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74 Cards in this Set
- Front
- Back
Lifeline
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Between 0 and 100. 77 is the average life expectancy in the US (74 for women, 80 for men)
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Thanatology
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The scientific study of death among humans
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Thanatos
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death
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Hypnos
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Sleep
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Type A Pedestrian
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Look both ways before crossing street. Cautious
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Type E Pedestrian
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Walk without looking or caring about cars. Are more of a risk taker.
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Developmental stages of child's understanding of death
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birth-6 months: baby has no concept of self
6 months - 2 years: aware of alternating stages. belief that separation is temporary. 3-5 years: children think dead isn't really dead. Believe that they may come back some time in the future (the way flowers return in the spring) 6-9 years: Personify death, know that the dead don't return. Believe that they can avoid death by being good. 10 years: final, universal. |
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How to talk to children about death
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Avoid euphamisms, let the child grieve, it's okay to say someone is dying but do not say they are "sleeping". Children should see parents cry. Remind children that "magical thinking" (you can think someone to death) did not cause the person to die
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Images of death
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connection: feeling loved and surrounded --> separation: child feels alone.
movement: life, being able to run --> stasis, state of stability. integrity: child stays in one piece --> disintegration: cuts, bruises |
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Truthtelling
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Vernick was a social worker and Kavin was a socialist. They worked in a hospital with a floor of children with cancer. The staff lied to the children and said they would eventually end up in the 15th floor so that the children would believe they were going to heaven, however the 15th floor was actually the adult cancer floor. Eventually the children figured it out and the staff began telling them the truth about procedures and the likelihood they were going to die. They found that truth telling was the most effective way of coping with cancer patients.
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3 forms of communication
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Direct language: being comfortable saying cancer. Verbal symbolic language: less threatening words "it", "the big c". Nonverbal symbolic language: drawing, body posture, hand gestures
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Dying trajectory (7)
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Lingering trajectory: dying slowly, considered socially dead. Expected quick trajectory: ICU / ER. Pointed trajectory: patient exposed to something risky. Time for families and patient to talk and be together. Danger period trajectory: 2 hour time frame (after heart attack). Crisis trajectory: life could be threatened at any time, time to be with family now. Will die trajectory: keep patient comfortable and wait for death. Unexpected quick trajectory: unexpected health problem, someone drowns, can be very traumatic for hospital staff.
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Spinetta
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Heard many anecdotes about children dying with a sense of isolation. Studied children ages 6-10 with chronic illnesses and life threatening illnesses. Created a diarama of the hospital room and asked children where to put the nurse and mom dolls and then measured the distance the child put the doll in relation to the bed. Results showed that child was going through emotional withdrawal.
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Freud's death instinct
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Eros = life instinct (hunger, thirst, sleep, sex). Thanatos = death instinct, may overwhelm life instinct. He believed in the theory of constancy (all life forms return to the instability of the inorganic state, destructive and directed outward).
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Glasser & Strauss, 4 types of awareness in dying patients
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Closed awareness: patient is unaware he or she is terminally ill. Suspected awareness: suspects he or she is dying but no one tells them. Mutual pretense awareness: patient, family, doctors know but no one discusses it with patient. Open awareness: everyone involved and patient openly discuss.
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Kubler-Ross's 5 stages of dying, can slip back and forth between them, stages are not inevitable.
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1. Denial: fueled by anxiety, and usually lasts for a short period of time. 2. Anger: can be rational 3. Bargaining: person wishes for an extension of life to be able to attend an event. bargaining usually with god, doctor or family member. Depression: occurs when a person experiences weakness. Fear of dying, patient becomes less responsive, sense of loss. Acceptance: void of feelings, pain has gone and struggle is over. Time of rest before the long journey.
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Kubler-Ross's two types of depression
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Reactive: depressed about all the past losses, never going to experience something again. Preparatory: things you wanted to do but aren't going to get to accomplish
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Hospice Care
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Used to mean "waiting room". The main goal is home care, for patient to be in familiar surroundings. Allows the person to live meaningfully, promote care for family. 80% can be taken care of at home. In-patient care: no family or friends, care is too overwhelming for patient. In home care, family is trained how to administer medicine and feed. Usually free, insurance might pay for it.
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Cremation
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Done by 35% of people in the US. First body is baked and then remains are crushed and turned to ash (shake and bake), then put into urn.
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Burial at sea
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Body taken on boat and dumped overboard. If it isn't eaten by sharks or fish, it will eventually decompose and help to rebuild a coral reef.
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Cryonics
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"Frozen in time". Freeze dead bodies using liquid nitrogen. Costs between $28,000 and $120,000. It is cheaper just to freeze the head of the body.
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Celestis
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Burial in space. First done in 1997, contract with rocket firms to send rockets into space with cremains (ashes in urns). Urns will circle from 6-24 years above the earth and then begin to enter the atmosphere at which point they burn up on their way back down to earth.
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Mummification
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Costs $56,000. Uses alkaline hydrolysis.
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Bereavement
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Death of someone close to you. Someone or something has been taken away (statement of loss).
