Death and Dying

11 Key excerpts on "Death and Dying"

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  Understanding the Life Course

  Sociological and Psychological Perspectives

  • Lorraine Green, Lorraine Green(Authors)
  • 2016(Publication Date)
  • Polity

    (Publisher)

  8

  Death, Dying, Grief and Loss

  Introduction

  Death is the one final inevitability in our lives, even more inescapable than paying taxes, and we are the only species who has any understanding of death. Our ancestors accepted death as an everyday communal part of life and were psychologically and physically very close to it, but we confront death today far less frequently, publicly or personally. In our often urbanized, fragmented and impersonal Western societies, religion, the family and the community now play a smaller role in explaining and handling death than in previous eras. Improved environmental conditions and medical technology have led to greater longevity. People often die in hospital or, when someone dies unexpectedly, the body is immediately removed to the funeral directors or coroners. This institutionalized medicalization and bureaucratization of death shields us from most aspects of it, alongside its less obvious occurrence. We consequently often find death threatening and an affront to the emphasis we place on youth, vitality, beauty and the value of the individual. The positing of bereavement grief as potentially deviant or pathological, furthermore, leaves many people fearful about how they will or should react when someone close to them dies.

  Psychology and sociology examine different aspects related to Death and Dying. Psychology engages primarily with the emotional experience of the dying or bereaved individual whereas sociology concentrates on the impact of social and historical contexts on how death is perceived and responded to. Psychological theories relating to grief and loss, however, do not pertain exclusively to bereavement. One may grieve during a relationship breakdown or after a shift from a valued way of life to one potentially less valued. Asylum seekers, for example, may suffer grief and multiple losses associated with leaving behind home, family, culture and nation, further exacerbated by possible past traumatizing experiences of war, persecution or diminishing health. This may be exacerbated even more by racism, bureaucratic asylum processes and loss of status and a valued role in the host country. However, in this chapter bereavement acts as a key exemplar of grief and loss theories. The chapter initially appraises traditional and contemporary psychological perspectives, followed by the sociological ‘take’, later synthesizing them to present a more coherent, interdisciplinary understanding of grief, loss, Death and Dying.

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  Adult Development and Aging

  Biophysical Perspectives

  • Susan K. Whitbourne, Stacey B. Whitbourne(Authors)
  • 2020(Publication Date)
  • Wiley

    (Publisher)

  PSYCHOLOGICAL PERSPECTIVES ON Death and Dying From a psychological standpoint, Death and Dying carry many layers of meaning. Toward the end of their lives, individuals may begin to shift their identities to incor- porate the reality that faces them. As with changes they experience throughout life, people use identity assimilation to minimize if not deny, as much as possible, this coming reality. At some point, however, they must accommodate the fact that their life will be ending, at which point the process of identity balance may start to allow them to face this fact with equanimity. The way in which a person dies can become a part of the individual’s identity, at least when the individual becomes aware that death is imminent. Your life develops an ending that may cause you to think of yourself differently than you did prior to having that knowledge, a fact which may also help you ease your own death anxiety (Wojtkowiak & Rutjens, 2011). Furthermore, when you reach that point, Issues in End-of-Life Care 279 you may wish to take steps to leave a legacy that will continue to define you after you are gone, a process called legitimization of biography. Through this process, people attempt to see what they have done as having meaning, and they prepare the ‘‘story’’ of their lives by which they will be remembered in the minds of others (Marshall, 1980). Some individuals may put their memoirs in writing, and others achieve an internal reckoning in which they evaluate their contributions as well as their shortcomings. Psychologically, the dying process can begin well before the individual is in any real physical jeopardy. People first start to think about their own mortality when they reach the point called awareness of finitude, which is when they pass the age when other people close to them had themselves died (Marshall, 1980). For example, if a man’s father died at the age of 66, a kind of counting-down process begins when the son reaches that age.

