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Lecture 9

Lecture 9.docx

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Nevena Simic

LECTURE 9 – Psychological Issues in Advancing and Terminal Illness Outline  Leading causes of death -How does the cause of death differ as a function of age? Gender? Race?  Coping with dying  Settings in which people die -Hospitals, nursing homes, hospices, at home What Are The Leading Causes Of Death In Canada Today (2008)?  Cancer, heart disease, stroke Death As A Function Of Age When And How Do People Die?  Average Canadian life expectancy 80.3 years -Worldwide: 78 years  Beginning of 20th century: 47.3 years -Why the HUGE increase?  Lower infant disease, Shift in disease (before infectious now non-communicable diseases)  Decrease death from acute illnesses  Decrease infant mortality -1940: 47 deaths/1000 live births -2006: 6.7 deaths/1000 live births Death In Infancy Or Childhood  Infant morality rate: ratio of deaths to live births -5.1/1000 births -Relatively high compared with Western Europe o Used to be 6 thplace  27 th in 2007  Effects of SES -4.0/1000 in richest neighborhood -6.5/1000 in poorest  Effects of culture -First Nations > non-First Nations Leading Causes Of Death  Birth to 1 year: congenital abnormalities & sudden infant death syndrome (SIDS) -SIDS: 3 babies die/week in Canada o Babies simply stop breathing o More likely to occur in lower-class urban environments, when mom smoked during pregnancy, when baby is put to sleep on stomach o Back to Sleep campaign (1999) – reduced SIDS by ~50%  From ages 1-15, the causes shift to accidents (i.e. poisonings, falls) and childhood leukemia -Leukemia: cancer of bone marrow  excess white blood cells + severe anemia (80% survival rate today!)  Supervision (know where it‟s safe to bike ride/soccer, wear helmet), complicated medicine bottle caps, hazardous railings, electric outlets  Survival rate of leukemia is 80%. Majority of kids won‟t have to die from it. Good survival rate.  Lingering side effects though for brain and cognitive function it can be severely be impaired.  Earlier diagnosis and treatment is worse for child in terms of cognitive development. Can lead to retardation in some cases.  Brain is still immature at younger years so problem with radiation is it quickly acts over turning cells, which are cancer cells and newly maturing in the brain.  Radiation destroys myelin from growing properly.  Over years, child can‟t develop things like reading abilities. Children‟s Understanding Of Death  Up to age 5: death as “great sleep” -No understanding of death s final/irreversible -No fear – they are curious  5-9: death as final may develop -Most children fail to understand the biology of death -Some children believe death is a shadow figure (devil or ghost)  9-10: “death is universal and inevitable” -Understand processes that go along with death -Realize that person will not return Death In Young Adulthood  Leading causes of death for youth (15-24) 1. Unintentional injury (usually automobile accidents) 2. Suicide 3. Cancer 4. Homicide o Leading cause of death for young black males -Heart/Respiratory diseases & congenital abnormalities  Diagnosis of terminal illness  long and drawn out period of dying because fewer biological competitors for death  There aren‟t other conditions that have worn out the body. This is a healthy person except for the disease threatening them Death In Middle Age  Death becomes more realistic for two reasons: -More common -Development of chronic health problem that ultimately leads to death  Premature death: death that occurs before age of 79 -Main cause is heart attack or stroke (brain attack) -Death rates on the decline – less smoking!  Midlife Crisis -May occur in the 40s or 50s -Stems from the realization of impending death -Set off by death of parent, friend, or bodily signs that one is aging -Sometimes abrupt life changes are a result of the midlife crisis (seen as trying to postpone death) i.e. feeling younger  Wrinkles, grey hair, can‟t run as fast Death In Old Age  Death may be easier in old age -„Readiness to die‟: Elderly have seen friends and relatives die; have come to terms with issues associated with death, such as loss of appearance, & failure to meet goals  Typically die of degenerative diseases (cancer, stoke, hear failure, or physical decline) – leads to susceptibility to infectious diseases and organ failure  Greater change o
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