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Grief
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How someone is affected by loss. Often show emotions of sorrow, sadness, anger, frustration.
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Eric Lindemann first studied grief...
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In 1940 after the Boston Restaurant Fire. Interviewed 101 survivors of the fire. They experienced somatic distress like shortness of breath, worry of image of diseases, sense of unreality, strong feelings of guilt. Guilt put a tremendous stressor on our body and suppressed the immune system.
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Mourning
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Behavior determined by culture and religion. Some cultures wear black and drape black cloth over windows, listen to requiem music to signify mourning.
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Freud's "Mourning and Melancholy"
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Said grief was an adaptive response to loss. It is difficult and time consuming.
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Broken Heart Syndrome
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Mortality rate of survivors goes up. Some people lose their will to live. First time it was used in a journal article was 1967 when parents experienced the death of a child.
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Delayed grief reactions
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Spontaneous occurrence of memory, scent, sound that reminds someone of dead person and causes grief. Self help groups and interpersonal therapy can be helpful.
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Disenfranchised grief
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Hidden grief, keep emotions to self. Relationship with deceased isn't socially recognized, loss is not acknowledged by others as genuine (abortion, miscarriage). Might be a pet or former spouse, coworker, someone who is mentally retarded. People don't feel entitled to feeling grief for death.
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5 types of immortality
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physical, psychological, spiritual, social, economic
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Physical immortality
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will live on through children, organ donations, cryonics cloning
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Psychological immortality
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continuation of consciousness after death
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spiritual immortality
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the soul's "oneness" with god, nature, universe, extends beyond limited biological lifespan
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social immortality
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exists for others in symbolic ways, memories, things you did, oral tradition, given a name to memorialize you (Dia de Los Muertos)
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Economic Immortality
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Some people with lots of wealth can endow a building or school
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British Society of Psychical Research
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Wanted to study life after death to see if we can communicate with the dead. Weighed alive and dead bodies and found a difference in weight of about an ounce. Not recognized as legitimate by psychology departments.
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Raymond Moody
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Believed in "life after life", interviewed lots of people, events occur when a person could have easily died but continued to live physically even though the heart and respiration stopped. Positive account of a NDE. Out of body experience: 37% of people have it, the feeling of floating above yourself and describing what was happening. Panoramic memory: life review, life flashing before your eyes. Rapidly appearing memories in chronological order, visual imagery has great intensity.
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Autopsy procedure
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1. external examination of body to look for lesions, bruises, obvious causes of death. 2. dissection and examination of organs with a y-incision. Scoop out brain from head. 3. Microscopic examination of tissue in body. 4. Toxicology and cultures tests done. Blood in heart is tested for bacteria.
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Reasons and purposes of an autopsy
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Only about 2% of people get autopsies, most hospitals don't have a place to keep the dead. Autopsy helps us learn about death and why people die, also about quality control (was the diagnosis correct), and whether doctors made any mistakes
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Documents of death
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Death certificate: says how and when did they die. Disposal of the remains: asks how the remains are going to be handled. Obituary: in the newspaper, family / friends usually write it and can say whatever they want but usually gives date and time of funeral and brief info about person. Death notice is paid for and is the equivalent of an obituary. Last will and testament: the act in which the person determines the disposition of their property 6. harvesting the dead: organ donation (hospital can legally remove organs so family can choose whether or not to donate organs if the person hasn't specified. Organs are usable 15 minutes after death. Body donation: body can be given to medical schools to study, also used as crash dummies
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Testator - testatrix
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Male testator fills out will, female testatrix
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Executor - executrix
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male who's designed to carry out what's in the will, female is an executrix
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What is a funeral director? (certification, what does his job entail)
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A highly-skilled person who deals with funeral and death regulations. Goes to school for morticians and passes national and state-level exams
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7 steps of a funeral
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body removal, preneed or at need, embalming, restorative art, make up, dressing, casketing
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Body removal
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Body is zipped into body bag, put into refrigerated van. Funeral director takes care of death certificate and can't start embalming until they either have the death certificate or know it's pending
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Preneed or at need
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Preneed: all arrangements made ahead of time at need: arrangements need to be made after death.
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embalming
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body is pulled from refrigerator, taken to embalming room which has no see-thru windows, lots of vents. Embalmer is fully covered and wears a full surgical suit, special shoes, splash guard, latex gloves when working with formaledhyde. Body is sprayed with disinfectant, scrubbed and hair is washed. Cotton is stuffed in ears and in other openings. Face gets shaved, body is supposed to look like they're still living and are at peace.