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  Adult Development and Aging

  Biopsychosocial Perspectives

  • Susan K. Whitbourne, Stacey B. Whitbourne, Candace Konnert(Authors)
  • 2015(Publication Date)
  • Wiley

    (Publisher)

  PSYCHOLOGICAL PERSPECTIVES ON Death and Dying From a psychological standpoint, Death and Dying carry many layers of meaning. Toward the end of their lives, individuals may begin to shift their identity to incorporate the reality that faces them. As with changes they experi- ence throughout life, people can use identity assimilation to minimize, if not deny, as much as possible this coming reality. At some point, however, they must adjust to the fact that their life will be ending, at which point the pro- cess of identity balance may start to allow them to face this fact with equanimity. The way in which a person dies can become a part of his or her identity, at least when the person becomes aware that death is imminent. Your life develops an end- ing that may cause you to think of yourself differently than you did prior to having that knowledge, which may also help to ease your own death anxiety (Wojtkowiak & Rutjens, 2011). Furthermore, when you reach that point, you may wish to take steps to leave a legacy that will continue to define you after you are gone, a pro- cess called legitimization of biography. Through this process, people attempt to see what they have done as having meaning, and they prepare the “story” of their life by which they will be remembered in the minds of others (Marshall, 1980). Some individuals may put their mem- oirs in writing, and others achieve an internal reckoning in which they evaluate their contributions as well as their shortcomings. Psychologically, the dying process can begin well before the individual is in any real physical jeopardy. People first start to think about their own mortality when they reach the point called awareness of finitude, which is when they pass the age when other people close to them died (Marshall, 1980). For example, if a man’s father died at the age of 66, a kind of counting-down pro- cess begins when the son reaches that age. He anticipates the end of life and understands that life really will end.

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  Development Through Life

  A Psychosocial Approach

  • Barbara Newman, Philip Newman(Authors)
  • 2017(Publication Date)
  • Cengage Learning EMEA

    (Publisher)

  So, too, it is with death. The biological process of dying takes place in a psychosocial context of relationships, resources, and cultural beliefs and practices. Death is accompanied by trans-formations at the biological, psychological, and societal levels. It is the role of culture and religion to provide narratives or explana-tions for the transformations of energy that occur in death. Be-cause we cannot empirically test many of these explanations, it is the role of the ego to cope with the unknown aspects of death, to give it personal meaning. Death is at once a certainty in that all living things die, and a random event, in that the timing of death is unknown. Moreover, whereas through observation, systematic study, and the trans-mission of knowledge from generation to generation, we have a good idea about the trajectory of development beginning with the prenatal period until death, we have only speculations and belief systems to guide our understanding of what occurs at death and beyond. Thus, death is both inevitable and unknowable. Thanatology is the field of science that addresses dying, death, and the psychological mechanisms of coping with them. This field includes an analysis of the attitudes toward dying, the meaning of death for individuals and societies, the rituals and practices associated with death, the bereavement process, and the expressions of bereavement across situations and cultures. ● Mortality and Psychosocial Development OBJECTIVE 1 Explain how mortality influences psychosocial development. Psychosocial development focuses on the ongoing interac-tions between the person and the environment. A person’s abil-ity to understand the self and others matures and changes with each psychosocial crisis. At each stage of life, the ego is shaped by the perplexing nature of mortality. In infancy, as one achieves a balance between trust and mistrust, an outlook of hopefulness emerges.

