Assignment Prompt & Instructions
https://youtu.be/O-rQ3tIabvM?si=AKGkA-mOz1pgCbJJ
500-600 words
– ## SantrockTopical11e_Chapter17DeathDyingandGrievingcopy.pdf
– IMG_1989.png
**## SantrockTopical11e_Chapter17DeathDyingandGrievingcopy.pdf**
Because learning changes everything.®
A Topical Approach to
Life-Span Development
11th Edition
John W. Santrock
Chapter 17
Death, Dying, and Grieving
© McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.
© McGraw Hill LLC
Learning Goals
Describe the death system and its cultural and historical
contexts.
Evaluate issues in determining death and decisions regarding
death.
Discuss the causes of death and suicide at different points in
development.
Explain the psychological aspects involved in facing one’s
own death and the contexts in which people die.
Identify ways to cope with the death of another person.
2
© McGraw Hill LLC
The Death System and Its Cultural Variations 1
Components of death systems across cultures:
• People—everyone is involved in death at some point.
• Places or contexts—hospitals, funeral homes, cemeteries,
hospices, battlefields, memorials.
• Times—time/occasions set aside to honor those who
have died.
• Objects—many objects in a culture are associated with
death.
• Symbols—symbols and religious ceremonies are
connected to death.
3
© McGraw Hill LLC
The Death System and Its Cultural Variations 2
In the United States, it is not uncommon to reach adulthood
without having seen someone die.
Most societies have philosophical or religious beliefs about
death.
• Rituals that deal with death.
In most societies, death is not viewed as the end of
existence.
• Spiritual body believed to live on.
• Perspective favored by most Americans.
4
© McGraw Hill LLC
The Death System and Its Cultural Variations 3
Forms of death avoidance and denial in the United States:
• Funeral industry glosses over death and fashions lifelike
qualities in the dead.
• Adoption of euphemistic language for death that implies
forever.
• Persistent search for a fountain of youth.
• Rejection and isolation of the aged, who may remind us
of death.
• Adoption of the concept of a pleasant and rewarding
afterlife, suggesting that we are immortal.
• Medical community’s emphasis on prolonging biological
life instead of diminishing human suffering.
5
© McGraw Hill LLC
Changing Historical Circumstances
Today, death occurs most often among older adults.
• Two hundred years ago, nearly half of all children died
before the age of 10.
Larger number of older adults today die apart from their
families.
• More than 80% of deaths occur in institutions or hospitals.
• Minimizes exposure to death and painful surroundings.
6
© McGraw Hill LLC
Defining Death and Life/Death Issues
In the past, the end of certain biological functions were
considered clear signs of death.
• Breathing, blood pressure, rigidity of body (rigor mortis).
Brain death: a neurological definition of death.
• Person is brain dead when all electrical activity of the brain
ceases for a specific period of time.
• Higher brain regions may die but lower portions may allow
for continued breathing and a heartbeat.
• Current definition among most physicians includes death
of both the higher cortical functions and the lower brain
stem functions.
7
© McGraw Hill LLC
Decisions Regarding Life, Death, and Health Care 1
Advance care planning is the process of patients thinking
about and communicating their preferences for end-of-life
care.
Laws in all 50 states now accept an advance directive, such
as a living will.
Advance directive states preferences such as whether life-
sustaining procedures may be used to prolong life.
Living will: designed to be completed while the individual
can still think clearly.
• Expresses desires regarding extraordinary medical procedures that
may sustain life when medical situation becomes hopeless.
8
© McGraw Hill LLC
Decisions Regarding Life, Death, and Health Care 2
Euthanasia: the act of painlessly ending the lives of
individuals who are suffering from an incurable disease or
severe disability.
• Passive euthanasia: when a person is allowed to die by
withholding available treatment, such as withdrawing a
life-sustaining device.
• Active euthanasia: when death is deliberately induced,
as when a legal dose of a drug is injected.
9
© McGraw Hill LLC
Decisions Regarding Life, Death, and Health Care 3
Assisted suicide is now legal in six countries.
• In the United States, it is allowed in California, Colorado,
Hawaii, Maine, New Jersey, Oregon, Vermont, New
Mexico, Washington, and Washington, DC.
• Those in favor of euthanasia argue death should be calm
and dignified, not full of suffering.
• Those against euthanasia stress it is murder; and many
religious individuals say it is against God’s will.
Too often, death in American is lonely, prolonged, and
painful.
10
© McGraw Hill LLC
Decisions Regarding Life, Death, and Health Care 4
Care providers are increasingly interested in helping
individuals experience a “good death.”
• Physical comfort, support from loved ones, acceptance,
and appropriate medical care.
Hospice: a program committed to making the end of life as
free from pain, anxiety, and depression as possible.
• Emphasizes palliative care—reducing pain and suffering
and helping individuals die with dignity.
• Today a majority of hospice programs are home-based.
11
© McGraw Hill LLC
A Developmental Perspective on Death
In the United States, deaths of older adults account for
approximately two thirds of the 2 million deaths that occur
each year.
• What is known about death, dying, and grieving is mainly
based on information about older adults.
• Youthful death is much less common.
12
© McGraw Hill LLC
Causes of Death
Death can occur at any point in the life span.
