Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
AGING, DEATH, AND DYING AGING Ways to measure a person’s age 1. Chronological Age 1. # of years a person has lived 2. Biological Age 1. How well a person’s body systems are functioning 3. Social Age 1. Measure of the activity level engaged on a daily basis STAGES OF DEATH Elizabeth Kubler-Ross I believe they should be called stages of loss A person may experience these for any type of loss, such as: divorce, a pet, moving, going away to college, a relationship ending…. People tend to go through a series of stages, they may go back and forth, skip about or have periods where the stages seem to overlap, this is all according to their needs. Stage One: DENIAL Usually the first reaction: NOT ME People are in shock Unable to admit to themselves that the patient might die and/or they will suffer the loss death represents The best thing to do is just listen to what they are saying, you don’t need to come up with the correct response to fix the situation Stage Two: ANGER “WHY ME” May be angry at the situation, not at you The pain of loss is projected onto others Try not to take it personally Stage Three: BARGAINING Last attempt to correct situation and avoid the inevitable Pray to God, promise to reform their life STAGE FOUR: DEPRESSION They are losing everything and may feel hopeless and helpless Unfinished business When the full impact of imminent death strikes them Feel bad for the people they will leave behind The best thing to do is just listen and be there for them STAGE FIVE: ACCEPTANCE Learning to say goodbye Accept the reality of death May get personal affairs in order, by way of will and/or living will Try to live the rest of their life to the fullest Listen to their wishes and be there for them TERMS Grief Intense emotional suffering caused by a loss, disaster, or misfortune Empathy Ability to share in another person’s emotions or feelings Coping Dealing successfully with difficult changes in your life Mourning the act of showing sorrow or grief Ways to help a Grieving Person Express your sympathy as a sign of respect Feelings of guilt, despair, and similar feelings are normal Listen to, hold (hug), and touch a grieving person. Allow the person to share their feelings with you. Randy Pausch (2008) • http://video.stumbleupon.com/#p=ithct48c qw Diseases of the Elderly: Alzheimer’s Disease- more than 5 million Is a fatal brain disorder that causes physical and chemical changes in the brain. An incurable illness characterized by a gradual and permanent loss of memory. Dementia deterioration of intellectual faculties (memory/content) Arthritis inflammation of the joints/ breakdown of cartilage Diseases of the Elderly: ALS (Amyotrophic Lateral Sclerosis) Lou Gehrig Disease Progressive disorder of the nervous system Cataracts lens become cloudy, impaired vision, causes blindness Glaucoma fluid inside the eye builds up, may cause blindness Diseases of the Elderly: Osteoporosis- more common in women Brittle bones, which may lead to a broken bone. Due to the lack of calcium in developmental years Geriatrician a physician who specializes in caring for the elderly Death & Dying Terms: Funeral The observances held for a dead person usually before burial or cremation Embalming Removing Blood and other fluids from a body that prevents deterioration of the body (formaldehyde, methanol, ethanol ) Cremation Complete reduction of a body to ashes by intense heat Epitaph An inscription on a tomb or at a grave in memory of the dead person Eulogy A prepared speech or writing extolling the virtues & services of a person Obituary A notice of the death of a person, usually published in a newspaper and includes a short biography Death & Dying Terms: Probate Establishing a will to settle your estate Power of Attorney A legal instrument allowing one person to act as the agent of another person (living will) Living Will (see handout) A document enabling individuals to provide instructions about the kind of medical care they wish to receive or refuse if they can no longer make decisions Defining Death Harvard Medical School Criteria: brain death Unreceptiveness/Unresponsiveness • Patient does not respond to painful stimuli Absence of muscular movement and breathing • No breathing for over an hour Lack of Reflexes • Knee Reflex is absent. Pupils will not respond to light Absence of brain activity (EEG-Electroencephalograph) • For 20 min, the brain does not generate electrical impulses Death & Dying Terms: Palliative Care Measures taken to reduce the intensity of a disease Hospice An agency that assists people with a terminal illness May be in the house or in an area of a hospital Gives them more control over their death and how they want to die Medications are freely administered for pain Family members receive counseling to work through grief (better prepared to interact w/ the dying person) Life Support Systems Medical technologies used to keep