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restorative art
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cheeks, forehead, hands are massaged to get rid of tenseness and stiffness in muscles. Head is tiled 15 degrees to the right so that it looks like they're looking at you and not straight at the cieling. Eyelids are glued down, disinfectant is sprayed in mouth and then cotton is stuffed in. Staple gun is used to staple jaws, mouth is closed, lips are shaped with putty and then glued. Formaldehyde is pumped into body, skin is painted and blood is pumped out
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make up
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make up put on hands and face
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dressing
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body dressed in waterproof pants, underwear, outer clothing. Body is supposed to match how they would look if they were still alive
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casketing
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body is manipulated and placed on casket with head on pillow
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griefwork theory
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Freud said grief is normal, the work of grief is difficult and time consuming. The basic goal of grief work is to accept the reality of death and detach from dead person and invest in a new relationship. Focuses on emotional needs of grieving people
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What stages of Kubler Ross's theory did Peter go through?
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Peter experienced denial when others told him he had a terminal illness. He experienced rage and anger towards the doctors and his mother. He bargains with himself, saying if he pulls through he will start writing, singing and playing the piano. His social worker could tell he was depressed, and he accepts death and admits he might die
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What is meant by the Screaming Room
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Barbara wishes she had a room she could go into and release her bottled up emotions
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What did Peter experience physically?
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Severe diarrhea, high fever, bumps, CMV, blindness, brain damage, seizures, herpes
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History of a funeral: Iraq, Egyptians, Greeks, Romans, Hebrews, Christians, Dark Ages, Da Vinci, US
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Iraq: funerals were done 60,000 years ago
Egyptians: original funerals where they buried bodies in sand, shriveled body was preserved so soul could return to body. Also performed mummification on bodies, preserved organs and stuck instrument up nose to liquefy the brain. Put a salt compound into the body for 40 days. Greeks: family would prepare body using spices and purfumes to hide smell, bury or cremate. Romans: also buried or cremate. Hired mourners to attend funeral. Hebrews: bury body within 24 hours of death. This happens today unless an autopsy is being done. Buried in a simple wooden box or plank of wood, then into a tiny cave Christians: washed body with alcohol, water and sweet oils. Would use seplicas Dark Ages: bury people under floors of cathedral. Cremation for a period of time but wanted to save wood so that stopped happening. Da Vinci: anatomical sketches of people, hire grave diggers to bring dead bodies to him to sketch. Take alcohol and hand pump blood out and alcohol in US: originally bodies were put on ice before being buried, 19th century: carpenters and cabinet makers started making coffins. Part time undertakers would take care of body. During the civil war, embalming began to be used. President Lincoln told army surgeons to find a way to get bodies back to families so they pumped in arsenic and pumped out blood. Eventually formaldehyde was used. |
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Wall vs. Door
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Feifel's metaphor. door: body doesn’t necessarily provide a being, it just holds our soul during we’re alive (spiritual) Wall: once body and physical matter break down, you don’t live in any way (scientific perspective)
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Fister
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Describes NDE as a release of endorphins. Can explain a near-death experience without including the idea that there is life after death. An NDE could be due to drugs, anesthesia, dream state.
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children's exposure to death
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They understand animals die, understand sometimes children die but usually older people die. Should be allowed to see people grieving, should be allowed to attend the funeral, should be taken to nursing home to understand death.
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Bowlby
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wrote about children's normal reactions to death. Wrote Attachment, Separation, and Loss about attachment theory.
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Anna Freud
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Worked with children who had deceased parents. Found that the worst outcome was if a child was obsessed with the dead. Children who did the best were the ones who accepted death and found someone else to love
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Possible reactions to death of a parent
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Picking up parents mannerisms, find someone else to love, carry out wishes of dead parent, anxiety, depressed, hostile.
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Child's reaction to dying
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Worried when confronted with secrecy, relieved when parents were honest and leveling, up until death is just a fear of separation, anxiety can cause regression to early behaviors. 5-10 fear of painful procedures, be honest about how painful the procedures are. 10+ fear of losing friends and death itself.
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Internal vs. external locus
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Internal: you control your life, external: you believe your environment, other people or a higher power control the decisions in your life.
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social death
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social isolation, ignored, avoided. Treating someone as if they are already dead, making decisions for them
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interventions with dying patient (4)
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physical pain: mild, constant, dehabilitating, pain is rated on a scale. Emotional pain: frightened, anxiety, lonely, depressed. Therapy and meds might be used. Social: interpersonal relationships, help patient with unfinished business and saying goodbye. Spiritual pain: religion can help
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St. Christophers Hospice, Cecily Saunders
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first hospice care unit
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stages of grief
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Shock, state of confusion, repeated stories or events, rage, anger, volatile emotions, guilt from believing death could be prevented, moral or cultural guilt, loneliness, relief
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bereavement overload
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Loss follows loss follows loss. Difficult for person to cope with all of the deaths in their life
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Knapp's Beyond Endurance
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shadow grief is a grief that is never completely resolved and results in emotional dullness. Parent thinks about how much child could have accomplished, feel like there's no way to continue on without them. Will neglect themselves as a result.
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Albert Heim
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Loved to mountain climb, fell off a mountain and had a few experiences while falling including 5 separate thoughts about planning what would happen if he survived. Found that others who had fallen went through similar mental processing.
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Michael Sabom
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Interviewed people with NDE. High correlation among what medical staff saw, what was noted in the chart and what supposedly dead patient saw. Does not say this is proof of life after death
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