicides occurring within a short
period of time and involving people within the same community or connected in another way
Possible Warning Signs of SuicideChange in eating and sleeping habitsWithdrawal from friends, family, and
regular activitiesUse of alcohol or other drugsViolent actions (rebellious behavior,
running away, angry, and destructive)Marked personality changesNeglecting personal appearanceDecline in their work (school/work)
Possible Warning Signs of Suicide
Giving away favorite possessionsInability to concentrate or make decisionsNot tolerating praise or rewardsRe-occurring theme of death in writingFrequent complaining about physical
symptomsIncreased Risk taking
Factors that Contribute to Suicide
Rising divorce rate, and break-up of families.Many teens live in troubled families.Pressure to succeed in school and life.Questions about sexual orientation.Increase in use of alcohol and drugs.
Why Someone Would Want to Die?
End the emotional pain they haveUnder extreme stressTrivial matters become overwhelmingBecome tunnel visionSuicide Mindset: the feeling that suicide is
the only solution to the problems of living
What do you do if someone is Suicidal?You might ask the person directly are you
contemplating suicide?
Most people will reach out for help before they try to kill themselves.
Listen to your friend.
Let them know that you are listening and that you understand.
What do you do if someone is Suicidal?
Don’t debate whether suicide is right or wrong.
Allow them to express their feelings.
Get involved. Become available. Show interest.
Don’t lecture on the value of life.
Get help from people or agencies specializing in crisis.
Adults who can help in a crisis
ParentGrandparent, uncle, aunt, other relativesTeacher or CoachFriendsTherapist at a schoolReligious leadersPerson working the suicide hotline