patients alive that would otherwise die Karen Ann Quinlan – Nancy Cruzan – Terri Schiavo Death & Dying Terms: • Passive Euthanasia – The practice of withholding or withdrawing lifeprolonging treatment,allow for the terminally person to die naturally • Active Euthanasia – The practice of intentionally hastening the death of a person who requests it to avoid painful or prolonged living – Dr. Jack Kevorkian – http://www.nndb.com/people/272/0000232 03/ • Lethal Injection – Injecting a drug that will result in death Karen Ann Quinlan 1975- 21 yr. old ingested alcohol and sedatives Cardiopulmonary arrest and fell into a persistent vegetative state Parents wanted to remove respirator Hospital said no Parents’ lost the first case Parents’ won the second case and turned the respirator off Karen continued to breath without life support and lived for 10 years This case: led to hospital and hospice ethics committees Led to advance directives (living wills) Nancy Cruzan 1983 automobile accident Permanently unconscious, no higher brain function Kept alive by feeding tube Parents’ lost the first case Later showed evidence and won Removed the feeding tube in December 1990 and later died that month Terri Schiavo Feb. 1990- 26 yr. old severe brain damage from respiratory and cardiac arrest and her heart stopped for 5 minutes 1998- husband filed to get the feeding tube removed (saying wife told him that she didn’t want artificial respirator if she were ever put on one) Parents fought 2000- Husband could discontinue life support The feeding tube was removed in 2003 and then reinserted six days later “Terri’s Law” “Terri’s Law”- gave the governor authority to order the reinsertion of the feeding tube, which had been removed six days earlier in compliance with a court order. 2005- Tube was removed again, after two weeks of no food and water, she died March 2005 Death With Dignity – Oregon, Washington, Netherlands, Belgium, Switzerland, Thailand, Luxembourg Allows patient to gain control over their death • Plan their funeral or memorial service • Want to decide who their doctors will be, type of treatment, and who can visit them. • 18 years old or parent consent if under 18 • 2 Doctors must diagnose & 6 months terminal illness • Mentally capable of making the decision on your own • Resident of the state • Patient makes three requests; two oral and one written • • • Patient drinks a strong Barbiturate potion (9g Pentobarbital) Time from ingestion to unconsciousness is 1 to 20 minutes (avg. 4 minutes) Time from ingestion to death 5 minutes to 48 hours (avg. 20 minutes) http://www.deathwithdignity.org/media/uploads/OregonYear12Table.pdf Suicide The act of intentionally taking one’s own life. Third leading cause of death among people between the ages of 15-24 years of age lack of family support sense of isolation Guilt, low self-esteem, sense of worthlessness Increased use of drugs and alcohol People who attempt suicide give warning signs that are a cry for help. Many suicidal people reach out for help repeatedly before taking their own life. Cluster Suicide A series of suicides occurring within a short period of time and involving people within the same community or connected in another way Possible Warning Signs of Suicide Change in eating and sleeping habits Withdrawal from friends, family, and regular activities Use of alcohol or other drugs Violent actions (rebellious behavior, running away, angry, and destructive) Marked personality changes Neglecting personal appearance Decline in their work (school/work) Possible Warning Signs of Suicide Giving away favorite possessions Inability to concentrate or make decisions Not tolerating praise or rewards Re-occurring theme of death in writing Frequent complaining about physical symptoms Increased Risk taking Factors that Contribute to Suicide Rising divorce rate, and break-up of families. Many teens live in troubled families. Pressure to succeed in school and life. Questions about sexual orientation. Increase in use of alcohol and drugs. Why Someone Would Want to Die? End the emotional pain they have Under extreme stress Trivial matters become overwhelming Become tunnel vision Suicide Mindset: the feeling that suicide is the only solution to the problems of living What do you do if someone is Suicidal? You might ask the person directly are you contemplating suicide? Most people will reach out for help before they try to kill themselves. Listen to your friend. Let them know that you are listening and that you understand. What do you do if someone is Suicidal? Don’t debate whether suicide is right or wrong. Allow them to express their feelings. Get involved. Become available. Show interest. Don’t lecture on the value of life. Get help from people or agencies specializing in crisis. Adults who can help in a crisis Parent Grandparent, uncle, aunt, other relatives Teacher or Coach Friends Therapist at a school Religious leaders Person working the suicide hotline