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Lecture 29

GERO 200 Lecture 29: GERO 200 Lecture 29 (4/14/17)

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Gerontology (UNO)
GERO 200

GERO 200 Lecture 29 (4/14/17) Death and Dying ● The US is a death-denying society ● Avoidance of death ○ Euphemisms ■ Passed away ■ Passed on ○ Funerals project illusion of life ○ Movies, TV avoid consequences of death ● Medical technology has replaced religion as a way to understand death ● Dying process has changed since the 1800s Denial Getting Easier ● 60% of American deaths occur in hospitals or nursing homes ○ Final moments of life seldom observed, even by family ● Healthcare professionals are trained to extend life, not deal with it as a natural part of the life cycle ● Interest in the topic has escalated, with many books, college courses and seminars available. 19th Century ● Higher incidence of epidemics; no cure available ○ Acute infectious diseases - sudden onset ● Death and dying was a household event ● Death encompassed all ages 20th Century ● Dying is delayed by life-extending medical procedures ○ Chronic illness, slow progressive course ● Death becomes an institutional event ○ Happens at a hospital or skilled nursing facility ● Mortality is highest among older adults 21st Century ● Death with Dignity movement ● Reduced use of institutions ○ Hospice care so they can die at home ● Expanded end-of-life care in the home Fear of Death ● Thanatologist Richard Kalish states: ○ Older people appear to be less fearful than younger people ○ Many older people feel like they have completed the most important tasks in life ○ They are more likely to be in pain or to be suffering from chronic diseases and view death as an escape from that pain ○ They have lost many friends and relatives and death has become real ○ People in late midlife may go through a transitory stage when awareness of aging and death are heightened ○ Counseling and hospice care can decrease the fear of death ○ For some older adults, fear of death is triggered by a sense of unresolved developmental tasks or relationship conflicts ○ Humans have an innate fear of death which provides direction for life’s activities ○ Understanding our mortality allows us to gain perspective on the meaning of our lives ● Thanatology = study of death Specific Fears Related to Death ● Fear of long-term pain and suffering ● Fear of dementia and losing a sense of self ● Fear of dying alone or dependent on others ● Fear of dying in a hospital or nursing home ● Fear of the unknown and nonexistence ● Fear of judgment in the afterlife ● Fear of loss of control ● Fear of what will become of loved ones Factors Related to Less Fear ● Traditional religious beliefs such as a belief in an afterlife or heaven ○ Lower death depression scores ● Beliefs in angels or other personal guides ● Strength of beliefs, whatever they are, may be more important, than church attendance or knowledge of religious dogma to predict lower fear of death. Fears Maybe Somewhat Unfounded ● Most people die relatively painless deaths ● In most cases, an individual’s health does not deteriorate until he or she is very close to death ● Most people are in good or excellent health a year before they die, and many are in good health the week of their death. ● It is the haunting stories of lingering, painful, lonely death that many people carry in their heads when they think of death that feeds our innate fears Coping With Death ● Death competency ○ Our capability or skill to cope with death ■ Personality patterns ● Elders’ fears must be dealt with openly ● Elisabeth Kubler-Ross identified 5 stages of the dying process Dr. Kubler-Ross ● Advocate for hospice care ● 5 stages ○ Denial ■ Initial shock of being terminally ill ● “This is not happening to me.” ○ Anger ■ Resentment towards those whose lives will continue
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