DEATH AND GRIEVINGLesson 6

WHAT IS DEATH?Harvard Medical School has 4 criteria that must

be met for a person to be considered dead

1. Unreceptive and unresponsive The patient is totally unresponsive to

applied painful stimulus.

2. Unresponsive in breathing For over an hour, the patient shows no

spontaneous muscular contraction or breathing

3. Lack of Reflexes Knee jerk is absent, Pupils do not dilate

when light is exposed to them.

4. Flat EEGFor 20 minutes, the patient’s brain does

not generate an electrical impulse or brain wave

Myth FactSuicide occurs without warning

While some suicides may be impulsive, usually the person has thought about suicide for a long time

People who talk about killing themselves rarely commit suicide

Most people who commit suicide have talked about it before

Myth FactIf you ask a person if he or she is considering suicide, you will encourage that person to commit suicide

You will not cause a suicide by asking if someone’s thinking about it. People who are not suicidal will not be influenced by the question. People who are considering will feel relieved that someone cares enough to ask and to listen to their problems.

Myth FactAll suicidal people want to die

A suicide attempt is often a cry for help. The person may be asking for help to live.

When a suicidal person suddenly seams calm and serene, there is no longer any danger of suicide

A suicidal person suddenly seams calm and serene may have decided to commit suicide and therefore feels relief that a decision has been made

Myth FactIf some makes a suicidal comment while drunk or high it is not serious

People under the influence of alcohol or other drugs may be at greater risk of acting on suicidal thoughts because their judgment is impaired and they may be more impulsive

All people who commit suicide are mentally ill

Many people who feel suicidal are not mentally ill. They may be in a period of intense emotional crisis

Myth FactOnce a person is suicidal, he or she will always be suicidal

Many people consider suicide for only a brief period in their lives. A person who attempts suicide and survives may never attempt again if proper support and treatment is found

The tendency toward suicide is inherited and passed from parent to child

Suicide is a behaviour and cannot be inherited. However, depression may have a genetic basis. Severely depressed people may harbour more thoughts of suicide than those who do not suffer from depression.

TEENAGE SUICIDE

Suicide – The act of intentionally taking one’s own life

Stats from the Canadian mental health association

TEENAGE SUICIDE

Canadian rates 15 in 100 000Aboriginal communities are 3- 6

times higher Among Aboriginal males, the rate for

the 15-24 year age group is 90.0The rate of suicide among Native

youth is five to six times higher than the Canadian average

TEENAGE SUICIDE

suicide accounts for 24 percent of all deaths among 15-24 year olds and 16 percent among 16-44 year olds

Suicide is the second leading cause of death for Canadians between the ages of 10 and 24

TEENAGE SUICIDE

Seventy-three percent of hospital admissions for attempted suicide are for people between the ages of 15 and 44.

Native communities which have retained some of their historical traditions have lower suicide rates.

WARNING SIGNS OF SUICIDE

80 percent of people who commit suicide give warning signs or cry for help. Below is a list of possible warning signs.

Change in eating and sleeping habits Withdrawal from friends, family, and regular

activities / avoidance from friends Violent actions, rebellious behaviour, or

running away

WARNING SIGNS OF SUICIDE

Use of alcohol or other drugs Unusual neglect of personal

appearance Marked personality change Persistent boredom, difficulty

concentrating, or a decline in the quality of school work.

Risk taking behaviour Self-destructive behaviour (cutting, new

“accident-prone behaviour

WARNING SIGNS OF SUICIDE

such as stomach-aches, headaches, or fatigue, which are often related to emotions.

Giving away favourite possessions

Loss of interest in pleasurable activities

Not tolerating praise or rewardsWrites poems or drawings about people killing themselves

WARNING SIGNS OF SUICIDE

Feelings of helplessness, worthlessness

Feelings of guilt or shamePoor self-esteemFragmented family (losses due to death, divorce, re-marriage..)

Overprotective family (teen has no experience making own decisions

WARNING SIGNS OF SUICIDE

Previous attempts of suicidePoor grades, truancy, discipline problems at school

Trouble with the lawExperiencing abuse, bullyingLack of support network (friends, family, church) or no connection to professional support

INTERVENTION STRATEGIES

– Canadian mental health Association

If you are suspecting someone of committing suicide, here are a few tips that you can use.

If possible, talk with the person directly. The single-most important thing you can do is listen attentively without judgement.

