Death and Dying in Adulthood

1
Death and Dying in Adulthood

• Young, middle-aged, and elderly

2
Adulthood

• Erikson early 20s to 65
• Intimacy vs. Isolation can you find someone with
  whom to share your life? (How might coping with a
  life threatening illness impact intimate
  relationships).
• Generativity vs. Stagnation Am I contributing to
  the world? Can lead to a renewed appreciation of
  life. (How might coping with a life threatening
  illness impact this stage of life?)

3
What causes death?

• Early Ages 25-44
• Accidents
• Cancer
• Heart Disease
• Suicide
• HIV
• Homicide

• Late 45-64
• Cancer
• Heart Disease
• Accidents
• Strokes
• Lung Disease
• Diabetes

4
Attitude Toward Death

• Sandwich Generation
• Individuals in this age group are surrounded by
  death.
• Their parents, miscarriages, potentially the
  death of their own child.
• Much of death is seen as death of others, but
  there is a growing realization of their own
  mortality.

5
Adult Bereavement and Grief

• All significant, but the order of significance is
  generally understood to be
• Ones own child
• Ones spouse
• Ones parents

6
Fetal Deaths

• Include miscarriages, stillbirths, spontaneous
  abortions (non-elective).
• Of confirmed pregnancies, 11 end in miscarriages
  or stillbirths.
• Grief is often ignored. Yet, parents often have
  begun to changes lives and become attached.
• Some parents choose to complete the bonding
  process.
• Even those who electively abort or give a child
  up for adoption report a sense of loss and grief.

7
Neonatal Deaths

• Two main categories
• (1) Congenital abnormalities, low birth weight,
  respitory distress syndrome.
• Involves a large amount of medical intervention.
• Death occurs in an institutional context.
• (2) SIDS
• The first symptom is death.
• Back to Sleep campaign.

8
Issues

• Do you have another child?
• What do you tell the other children?
• Do you feel guilt?

9
Guilt

• Six potential sources
• Death causation did you fail to protect?
• Illness related related to perceived
  deficiencies in the parental role during the
  childs illness or at the time of death.
• Parental role guilt failed to live up to
  societal/self expectations in the overall
  parental role.
• Moral guilt childs death was punishment for
  your sins.
• Survival parent shouldnt outlast child
• Grief guilt did you grieve properly?

10
The Elderly

• Defined as 65 or older.
• Arbitrary distinction tied into life expectancy
  and Social Security.
• Beginning to divide the category further
• 65-74
• 75-84
• 85 and up

11
Ageism

• A form of discrimination.
• What are the causes of ageism?
• Physical attractiveness stereotypes.
• Productivity and the Protestant work ethic.

12
Erickson and the Elderly

• Final stage is Ego Integrity vs. Despair
• A positive resolution equals the attainment of an
  inner sense of wholeness.
• Similar to Maslows concept of self-actualization.

13
Causes of Death

• The elderly comprise 74 of all deaths in the
  United States.
• Most causes are chronic or degenerative illnesses
  (e.g., heart disease, cancer, strokes).
• Although there are some noteworthy exceptions
  (e.g., flu/pneumonia, septicemia, accidents).

14
Suicide

• Highest suicide rate is among the elderly
• Particularly in the 85 and up age group.
• This appears to contradict the research on
  happiness among the elderly.
• Theories
• Have lived long lives.
• View selves as having less value.
• Accept own death after seeing many others.

15
Suicide

• Caucasian males are most likely.
• Much less likely to fail than adolescents.
• Arguments used to stop adolescents tend not to
  work for the elderly.
• Greatest factor is depression
• Loss of sense of productivity
• Institutionalization
• Death of spouse
• Physical/mental losses
• Social isolation

16
Bereavement and Grief

• Cumulative impact?
• Death of own children
• As life expectancy increases the probability
  increases.
• 10 of elderly experience death of a child after
  the child has reached 60 years of age.
• Is there survivor guilt?
• What if child were primary care provider?
• Do you become responsible for grandchildren!?