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Thanatology: Study of The Experiences of Dying and Bereavement

The document discusses thanatology, the study of death and dying, including definitions of death, the dying process, and different types of deaths. It also covers legal aspects of determining and certifying death, stages of death and dying, near death experiences, considerations around death across the lifespan, and managing grief, mourning, bereavement, and complicated forms of bereavement.

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331 views17 pages

Thanatology: Study of The Experiences of Dying and Bereavement

The document discusses thanatology, the study of death and dying, including definitions of death, the dying process, and different types of deaths. It also covers legal aspects of determining and certifying death, stages of death and dying, near death experiences, considerations around death across the lifespan, and managing grief, mourning, bereavement, and complicated forms of bereavement.

Uploaded by

nkivc
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Thanatology

Study of the experiences of


dying and bereavement
Definitions
 Death
 absolute cessation of vital functions

 Dying
 process of losing these functions

 Good death
 Free from avoidable distress and suffering

 Bad death
 Needless suffering, dishonoring of patient/family wishes or values
Uniform Determination of Death Act
(1981)
 Irretrievable cessation of circulatory and
respiratory functions

 Irretrievable cessation of all brain


functions, including the brain stem
Interval between 2 evaluations
according to age
 Term to 2 months – 48 hours

 > 2 months to 1 year – 24 hours

 > 1 year to < 18 year – 12 hours


Legal Aspects of Death
 physicians must sign death certificate

 Attest cause of death

 Attribute death to natural, accidental, suicidal, homicidal or unknown

 Unattended cases – medical examiner, coroner or pathologist must


examine and perform an autopsy

 Psychological autopsy in some cases


Stages of Death and Dying
(Elisabeth Kubler Ross, MD –1969)
 Stage 1 – Shock and Denial

 Stage 2 – Anger – Why me?

 Stage 3 – Bargaining

 Stage 4 – Depression

 Stage 5 – Acceptance
Near Death Experience
 Strikingly similar
 Descriptions
 Out of body experience Viewing one’s body
 Overhearing conversations
 Feeling of peace and quiet
 Hearing a distant noise
 Entering a dark tunnel
 Leaving the body behind
 Returning to life to complete unfinished business
 Described as peaceful/loving
 Feels real
 Provoke sweeping lifestyle changes
 Experience of “visions” ( unio mystica )
Life Cycle Considerations about
Death/Dying
 Children
 Pre- school
 Death seen as temporary absence, incomplete and
reversible (departure/sleep)
 Maybe unable to relate treatment to illness

 School – age
 Recognize death as a final reality
 Active fantasies of violence/aggression (6-12 yrs)
II.
 Adolescents
 Understand death is inevitable/final but may not
accept that their own death is possible
 Concerns about body image or loss of body functions
– great resistance to treatment
 Alternating emotions of despair, rage, grief, terror, are
common
 Potential for withdrawal/isolation
 great
III.
 Adults
 Common fears
 Separation from loved ones
 Becoming a burden
 Losing control
 What will happen to dependents
 Pain
 Being unable to complete life tasks
 Dying
 Being dead
 Fears of others
 Fate of body
 The afterlife
 Sense of integrity vs. despair (Erik Erikson)
Management
 Highly individual
 caretakers need to need to deal with death
honestly; tolerate wide range or affects,
connect with patients and resolve issues
as they arise
 Major themes confront all health providers
caring for dying patient
Grief, Mourning and Bereavement
 Grief
 Subjective feeling precipitated by the death of a
loved one
 Mourning
 process by which grief is resolved
 Bereavement
 State of being deprived of someone by death ….
Being in a state of mourning
Normal Bereavement Reactions
 Protest
 Searching behavior
 Despair and detachment
 Reorganize self
Duration of Grief
 Few weeks to months to years
 Lasting manifestation is loneliness
 Protracted grief occurs intermittently
 Bittersweet memories may last a lifetime
Complicated Bereavement

 Chronic grief
 Hypertrophic grief
 Delayed grief
 Traumatic bereavement
Grief Depression
 Fluid, changing and  Pervasive
evolving state  Recognizable cluster of
 Fluctuating state and debilitating symptoms
cognitive and behavioral accompanied by a
adjustments are protracted, enduring low
progressively made mood
 Time limited fleeting with  Persistent and associated
full resumption o function with mark
social/occupational
dysfunction
Grief Therahy
 Normal grief – seldom need psychiatric help
 Seriously suicidal – psychiatric intervention ex.
Sleeping medications, antidepressants,
anxiolytics
 Counseling sessions – depressive disorder,
pathological mourning
 Grief theraphy – one on one or group

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