By C Settley

Demonstrate an understanding of the

death and dying process

Reflect on the stages of death and dying

(content knowledge acquired)

Identify the stages of death and dying

(content knowledge)

Be able to identify the principles

underpinning healthy interpersonal

interactions and explained in terms of their

role in the creation of an emotionally

supportive environment

Demonstrate communication and

interactions with patients, staff and other

health team members

Any form of medical care or treatment that

attempts to reduce the severity of

symptoms of a disease rather than

stopping or delaying or truing to cure it.

It is aimed at relieving suffering and

improving the quality of life for people who

are seriously ill.

May also refer to any care that reduces

symptoms, so that it may also lessen the

side effects of treatments

Such as relieving nausea associated with

chemotherapy

provides relief from pain and other distressing symptoms;

affirms life and regards dying as a normal process;

intends neither to hasten or postpone death;

integrates the psychological and spiritual aspects of patient care;

offers a support system to help patients live as actively as possible until death;

offers a support system to help the family cope during the patients illness and in their own bereavement;

uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;

will enhance quality of life, and may also positively influence the course of illness;

is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications

Confronted by death and dying at some

time- we cannot avoid it

Unexpected death of a spouse can cause

intense emotional reactions.

Differences in cultures on how death is

viewed (emotions evoked, how death is

talked about, how the death are treated

and the grieving process)

Video*

The most difficult developmental task is to accept the inevitable: death

The awareness thereof makes people more philosophical and reflective

They try to put their lives in perspective and may become more aware of religion and spirituality

Erikson’s last stage- be able to look back with a sense of integrity and feel that life was worth while OR disappointed and embittered and face death with despair and regret

When we care for the

elderly, we realise that

we will be confronted

with death too

This may be why

many of us find it

difficult to meet the

needs of the dying

The death of a loved one is extremely painfulWe find it easier to accept that the older

generation will predecease us, not the other way round

Grief may lead to depressionMany people feel uncomfortable to talk about

deathSometimes, because of our own fear about

death, we may want to keep our distancePeople who suffer from illnesses are intensely

confronted with their death

A person is regarded as dead when his or

her physiological processes have stopped:

WHEN THE HEART HAS STOPPED

BEATING

WHEN BREATHING HAS STOPPED

NO LONGER REGISTERS BRAIN

ACTIVITY

Read case on page 71 (Meena’s story)

Fear of physical suffering:

Cancer, pain, removal of body parts, operations

Fear of isolation and loneliness:

People often act strangely and artificial like towards

dying persons because they do not know how to

handle the situation. Many people develop a fear

that they will be avoided and therefore become

isolated and lonely when dying

Fear of nonbeing:

It is alleged that human beings are the only

creatures on earth who live with the constant

awareness that they will someday have to die. Can

lead to intense anxiety.

Fear of cowardice and humiliation:

Many people fear that they will become cowards in

the face of death.

Fear of failing to achieve important goals:Some people define the length of their lives not in terms

of years but in terms of accomplishments. We may therefore fear death because it will deprive us of achievement.

Fear of the impact of death on those who outlive you:Fear of the financial, psychological and emotional

impact that death may have on loved ones and other survivors.

Fear of punishment or the unknown:

Some religions preach that sinners are doomed

after death and will forever burn in hell. The fear that

they are in this category evokes fear. Religion may

also have the opposite effect.

Fear of the death of others:

Fear of loosing another. Emotional and physical pain

STAGE 1-

The first typical reaction is to deny it

Eg “this is not possible. This cant be

happening to me. This is a mistake”.

Against reality

STAGE 2-

The individual realise that death is approaching and often expresses anger.

Eg “why me? May others smoke but they don’t get lung cancer”

The anger may be directed at others- close relatives, the hospital staff, and even God.

STAGE 3-

During this stage, individuals will try to negotiate

They might promise to live a more healthy life if their lives are saved, or if only they could live a little longer

STAGE 4-

When the dying person can no longer deny the illness, the anger is replaced by a powerful feeling of loss which may cause severe depression.

The person may withdraw and easily cry.

According to Kübler- Ross, one should not try to cheer up this person.

The person should be given the opportunity to work through death.

STAGE5-

The final stage.

When the person has had adequate time and help in working through the previous stages.

By this time, he or she has come to terms with death.

This stage may be relatively without feeling.

People who are at this stage give the impression that they are quietly waiting

VIDEO*

According to Kübler- Ross, these stages

do not always occur in the same

sequence.

They may overlap.

Not all individuals experience all the

stages

Culture, personality traits and a personal

philosophy influences people’s reactions

Euthanasia (mercy killing)The practice of intentionally ending a life in

order to relieve pain and suffering.

Active EuthanasiaThe ending of life by the deliberate

administration of drugs.

Passive EuthanasiaThe ending of life by the deliberate

withholding of drugs or other life-sustaining treatment

• Louw, D.A, Van Ede, D.M.& Louw, A.E (1998). Human development. 2nd edition. Cape Town. Kagiso.

• Louw, D.A & Edwards, D.J.A (2008) Psychology: An introduction for students in South Africa. 2nd edition. Cape Town: Heinemann Higher and Further education.

• Middleton, L. Nicholson, G. & O’Neill, V. Juta’sNursing Psychology. Applying Psychological concepts to Nursing Practice

http://youtu.be/UfoBPMKwnb0. retrieved on 10/02/2015 http://medical-

dictionary.thefreedictionary.com/active+euthanasia. retrieved on 10/02/2015