INTERVENTION STRATEGIES

Talking about suicide can only decrease the likelihood that someone will act on suicidal feelings.There is very little risk that talking about it will push someone over the edge.

Find a safe place to talk, allow for as much time as necessary

INTERVENTION STRATEGIES

Ask the person about what has been happening and their emotions.

Ask the person if they are considering suicide, ask if they have a plan.

Do not tell them that their thoughts are bad.

Ask if there is anything you can do to help

Talk about possible resources (family, friends, crisis centers, etc.)

INTERVENTION STRATEGIES

Make a plan with the person for the next few hours or days.

Check up on the person

If possible go with them to get help

Try to arrange someone to be with them at all times so that you do not burn out.

INTERVENTION STRATEGIES

Ask who else knows about the suicidal feelings. Are there other people who should

know? Is the person willing to tell them?

Confidentiality is important, but do not keep the situation secret if a life is clearly in danger.

INTERVENTION STRATEGIES

Praise the person for having the courage to trust you and for continuing to live and struggle.

Remember, if the person is serious, get extra help. The person may hate you for saving them but in the end you may have saved a life.

STAGES OF GRIEF

In 1969, psychiatrist Elisabeth Kübler-Ross introduced what became known as the “five stages of grief.”

These stages of grief were based on her studies of the feelings of patients facing terminal illness, but many people have generalized them to other types of negative life changes and losses, such as the death of a loved one or a break-up.

STAGES OF GRIEF

1. Denial “this cannot be happening to me” No acceptance or acknowledgement of

loss

2. Anger "why me?" Anger at the diseased for leaving or

angry with self for not preventing it

STAGES OF GRIEF 3. Bargaining Begging, wishing, praying for them to come back

4. Depression Overwhelming feelings of hopelessness,

frustration, bitterness, self pity, and mourning Lack of control, feeling numb, possibly suicidal

5. Acceptance There is a difference between resignation and

acceptance. You have to accept the loss, not just try to bear it

quietly

No two people ever experience grief in the same way, or with the same intensity, but there are strategies that can help you cope with your loss.

Acknowledge that the death is a suicide

Recognize your feelings and loss

Talk openly with your family so that everyone’s grief is acknowledged and can be expressed

Reach out to your friends and guide them if they don’t know what to say or do

Find support groups where you can share your stories, memories and methods of coping

Be aware that anniversaries (e.g. birthdays) can be especially difficult and consider whether to continue old traditions or begin new ones

Develop rituals to honour your loved one’s life

PREPARING FOR NEXT UNIT: MENTAL DISORDERS (ASSIGNMENT) Read the following case studies and record

the potential internal and external factors that may currently (or in the future) be affecting the individual’s mental health in the specific case study. Highlight the key words/statements in the case study. Indicate any suicide risk factors that may be present.

Internal Factors – genetic, hormonal, physical, neurological, physical fitness, interpersonal

External Factors – family influence (physical, sexual, emotional abuse), drug/alcohol abuse, dietary deprivation, environmental factors (crime, unemployment, role models). lack of available services and supports

CASE STUDY #1 “JOHN” John is a 16 year old student who is trying to her his

weight under control. His size has made the football coach notice him, but John needs to become more fit. He has head about the negative effects of steroids, and knows that there are other street drugs available too if he chooses to try to escape from his feelings. Female classmates will talk with him but there isn’t a girl that is interested in being his girlfriend. He can’t talk to his mother because she is busy working to support the two of them. John would like to fit in more with his classmates but is having difficulty socializing. He fears that he would get teased about his situation. John doesn’t want his classmates to know that his father has left his mom, his father’s history of drug use, and run-ins with the police.

CASE STUDY #2 “Joanne” Joanne is a 17 year old high school student. She gets

good grades and is well liked by her teachers. She hopes to one day be a veterinarian. Despite her success in school and hopes for the future, Joanne has few close friends. She spends her time working at the grocery store and helping with the care of her two younger siblings. Her mother holds down tow jobs, which is needed to pay the household bills, but keeps her away from the family quite a bit. After an eight year battle with depression, Joanne’s father committed suicide three years ago. Because of her busy schedule, Joanne has no time to participate in school team sports or any other physical activities. She is self-conscious about her weight and body. Unfortunately, living in a smaller community, there are not many resources of services which Joanne or her family can seek help.