PSYC 3170 Chapter Notes - Chapter 12: Chronic Condition, Terminal Illness, Lung Cancer

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24 Apr 2012
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Chapter 12 Notes: Psychological Issues in Advancing and terminal illness
How does death differ across the life span?
100 years ago people died primarily from infectious diseases, such as
tuberculosis, influenza, or pneumonia
People on average can expect to live 80.3 years
When death comes it will stem from chronic illness, such as heart disease or
cancer
Death in Infancy or Childhood
Infant mortality rate: is still high; during 1990-2005 Canada’s infant morality
decreased from 6.8 to 5.4
o Remains significant disparity in the rates of infant deaths across different
socio-economic groups
Example: rich neighborhood in Canada have the same morality
death as it is in Sweden at 4.0, whereas poor neighbourhood are at
6.5
The difference between this may be due to socio-economic; however, the
differences in Aboriginals is the same, suggesting unrelated to socio-economic
Sudden death syndrome (SIDS): can happen during the first year of life, due to
congenital abnormalities
o 3 babies dying of SIDS each week
o Higher among Aboriginals
Causes are unknown, baby just stops breathing
More likely to occur in lower-class urban environments
When mother smoked during pregnancy
Or when baby is placed to sleep on stomach
Adjustments are better if parents do not blame themselves for the death
Back to Sleep campaign (1999) resulted in 65% in number of SIDS death
External causes are the main death of children under age of 15
o 42% off all deaths
o Early childhood death caused by:
Motor vehicle accidents
Accidental drowning
Poisoning
Injuries
Falls at home
Later on automobile accidents account for external deaths
o Rates of suicide have increased in children ages 10-14
Cancer, especially leukemia is second leading death in children ages 1-5
o Leukemia is a cancer that strikes the bone marrow
Children’s understanding of death
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Up to age 5, children think death is a great sleep
o Curious by death rather than saddened or frightened
5-9 idea that death is final may develop, but most children do not have a
biological understanding of death
o Personified into a ghost or devil
Death is universal and inevitable develops at 9 or 10
Death in Young adulthood
Major cause of death in this age group is unintentional injury = car accidents
Suicide is second leading
Cancer is third leading cause
Homicide is fourth
Heart disease is the rest of this group
Reactions to young adults death
Young adults = products of socialization and education and start their own
families
o Death is therefore tragic
o Young adults receive terminal illness reaction = shocked, mad, cheated of
life, sense of injustice, etc.
Death in middle age
Middle age death begins to assume more realistic
o More common for people to develop chronic illnesses that can kill them
o Gradual realization of impending death
Fear of death = symbolically out as a fear of loss of physical appearance, sexual
prowess, athletic ability
o Life changes may be made to act in this response such as:
Divorce, remarriage to younger person, job change
Premature death
Premature death: death occurs before the projected age of 79 sudden death
such as hearth attack or stroke
o Sudden and painless
Disadvantage: not allowing people to prepare their exit
o Some ways = more graceful departure
o Family does not have to go through emotional torment watching patient
suffer when condition worsens
Death rates in middle-aged group has declined
o Lung cancer (due to smoking)= more for women then men
o Heart disease and stroke = more for men than women
Death in old age
Is more easier in old age, more prepared for death
o Made preparations by seeing friends die
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o Come to terms with loss of appearance and ability to perform goals
Death (degenerative)= cancer, stroke, heart failure, general physical decline
(predisposition to infection), organ failure
Terminal phase of illness = shorter (more than one biological competitor for
death)
o Achieve death with dignity
Heath psychologists study factors predicting mortality in elderly
o New illnesses and worsening pre-existing conditions
o Psychological distress
o Men: association between distress and mortality is for socio-demographic
differences and presence of chronic disease
Lower education and widowhood (also account)
o Women: experiencing greater financial distress
Health goals for elderly = improving quality of life
Women live longer (82) than men (77)
WHAT ARE THE PSYCHOLOGICAL ISSUES IN ADVANCING ILLNESS?
Continued treatment and advancing illness
Radiation therapy and chemotherapy for cancer produce discomfort, nausea, etc.
o Chronic illness = needs treatment and have bad side effects
Have multiple surgeries or chemical therapy to save lives = after a while want to
stop
o Each treatment = threat of death, exhaustion, discomfort, depression
o Example: patients with end-stage renal disease wants to not have kidney
dialysis, decision influenced by major depressive disorder and suicidal
thoughts
Is there a right to die?
Right to die movement = maintains that dying should become more a matter of
personal choice and personal control
1992 Sue Rodriguez: suffering from amyotrophic lateral sclerosis
o Challenged the legislative ban, by arguing her right to die
o 42 years old from Victoria, took case to Supreme Court and lost by 5-to-4
vote
o Committed suicide in 1194 in presence of unknown physician
50% of public and 60% of cancer patients believe that euthanasia should be legal
Moral and Legal issues
Euthanasia: is the ending the life of a patient suffering from a painful terminal
illness
o Request for euthanasia when they are distresses, fatigues, and suffering
and when they feel to be a burden to family
Physicians feel assisted suicide is a conflict to their oath not to harm people
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