Gerontology: Death & Dying

Death involves an interaction of physiological, social, et psychological factors. Measures of death are physical (i.e. absence of heartbeat or brainwaves, psychosocial factors can influence the biological event (i.e. the will to live).

1. Shock et denial
2. Anger (Why me?)
3. bargaining (making a deal with God).
4. Depression et withdrawal from others
5. Adjustment/acceptance

*note that dying persons need to complete each stage before moving onto the next.*

How the end of life is defined has implications for quality of care et quality of life; when decisions need to be made about life-sustaining care et eligibility for hospice.

One definition of the end of life is the beginning of an illness that is characterized by any of the three dimensions of severity.

The three dimensions of severity are as follows:

1. Diagnosis of a potentially fatal illness.

2. The beginning of a functional limitation in one's ability to perform any of the basic physical activities of daily living.

3. The advent of pain or physical symptoms that are either or both (a) a major distress to the patient et (b) precursors to et resulting in death (Lawton 2001).

are natural et comforting responses to our inability to comprehend our own death et lack of physical existence. When diagnosed with a terminal illness, nearly 30% of patients remain in denial et 15% in fear (Butler 2000).

developed over 20 yrs ago, states that individuals have the right to personal dignity et privacy; informed patticipation, incl to have their end-of-life choices respected by health care professionals; et considerate, respectful service et competent care.