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  Adult Development and Aging

  Biopsychosocial Perspectives

  • Susan K. Whitbourne, Stacey B. Whitbourne(Authors)
  • 2020(Publication Date)
  • Wiley

    (Publisher)

  You may think occasionally about what death means to you, and how you would approach the ending of your life. As people age, the concept of death takes on greater reality. Perhaps what most people wish for is to live a maximum health expectancy, which is the length of time an indi- vidual can live without significant disease and disability. In keeping with Erikson’s concepts of generativity and ego integrity, many people also wish to leave something behind to be remembered by and to have made an impact on other people’s lives. From the biopsychosocial perspective, Death and Dying are best understood in a multidimensional manner. Death is, of course, a biological event, as it is the point in time when the body’s functions cease to operate. However, this biological fact of life is overlaid with a great deal of psychological meaning, both to the individual and to those in the individual’s social network. Socioculturally, death is interpreted in multiple ways varying according to time, place, and culture. WHAT DO WE KNOW ABOUT DEATH? The technical definition of death is the irreversible cessa- tion of circulatory and respiratory functions, or when all structures of the brain have irreversibly ceased to function (President’s Commission for the Study of Ethical Prob- lems in Medicine and Biomedical and Behavioral Research, 1981). The 1981 report was the basis for the Uniform Deter- mination of Death Act, a model state law that was adopted by most U.S. states. The term dying refers to the period during which the organism loses its vitality. These terms, as you will learn, are not always clear-cut, particularly with advances in life support technology that allow people to be kept alive almost indefinitely after an organ vital to sur- vival has failed.

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  Adult Development and Aging

  • Susan K. Whitbourne, Stacey B. Whitbourne, Candace Konnert(Authors)
  • 2021(Publication Date)
  • Wiley

    (Publisher)

  You may think occasionally about what death means to you and how you would approach the ending of your life. As people age, the concept of death takes on greater reality. Perhaps what most people wish for is to live a maximum health expectancy, which is the length of time an individual can live without significant disease and disability. In keeping with Erikson’s concepts of generativity and ego integrity, many people also wish to leave something behind to be remembered by and to have made an impact on other people’s lives. From the biopsychosocial perspective, Death and Dying are best understood in a multidimensional manner. Death is, of course, a biological event, as it is the point in time when the body’s functions cease to operate. However, this biological fact of life is overlaid with a great deal of psychological meaning, both to the individual and to those in the individual’s social network. Socioculturally, death is interpreted in multiple ways, varying according to time, place, and culture. WHAT WE KNOW ABOUT DEATH According to the Law Reform Commission of Canada, the technical definition of death is the irreversible cessation of brain function that can be determined by the prolonged absence of spontaneous cardiac and respiratory functions. The term dying refers to the period during which the organism loses its vitality. These terms, as you will learn, are not always clear-cut, particularly with advances in life-support technology that allow people to be kept alive almost indefinitely after an organ vital to survival has failed. In fact, in 2019, Nova Scotia passed an act ‘‘Respecting Human Organ and Tissue Donation,’’ which alters the definition of brain death to state ‘‘irreversible loss of the brain’s ability to control and co-ordinate the organisms’ critical functions’’ instead of the terminology of ‘‘irreversible cessation’’ (Nova Scotia Legislature, 2019).

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  Visualizing

  The Lifespan

  • Jennifer Tanner, Amy Warren, Daniel Bellack(Authors)
  • 2015(Publication Date)
  • Wiley

    (Publisher)

  Living wills can only be used in cases where there is clear agreement among physicians that the person has advance directive Legal instructions regarding specific health care measures to be taken in the event that an individual is rendered unconscious because of a terminal illness. The Process of Death and Dying LEARNING OBJECTIVES 1. Identify four dimensions of cognitive understanding of death. 2. Explain the five stages of dying. 3. Explain the role of hospice. nly from the most limited perspective is death simply a biological state or a medical process. Death is a complex, multidimensional expe- rience, an active process of the living. Both O the person who is dying and those witnessing and expe- riencing dying and death are challenged to understand death at a cognitive level. And Death and Dying, above all else, place demands on our ability to process emotions. 504 CHAPTER 17 Death, Dying, and Grieving Attitudes about death involve the emotions that accom- pany thoughts about Death and Dying. Two attitudes to- ward death are relevant in determining how a person experiences death: fear of death and death anxiety (De- paola, Griffin, Young, & Niemeyer, 2003; Kastenbaum, 1996; Kastenbaum & Costa, 1977). Fear of death is a conscious and perhaps universal emotion that can be articulated and expressed. Death anxiety, on the other hand, is not conscious and is demonstrated as denial of death. Research suggests that both fear of death and death anxiety are sources of stress and depression in adulthood (Becker, 1973), although denial is believed to be more problematic. Childhood The research concerning a child’s percep- tion of the concept of death has taken several approach- es. One predominant view is that a child’s understanding of death is correlated with cognitive ability (Childers & Wimmer, 1971; Cotton & Range, 1990; Koocher, 1973). Much of the data is based on cross-sectional interviews (e.g., Nagy, 1965; Speece & Brent, 1984).

