Death and Dying Fill-In-The-Blank Questions

Fill-In-The-Blank Questions 104. The study of death is called _____. 105. Thanatology is the study of death and _____, especially its social and emotional aspects. 106. One hundred years ago, most people died at home; today, most deaths occur in _____. 107. Children as young as _____ have some understanding of death. The ______ is the idea that people adopt 108. cultural values and moral principles in order to cope with their fear of death. 109. After he recovered from a severe heart attack, Jason said he remembered being surrounded by a white light, and feeling at peace. Jason described a ______. 110. Dying that is peaceful, quick, and at home is often considered to be a _____ death. One way that modern medicine has increased the likelihood of a good death is that death 111. now usually occurs at the end of a long _____. 112. Kübler-Ross proposed that the dying go through _____ emotional stages. 113. Maslow also identified stages of dying based on his ______. In a _____ environment, dying individuals receive medications, massages, and other 114. pain-relieving measures but no lifeprolonging interventions. _____ care aims to provide comfort and care 115. for the dying person and guidance and support for that individual's family and friends. 116. One of the barriers to hospice care is that it can be _____, especially when curative therapies provided by doctors, nurses, and therapists continue over time. 117. _____ care is a medical specialty focusing on the relief of pain and suffering. Opiates, such as morphine, can relieve pain 118. and also slow respiration, producing what is known as a ______. 119. The initials DNR on a patient's hospital chart mean “do not ______.” 120. Passive euthanasia is legal ______. Allowing a seriously ill person to die 121. naturally by ending medical treatment is called ______ euthanasia. Taking action to bring about another person's 122. death with the intention of ending the person's suffering is called ______ euthanasia. 123. In ______, a doctor provides the means for someone to end his or her own life. Some people believe that allowing physicianassisted suicide and euthanasia will lead to 124. a(n) ______, in which more and more extensive practices of eliminating the elderly, the disabled, or the poor will occur. 125. An individual's instructions regarding end of life care are known as a(n) _____. A document that indicates what medical interventions an individual wants if he or she 126. is incapable of expressing his or her wishes is a ______. 127. Another person designated to make medical decisions for an individual is called a _____. Because Martin was intentionally excluded 128. from his ex-wife's memorial services, he is experiencing _____ grief. Joan's husband was killed while at war, and it took several months to recover and identify 129. his body. As a result, she experienced _____ grief. Eric did not seem to grieve the death of his elderly mother, with whom he had been quite 130. close. Eric's wife is concerned that he may have _____ grief. ______ is the public and ritualistic expression of bereavement, the ceremonies and behaviors 131. that a religion or culture prescribes to honor the dead. 132. About 10 percent of individuals exhibit _____ grief after the death of a loved one. Almost all widows and widowers _____ their 133. past marriages; a tendency that has been correlated with psychological health. In a study of reactions to spouses' deaths, about 10 percent of individuals were noted to 134. be _____ depressed than before their spouse's passing, perhaps because they had been caregivers for their seriously ill partners. Essay Questions There has been a great deal of media coverage regarding physician-assisted suicide. Define physician-assisted suicide and state whether 135. you think it is acceptable. Explain your reasoning and offer a specific example to justify your response. What is the goal of hospice care? Who does it 136. aim to serve? How? What barriers can keep people from receiving this kind of care? Discuss how the process of death has changed 137. over the past 100 years, citing at least three examples. Define absent grief, disenfranchised grief, and 138. incomplete grief, and identify circumstances that can lead to each. Apply the notion of “placing blame and seeking meaning” to a tragic death (or the 139. tragic death of many people) that you have heard about in the news recently. What actions did mourners take after the event? What is a good death? Identify and explain three steps that medical professionals could 140. take to help more individuals have a good death. What are the central issues that healthcare providers should consider (or be aware of) in 141. caring for terminally ill individuals at various stages of life, including childhood, emerging adulthood, adulthood, and older adulthood? Text-Based Questions 142. Why is death a topic of hope, not despair? 143. What is the difference between a good death and a bad one? 144. How does mourning help with grief? Why are people less familiar with death than 145. they were 100 years ago? What impact might this have? According to the ancient Egyptians and 146. Greeks, what determined a person's fate after death? 147. What is one example of contrasting rituals about death? 148. What should parents remember when talking with children about death? 149. How does terror management theory explain young people's risk taking? 150. How does parenthood affect people's thoughts about their own death? How do attitudes about death shift in late 151. adulthood? What evidence is there of this shift? 152. In what ways do people change after a neardeath experience? 153. What is a good death? According to Kübler-Ross, what are the five stages of emotions associated with dying? 154. Why doesn't everyone agree with KüblerRoss's stages? What determines whether a dying person will receive hospice care? What are the guiding 155. principles of hospice care, and why is each one important? 156. What differences of opinion are there with respect to the definition of death? 157. What is the difference between passive and active euthanasia? What are the four conditions of physician158. assisted “death with dignity” in Oregon? Why is each condition important? 159. Why would a person who has a living will also need a health care proxy? 160. What is grief, and what are some of its signs? 161. List three types of complicated grief. Why is each type considered “complicated”? 162. What is the difference between grief and mourning? 