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Chapter 12

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PSYC 314
Frances Chen

*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, injustice. -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 -more prepared -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. 3. Bargaining:
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