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  Visualizing the Lifespan

  • Jennifer Tanner, Daniel Bellack, Colleen MacQuarrie(Authors)
  • 2017(Publication Date)
  • Wiley

    (Publisher)

  According to psychologists, being able to accept death involves four cognitive elements: irreversibility (the dead person cannot return), non-functionality (all functions cease at death), universality (death is inevitable for everyone), and causality (everything dies for a reason). Young children cannot truly understand death, but they develop the ability as they age, although other factors 554 CHAPTER 17 Death, Dying, and Grieving 3 Bereavement and Grief 549 • Grief is a powerful emotional response to a loss, whether of a family member, friend, pet, or job. Grief affects a person in cognitive, emotional, and physiological ways. Normal grief is typically distinguished from complicated/traumatic grief (CG) by time or by how long a person is emotionally distressed. Six months is considered an average amount of time for normal grief, whereas complicated grief may last years, interfere with daily functioning, and cause other negative emotions like anger and depression. This type of grief is especially prevalent in parents who have lost a child, such as the man shown in this photo. Challenges in Development: Coping with the Loss of a Child Finbarr O'Reilly/REUTERS/Landov • Bereavement is the process of losing a loved person and involves customs, rituals, and personal changes. It is strongly affected by culture. Mourning is involved in the bereavement process and is also influenced by religion and culture. can play a part. By late adolescence, young people have a stronger grasp of death and control of their emotional reactions to it. By adulthood, all four elements of death are recognized. For some, later adulthood brings along a fear of death or death anxiety, because of a growing awareness of death’s finality. • Elisabeth Kübler-Ross outlined stages of death, including denial, anger, bargaining, depression, and finally, acceptance, which is depicted in the figure.

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  Health Psychology

  A Critical Introduction

  • Antonia C. Lyons, Kerry Chamberlain(Authors)
  • 2006(Publication Date)
  • Cambridge University Press

    (Publisher)

  Although we are focusing here on the person dying, we should not lose sight of the fact that deaths are also constructed by the survivors, in the service of accepting and managing the death that has occurred. We return to these issues later in the chapter. Fearing death Although health psychologists have conducted very little research into types of death and the process of dying, fear and anxiety about dying have been a particular focus of psychological research, generating many hundreds of studies. In a review of this research with elderly people, Fortner and Neimeyer 334 Health Psychology ( 1999 ) report that fear of death is stronger for those experiencing psychological problems, such as depression or anxiety. Stronger fear of death is also reported for people who report poorer overall physical health, and for those reporting lower levels of life satisfaction and purpose in life. Religiosity has also been Essentially anxiety surrounding all aspects of death; a multidimensional concept relating to fear and anxiety about one’s own and other people’s Death and Dying and concerns about the objects of death, especially corpses; synonymous with fear of death and death fear. linked to death anxiety , although it appears to be related to religious belief (e.g. belief in a God, belief in an afterlife) rather than to religious behaviour (e.g. frequency of reading the Bible) (Neimeyer & Van Brunt, 1995 ). Contrary to expectation perhaps, fear of death is reported to be higher for middle-aged people than for older people, and to decline as people reach their later years (Fortner & Neimeyer, 1999 ). This result is supported by a later meta-analysis People in the oldest stage of life, usually defined as those aged over 75 years and contrasted with the young-old, people aged over 60 and under 75 years. (Fortner et al. , 2000 ) and in research by Cicirelli ( 2001 ) with the old-old .

