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Chapter 14

SOC375 Chapter Notes - Chapter 14: Advance Healthcare Directive, Funeral Director, Palliative Care


Department
Sociology
Course Code
SOC375
Professor
Kwame Boadu
Chapter
14

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Chapter 14- Death, Dying, and Bereavement
Defining Death and Dying
- Some argue that we begin to die at birth or even at conception
o Ulear he dig egis ad depeds o oe’s poit of ie
- The older person, family members, and health care professionals have different views of the dying person
o Family may deny impending death, or may perceive the older person as dying long before the senior does
o “eior’s phsiia a ake a terial diagosis and later inform family members when death is imminent
- Seniors define themselves as dying, or not, depending on their assessments of their health
o May assess their health realistically, or in overly optimistic or pessimistic terms
- Concept of death also has its ambiguities
o In the past, we defined death as the cessation of cardiac and respiratory function
o I ore reet deades, its defied i ters of essatio of rai futio rai dead
Brain death, coma, persistent vegetative state, minimal consciousness, and life on a life-support
machine make the assessment of life vs. death difficult
- Distinguish physical death from social death
o Social death- refers to the perception or behaviour of others that indicates that they perceive or treat a
person as if physically dead when it fact the physical body has not yet died
Often describes socially marginalized elderly persons, including the very old, the frail elderly, the
isolated and ignored senior, a racial minority, etc. when society overlooks or ignores seniors, social
death precedes physical death
o Physical death sometimes precedes social death
“oe do’t akoledge the death util the fueral takes plae
Often keep the dead alive in our minds, memories, and rituals
Experiencing Dying and Death in Old Age
- Individual senior experiences dying and death as intensely personal, but culture and society also shape that
experience
o Societal perspectives toward death fall on a continuum (enemy to a transition into a blissful world)
o Death can be viewed positively as a transition to a better life or as something dark and mysterious
o Power of stories about life after death and their central role in religion and culture tell us that people have
always wondered about death
- New view of death and dying science/technology has extended life and pushed dying/death into late-old age
- Death challenges our moral and ethical codes
o Issue of physician-assisted suicide
Death in Old Age
- Death used to be common among all age groups
- Longer life expectancy today means that most people die of the diseases of old age
- In 2008, seniors made up 78% of all deaths in Canada most deaths occur in old age following a period of
illness/decline
o Today, less than 1% of deaths occur in young children
- Cancer and heart disease accounted for ½ of the deaths among older people in 2008
o Compared with women, men tend to have a higher rate of death by cancer in particular, compared with
women, men have a higher rate of lung cancer
o In otrast, oe hae higher rates of death  stroke ad Alzheier’s disease – may reflect the fact that
more women live into later old age
- The National Population Health Survey (NPHS) found that the following items increase the risk of death: psychological
stress, financial stress, low educational level, widowhood, inactivity, smoking, being underweight, and functional
limitation
o Compared with its effect on men, psychological distress (including financial stress) has an especially strong
effect on women
- Trajectory of dying (dying trajectory)- the pattern or course of dying over time, for example, sudden death or slow
decline
o Affects where a person dies (varies by age, disease, and support available)
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Ex. people over age 85 with dementia tend to die in nursing homes
o Death in later life often comes slowly and predictably
“eiors’ Vies of Dig ad Death
- Only a small number of studies have looked at how older people feel about death
- According to activity theory, people want to stay active throughout their lives and substitute new roles and activities
for one that they lose as they age
o Says nothing about death, although it would support living life to the fullest, even while dying
- Disengagement theory says that people want to disengage from social roles as they age
o Retirement and withdrawal from social responsibilities lead to high life satisfaction
o Awareness of impending death starts the process of disengagement people ko the’ll die soo, so the
ease their way out of social life
Disengagement produces a smooth transition of power/responsibility from one generation to the
next
Says that death disrupts society less of older people disengage from social roles as they age
- Erikso’s theor of ego deelopment claims that the last stage of life leads to a life review a dying person looks
oer their life, seeks a oitio that oe’s life has had eaig ad purpose, ties up loose eds, ahiees
acceptance of the life lived, and prepares for death
o Describes this as ego integrity aeptae of the otio that oe’s life le is soethig oplete ad
unique
o Older people respond to death in various ways: some deny it, some accept it, and some embrace it
- Older people think about death more than younger people, but they feel less afraid of death
o Seniors today typically express more concern about the process of dying than about death itself
- Seniors commonly state that they do not want to be a burden on others dying seniors in particular
o As a result, dying seniors tend to focus on the needs of their caregivers, minimize their own needs, and plan
for their deaths want self-esteem, closeness to significant others, and meaningful lives
o Older people want comfort in their last days, have their responsibilities take care of, and wanted their
spiritual beliefs honoured ated to e read to go
- Attitudes to dying, death, and bereavement vary by age, religion, and culture
The Good Death
- The good or the bad death depends on a number or criteria ad depeds o oe’s poit of ie
o “eior’s poit of ie: lack of pain, a quick death, dying at home surrounded by loved ones, maintaining a
sense of dignity, having a sense of control, and being prepared to die
o “igifiat others’ poit of ie: relieves family members of the burden of care, minimizes financial costs to
family members
o Societal point of view: minimal demands on resources, transfer of wealth and power smooth
- Dying from a heart attack that ours i oe’s sleep at hoe or dig ith loed oes ear are ersios of hat ost
would consider a good death
- Dying in the hospital in pain, without dignity, and alone or surrounded by strangers following a long, agonizing,
struggle with cancer would be considered by most as a bad death
Existential, Spiritual, and Religious Issues
- Eistetial issues for dig seiors iole fidig eaig i the life oe has lied ad i oe’s dig ad death
- Dying/death can become a spiritual quest, whether in religious or non-religious terms
- Religion plays a smaller role today than it did in the past, but many often turn to religious leaders and institutions at
the time of death faith communities can and do provide support to dying people
o Religious leaders spend time with dying people at their bedsides and lead religious services after one has
died
- People with different religious beliefs differ in their attitudes to death
o Most teach that people get the kind of afterlife they deserve
o Studies show that people with mild or uncertain religious beliefs fear death most, while those with strong
religious beliefs or no belief at all deal with death best
Stages of Dying
- **Kubler-Ross described 5 stages that her patients went through before they died:
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