163. How can a grieving person find meaning in death? How might reactions such as talking to the 164. deceased make it both easier and more difficult to adjust to the death of a loved one? 165. If a person still feels a loss six months after a death, is that pathological? 166. What should friends and relatives remember? 104. 105. 106. 107. 108. 109. 110. 111. 112. 113. 114. 115. 116. 117. 118. 119. 120. 121. 122. 123. 124. 125. 126. 127. 128. 129. 130. thanatology dying hospitals (the hospital) two (2) terror management theory (TMT) near-death experience good life five (5) hierarchy of needs hospice Hospice expensive (costly) Palliative double effect resuscitate everywhere passive active Physician-assisted suicide slippery slope advance directive living will health care proxy disenfranchised incomplete absent 131. 132. 133. 134. Mourning complicated idealized (romanticized) less Physician-assisted suicide is the taking of one's own life by using medication provided by a doctor. Answers will vary but should 135. reflect an understanding who it may help, who it could potentially harm, and how it has impacted death and dying in areas where it is already legal. The goal of hospice care is to allow dying individuals to spend their last days in comfort, and to support the close friends and family of the dying individual. It aims to serve dying people by respecting their wishes, and providing an environment and level of pain management that meets their needs. It aims to 136. support loved ones by providing counseling and guidance. Barriers to hospice care include that it is expensive and not always covered by insurance; that it is not available everywhere; that admitted patients must be terminally ill and approaching death (within 6 months); and that the patient and their loved ones must accept death. Examples will vary but may include that people are now dying later due to longer life 137. spans; taking longer to die due to medical intervention; dying in hospitals rather than at home; and dying from different causes. Absent grief is when mourners do not or cannot grieve. This may be a first reaction, when a mourner simply cannot face the fact that a loved one has died. Disenfranchised grief is experienced when some people, even though they are bereaved, are prevented from participating in mourning. This may be experienced by an ex-spouse or long-time but 138. unmarried partner who is excluded from mourning events for the immediate family. Incomplete grief occurs when circumstances interfere with or delay the process of grieving. This may occur when there is a delay in returning the body for burial, as with deaths that occurred in military action or as part of a crime scene. Answers will vary. For public deaths on a national scale, such as the killing of innocent civilians in a war-torn area, one nation will blame another, and often protest will ensue. Mourners may also protest after deaths caused by a drunk driver, dangerous intersection, or preventable violence, seeking to change laws and raise awareness. Mourners will often 139. create memorials – sometimes tied to the place of tragedy, or sometimes to share the news of their loss widely (as with obituaries). Mourners will often also find connection with others who have been through a similar tragedy, as when parents who lost children to gun violence join forces to provided needed support to each other. A good death is peaceful, quick, at the end of a long life, in the presence of loved ones, in familiar surroundings, and without pain. Answers will vary, but could include talking more honestly about the pros and cons of lifeprolonging interventions, offering pain 140. management without worry of addiction for the terminally ill, allowing for family and friends to visit freely, and allowing the terminally ill to leave the hospital and go home or to a hospice when there is no chance of recovery. 141. 142. 143. 144. At each life stage, individuals have different kinds of concerns regarding death. For example, terminally ill children tend to fear being abandoned or alone, so health care providers should allow family members to remain present at all times. Children also have some understanding of death, and the topic should not be avoided (as it is made more scary by doing so). Emerging adults who are terminally ill may first be saddened and shocked, and then seek to “live life to the fullest,” so allowing for engagement as long as possible may be important. With adults, concern for others left behind is paramount; for older adults, anxiety about death has likely decreased. While reactions to death vary according to a large number of variables, themes of hope emerge in many ways after the loss of a loved one: hope in some kind of life after death, hope that the world has been made better because someone lived, hope that the death occurred for a reason or that meaning can be found in the passing, and hope among the survivors to make the most of the lives they are still living. While ideas about a good death are created by a culture, it is generally considered to be one that is peaceful, quick, at the end of a long life, in familiar surroundings, surrounded by family and friends, and without pain. A bad death would be the opposite, namely to die alone and without consciousness, removed from loved ones. Mourning honors the dead with public and/or ritualistic expressions of grief that help mourners move from loss to reaffirmation. Mourners participate in religious practices, create memorials, stage protests, and partake in other acts that foster connection with others and allow for a positive remembrance of the deceased. 145. 146. 147. 148. 149. One hundred years ago, death often took place at home, where the dying person was surrounded by family and friends. Today, death most often occurs in hospitals, removed from the view of everyday life. Few people have witnessed death first-hand. As death has become less familiar, it has become more feared. The ancient Egyptians believed that one's fate after death was dependent on a combination of the person's actions during life, the circumstances of their death, and the propriety of the burial. The ancient Greeks believed that fate after death was dependent on the good and evil deeds a person committed while alive. Answers will vary, as multiple examples appear in the text. One example is that in many Muslim and Hindu cultures, the dead person's body is bathed by a family member, while in some Native American traditions, no family member is to touch the body. Adults should consider a child's stage of cognitive development when talking about death, and should strive to answer questions honestly. Avoiding the topic may give the impression that death is too terrible to even discuss, which could be very frightening for a child. Children are likely to exhibit signs of mourning, though it can be difficult to anticipate exactly how death might impact them; usually the death of someone (or, as with a pet, something) closely involved in their daily life has more of an impact on the child than a death of a close relative who is generally removed. Terror management theory helps explain some apparently illogical responses to death. With this in mind, young people may take extraordinary risks and then, when they survive, feel as though they have “proved” that they will not die. 150. 