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  Adult Personality Development

  Volume 2: Applications

  • Lawrence S. Wrightsman(Author)
  • 1994(Publication Date)
  • SAGE Publications, Inc

    (Publisher)

  7 Reactions to Death and Dying Do not go gentle into that good night .... Rage, rage against the dying of the light. Dylan Thomas* Awareness of death is present in some undifferentiated way even in young children, and some psychiatrists have speculated that a child's early response to death affects the whole of personality development (Lifton & Olson, 1982). But for most of us, death becomes a personal issue only much later in our lives except for brief periods; for example, when a classmate dies. It was only after he suffered a stroke in 1987, for example, that Edward Koch-then the mayor of New York City—carried his musings about his own mortality to the point of preparing for his funeral and composing his own epitaph (Finder, 1987). Even for most adults, who do not dwell constantly on their own death, the issue sooner or later has an impact on their personality development. This chapter deals with various aspects of Death and Dying, including the role of religion and support groups, the function of bereavement, and * From Poems of Dylan Thomas. Copyright 1952 by Dylan Thomas. Reprinted with permission of New Directions. 124 125 Reactions to Death and Dying personality factors in adaptation. Noted here-and emphasized at several points subsequently—is the observation that although the concepts of Death and Dying are often linked together in the professional literature (even here!), they are also separate issues with respect to personality development in adulthood. For example, the death of a spouse leaves adjustment challenges for the survivor, challenges that may only very slightly overlap with the survivor's own fears of death. Dying, as a concept present within one's thought processes, may be quite different from death. The term death anxiety, as it is usually referred to in the literature, may refer to a multitude of fears, some of which deal with the finality of death and some of which deal with the process of dying (Kastenbaum & Costa, 1977).

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  Counseling Older People

  Opportunities and Challenges

  • Charlene M. Kampfe(Author)
  • 2015(Publication Date)
  • American Counseling Association

    (Publisher)

  The meaning people assign to death will influence their responses to their own death. For those who are dying, variability will exist with regard to their fears or positive expectations, sense of comfort, sense of acceptance, view of what is to come, degree to which they cherish or are dissatisfied with their current lives, their perception of the dying process, and their desire to have more or less control over that process. Some people may believe in and practice passive acceptance of death; some may welcome death; some may accept death as a natural part of life; some may fight or be frightened of death; some may perceive that there is life after death; some may believe that death is the end of their being; some may be confused about the prospect of death; some may discover that their lifelong beliefs of death have changed as death draws near; and some may see that death enhances the meaning, significance, and direction of life and helps them to live fully in the present. Some may wish to die facing the East, some may wish to have ceremonies before their death, some may wish to die alone, some may want their loved ones near, some may wish to die at home, some may prefer to die outside under the trees and sky, and some may prefer to die in a health care facility or a palliative or hospice care program (Minkowski, 1970; C. A. Walter, 2003; Whitbourne & Whitbourne, 2011).

  People’s responses to death may be influenced by their “typical” responses to loss or crisis. Some may have a pattern of stoicism, some may feel great relief in being able to discuss their feelings, some may find comfort in being with others, some may feel more comfortable being alone, some may use their spirituality or their religious beliefs for support, some may wish not to be asked about their loss or impending loss, and so forth. Perhaps, for this reason, it will be important for counselors to ask their clients to describe their typical way of coping with stressful situations (Chetnik, 2000). This question might help identify effective and noneffective strategies that clients are currently drawing on or that are available to them. Counselors can support the strategies that are working as well as encourage clients to consider other strategies for dealing with death (C. A. Walter, 2003).

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