*Death in infancy or childhood
-Infant mortality rate: different in various SES groups.
Sudden infant death syndrome(SIDS). higher among aboriginal children. Cause is not entirely
known but is suggested that sleeping position matters.
Parents should not blame themselves.
-After first year, external causes like vehicle accident, falling are high factors of death.
-Cancer(leukemia: stirkes the bone marrow. excessive white blood cells) 2nd cause of death in 1-
15yrs. Nowadays, high survival rate.
*Children's understanding of death
-5-6: death is great sleep. curious rather than frightened, not realize that death is irreversible
-5-9: death is personified as shadowy figure, don't have biological understanding
-9-10: understand the processes involved in death like burial and cremation.
*Death in Young adulthood
-imagine a trauma or fiery accident.
-death rate is low, but major cause are unintentional injuries(car accident)
-suicide is second leading cause. 3rd cancer, 4th homicide
-Because they are about to start real social life, when sentenced to terminal illness, they feel anger,
-parents with young children grow concern for their offspring
*Death in Middle age
-becomes more realistic and fearful.
-They have more fear than later adulthood.
-midlife crisis may also be affected by this fear of impending death.
*Premature death -death before 79
-mainly sudden death like heart attack, stroke
-might be better because don't have to face gradual death and stress
-environmental factors contribute to premature death. (ex) adverse childhood events)
*Death in Old age
-die of degenerative/infectious/ diseases
-terminal phrase of illness is shorter because of more than one biological competitor for death.
-more chance of death with dignity
-psychological distress predicts declines in death, and increase mortality
-men: lower education, widowhood
-women: greater financial distress
-women live longer than men
*Continued treatment and advancing illness
-gives stress to the patient, and they may resist further treatments
*What is good death?
-different among various diseases, or what patients value but important to think about this matter.
*Right to die?
-should death be a personal choice and control?
-gaining publicity recently.
-EUTHANASIA: ending the life of a person who is suffering from a painful terminal illness.
-patients more likely to request when they feel distress/fatigue/burden to the family
-patient may be coerced into the decision against their will. -advance directives (living wills): do not use sustaining machines like respirators
-physicians may prolong unnecessary of painful procedures. ex) ignore the living will.
-concerns grew with the medical development and longer of life expectancy
*Psychological and social issues related to dying
-changes in the patient's self concept
can't do activities they did, and should adjust their life to the illness
-loss of biological control and social functioning
-intermittent body pain, mental regression and memory loss.
-social interaction is also harder, and patients go through difficulty of expressing affection &
preparing to leave at the same time.
-withdrawl, because of the fear of depressing others and being emotional burden.
-communication issues: as prognosis worsens and therapy becomes drastic, communication may
breakdown between patient and the family. Death is a taboo topic and they might think each
other doesn’t want to bring up the issue.
*Kubler-Ross's five stage theory: denial, anger, bargaining, depression, and acceptance.
1. Denial: defense mechanism. subconscious blocking out of the full realization of the reality and
implications of the disorder
2. Anger: WHY ME? Hard for family and friends to manage.