151. 152. 153. 154. When people become parents, they often eliminate many risk-taking behaviors in favor of more cautious practices. They often fear death in part because they do not want to abandon family members. In late adulthood, anxiety about death decreases while hope increases. Many individuals in this stage write wills, create health care proxies, and take other steps to plan for the moment of their own death; irrational actions associated with terror management theory are less prominent. In addition, priorities shift; many older adults seek to allocate more of their time to their family. And many older adults express a belief in life after death. After a near-death experience, people tend to move toward the same realizations: 1. the limitations of social status; 2. the insignificance of material possessions, and 3. the narrowness of self-centeredness. People tend to emerge more loving and hopeful than they were before. A good death is typically thought to take place after a long life, peacefully, quickly, in a familiar place, surrounded by loved ones, and without pain or discomfort. Kübler-Ross's five stages of dying are: 1. denial; 2. anger; 3. bargaining; 4. depression; and 5. acceptance. Some people do not agree with her staging because not everyone moves through all five stages in this order – or at all. Hospice patients must be terminally ill, with death anticipated within six months, and the patient and their family must be willing to accept death. In addition, a person's area of residence and even insurance (or ability to pay) are also factors in determining if a person will receive hospice care. Two guiding 155. principles for hospice care are that the dying person's autonomy and decisions are respected, and that the needs of mourners will be met. By providing the kind of environment and pain management a patient desires, and by supporting mourners during and after the loss of a loved one, hospice aims to make dying easier. While the prevailing opinion for decades was that death occurred when brain waves stopped, many doctors now argue that a person may still have primitive brain waves 156. even after death. Researchers seek to more clearly distinguish between a person in a permanent vegetative state and one in a coma, from which they may recover. In passive euthanasia, a person is allowed to die naturally, through the cessation of medical intervention. In active euthanasia, someone 157. takes action to bring about another person's death, with the intention of ending that person's suffering. 158. 159. 160. 161. The dying person must be an adult and an Oregon resident (which is important since physician assisted death with dignity is not legal in other states); the person must make the request twice orally and once in writing (which is important to help ensure that the person did not make the request simply as the result of a particularly bad day); fifteen days must pass between the first request and the prescription (which is also important in making sure the person has had time to consider the decision); and two physicians must confirm that the person is terminally ill, has less than six months to live, and is competent (which is important because the law is meant to help only those who are dying and can, in sound mind, make the decision). Living wills stipulate the medical interventions that people would like to have (or not have) if they are ever unconscious and unable to articulate these preferences themselves. However, no document can completely cover every circumstance and situation. A health care proxy is a person designated to make medical decisions for another person; in the event that a situation that is not clearly identified in a living will emerges, a health care proxy could be called upon. Grief is the powerful sorrow one feels after the death of another. Signs include crying, sleeplessness, delusional thoughts, loneliness, denial, anger, and sorrow, though it is highly personal and can manifest in many ways. Absent grief, in which mourners do not or cannot grieve. Disenfranchised grief, in which some people, even though they are bereaved, are prevented from participating in mourning. Incomplete grief, in which circumstances interfere or delay the process of grieving. 162. 163. 164. 165. 166. Grief is the intense sorrow felt after someone dies. Mourning is the public or ritualistic practices undertaken after a death, meant to move from a place of loss to reaffirmation. Bereavement is the state of being without a person who has died. A grieving person may find meaning in death through engaging in political protests or connecting to causes aimed at improving life for others (joining efforts to end gun violence or drunk driving or to find a cure for cancer, for example), or in reflecting on and sharing the impact that the deceased had on their own life. Talking to a deceased loved one may be a way of creating a continuing bond, though how much such actions help a person deal with grief may be dependent on culture. In China, talking to a deceased person appears to help the healing process; in the U.S., it may actually hinder it. While most people are about as happy and productive six months after a death as they were before the death occurred, current research highlights a diversity of reactions after death. Research also points to the importance of knowing about a grieving person's psychological history when analyzing their response to grief. Those close to a grieving person should remember that grief involves a variety of complex and powerful emotions, and that there is not one correct way to grieve. It is important to listen and sympathize and not to judge, as individuals exhibit a diversity of responses to death.