The Psychology of Dying

1
The Psychology of Dying
2
Kubler-Ross

• Page 44 (PADD)
• 5 stages
• 1) Denial (and Isolation)
• the defense mechanism by which a person is
  unable or refuses to see things as they are
  because such facts are threatening to the self
• 2) Anger
• blame directed toward another person
• 3) Bargaining
• 4) Depression
• 5) Acceptance

3
Lofland

• Page 46 (PADD)
• dying scripts
• Elements
• Space
• Population
• Knowledge
• Stance

4
Em. M. Pattison

• Page 48 (PADD)
• 3 phases of the dying process
• 1) acute crisis phase
• 2) chronic living-dying phase
• 3) terminal phase

5
A. Weisman

• 3 degrees of denial
• 1) the person denies the facts
• 2) the person accepts the diagnosis but refuses
  to believe that it is terminal
• 3) person vacillates beween open acknowledgement
  of death and its repudiation

6
Glaser and Strauss

• Page 49 (PADD)
• 4 contexts of awareness
• 1) closed awareness
• 2) suspicion
• 3) mutual pretense
• 4) open awareness

7
Duties of the Dying

• Page 49 (PADD)
• 1) arrange a variety of affairs
• 2) adapt to the loss of loved ones and self
• 3) manage medical needs and balance emotions
• 4) plan for future loss
• 5) identify and cope with the death encounter

8
Role of the FD With the Dying

• Page 50 (PADD)
• Prerequisites for the FD
• 1) acknowledge ones mortality
• 2) understand the grief process
• 3) effective listening and appropriate response
• 4) commitment to the dying
• 5) knowledge of personal limits

9
Social Responses to Death

• Page 53 (PADD)
• variety of socialization processes
• demographic norms
• Preindustrial high mortality rates
• small, tightly integrated communities
• Postindustrial drop in mortality rates
• death is distanced, sanitized

10
Death of a Parent

• Page 60 (PADD)
• natural event
• unfinished emotional business
• little/no allowance for untimely, violent, or
  unexpected death
• allow the adult child to express the feelings of
  loss
• support groups

11
Death of a Spouse

• Page 62 (PADD)
• secondary losses (Figure 12-1 page 155)
• social issues
• support groups

12
Death of a Child

• Page 63 (PADD)
• parents and siblings arent the only ones who
  mourn the loss of a child, but the parental grief
  response is the most complex
• friends may avoid the parents
• service guilt, survivors guilt

13
Guilt

• Composed of
• Regrets
• Misgivings
• Unresolved past conflicts with the child
• Every aspect of the relationship and childcare

14
Secondary Losses

• child may have filled a gap
• child as well as friend
• sense of status/self-esteem/purpose
• continued guilt can give rise to complications
• changed identity
• camily structure is altered

15
Parental Anger

• feel that core identities have been ripped out
• world no longer makes sense
• rage at those perceived to have a role in the
  death
• feelings of betrayal
• anger directed toward survivors

16
Coping With Other People

• Need to be aware that there are people in their
  lives from whom they will never get the support
  they would have expected or desire.

17
Parental Fear

• Fear of losing other children or any close person
  causes bereaved parents to overprotect.

18
New Me in a New World

• The image of the child exists within but is no
  longer physically available as an external
  reality.
• Create a new internal picture of who they are in
  the outside world.
• Their loss and grief accompany them everywhere
  they go.

19
Painful Reminders

• seasonal reminders
• unexpected moments
• continual acknowledgment of the child at family
  events
• can still feel connected

20
Linking Objects and Continuing Bonds

• Page 65 (PADD)
• helps maintain continuity of a relationship
• provide support for grieving parents

21
FD Responsibilities

• Page 65 (PADD)
• reinforce that their feelings are acceptable and
  normal
• point out to them societys inability to
  comprehend their loss
• well-meaning peoples comments
• create an atmosphere of security, comfort and
  accessibility

22
Death of a Sibling

• greater chance of healing if parents remain in
  their lives
• parents grieve openly
• parental grief is shared
• siblings may experience shame or embarrassment
• preteens and teens are particularly sensitive

23
Replacement Expectations

• parents may inappropriately place expectations on
  children
• parents may consciously or unwittingly
  communicate that surviving children take on the
  dead siblings role
• parents may deify the dead child
• parents may focus on the dead child to the
  exclusion of the surviving siblings

24
Surviving Adult Siblings

• Page 65 (PADD)
• least acknowledged by society
• facing the death of someone in their own
  generation..personal confrontation with their
  own mortality
• FD should be available to them

25
Implications for Funeral Directors

• Page 66 (PADD)
• 1) societys perception of the death may not
  track with the individuals response
• 2) be sensitive to conflict between what is
  expected and what they feel
• 3) provide information about resources
• 4) small library of books, tapes etc.
• 5) provide clear, complete and accurate
  communication