In infancy, sudden infant death syndrome (SIDS).
In childhood, most often due to accidents or illness.
• Major illnesses that cause death in children: heart disease, cancer,
birth defects.
Death in adolescence is most likely to occur because of
motor vehicle accidents, suicide, and homicide.
Older adults are more likely to die from chronic diseases.
• Often incapacitated before death, producing a long course of dying.
Many young and middle-aged adults die of illnesses such
as heart disease and cancer.
13
© McGraw Hill LLC
Suicide
Suicide risk factors:
• Serious physical illness.
• Mental disorders.
• Feelings of hopelessness.
• Social isolation.
• Failure in school and work.
• Loss of loved ones.
• Serious financial difficulties.
• Drug use.
• Prior suicide attempt.
14
© McGraw Hill LLC
Suicide: Adolescence 1
Suicidal behavior escalates in adolescence and further
increases in emerging adulthood.
• Second leading cause of death among adolescents in the
United States.
Far more adolescents think about or attempt suicide
unsuccessfully than actually die by it.
Suicidal behavior varies by both gender and ethnicity.
• Females make more attempts.
• Native Americans have the highest rates.
15
© McGraw Hill LLC
Suicide: Adolescence 2
Depression is the most frequently cited factor associated with
adolescent suicide.
• Sense of hopelessness, low self-esteem, high self-blame.
In some instances, suicides occur in clusters.
• “Copycat” suicides raise the issue of whether suicides
should be reported in the media.
16
© McGraw Hill LLC
Suicide: Adulthood and Aging
Suicide is increasing among U.S. adults.
Females are three times more likely to attempt suicide; but
males are four times more likely to die by suicide.
Older adult most likely to die by suicide is male, lives alone,
has lost his spouse, and is experiencing failing health.
• Perceiving oneself as burdensome may contribute.
• Protective factors include a supportive network of family
and friends, emotional control, and comfort from religion.
17
© McGraw Hill LLC
Figure 2 What to Do and What Not to Do When Someone
Is Likely to Attempt Suicide
What to do
Ask direct, straightforward questions in a
calm manner: “Are you thinking about
hurting yourself?”
Assess the seriousness of the suicidal
intent by asking questions about feelings,
important relationships, who else the
person has talked with, and the amount of
thought given to the means to be used. If
a gun, pills, a rope, or other means have
been obtained and a precise plan has
been developed, clearly the situation is
dangerous. Stay with the person until help
arrives.
Be a good listener and be very supportive
without being falsely reassuring.
Try to persuade the person to obtain
professional help and assist them in
getting this help.
What not to do
Do not ignore the warning signs.
Do not refuse to talk about suicide if a
person approaches you about it.
Do not react with humor, disapproval, or
repulsion.
Do not give false reassurances by saying
such things as “Everything is going to be
OK.” Also do not give out simple answers
or platitudes, such as “You have
everything to be thankful for.”
Do not abandon the individual after the
crisis has passed or after professional
help has commenced.
18
© McGraw Hill LLC
Facing One’s Own Death 1
As we age, values concerning our most important uses of
time change.
When asked how they would want to spend a remaining 6
months of life:
• Younger adults prioritize travel and making
accomplishments.
• Older adults prioritize inner-focused activities such as
contemplation and meditation.
Most dying individuals want to make some decisions about
their own life and death and may want to complete unfinished
business.
19
© McGraw Hill LLC
Facing One’s Own Death 2
Kübler–Ross’ stages of dying:
• Denial and isolation—denies death is taking place.
• Anger—anger, resentment, rage, and envy.
• Bargaining—develops a hope that death can be delayed.
• Depression—perceives the certainty of death.
• Acceptance—develops a sense of peace, acceptance of
one’s own fate, and often a desire to be left alone.
Not demonstrated by independent research; and fail to take
into account individual situations.
• Some psychologists prefer to describe them not as stages
but as potential reactions.
20
© McGraw Hill LLC
Perceived Control and Denial
Perceived control may work as an adaptive strategy for some
older adults facing death.
• When individuals believe they can prolong their life, they
become more alert and cheerful.
Denial can be an adaptive or a maladaptive approach to
death.
• Can insulate people from having to cope with intense
feelings of anger and hurt.
• Can keep them from having a life-saving operation.
21
© McGraw Hill LLC
The Contexts in Which People Die
More than 50% of Americans die in hospitals, and nearly
20% die in nursing homes.
Hospitals offer important advantages to the dying individual:
• Professional staff members are readily available.
• Medical technology may prolong life.
Most individuals say they would rather die at home.
• Many worry, however, about being a burden, about limited
space, and about the competency and availability of
emergency medical treatment.
22
© McGraw Hill LLC
Communicating With a Dying Person
Most psychologists stress the importance of dying individuals
knowing that they are dying.
Advantages of an open awareness of dying:
• Can close their lives according to their own ideas about
dying.
• Opportunity to complete plans or projects, make
arrangements for survivors, and participate in decisions
about funeral and burial.
• Opportunity to reminisce, converse with others, and end
life conscious of what life has been like.
• Better understanding of what is happening and what
medical staff is doing.
23
© McGraw Hill LLC
Grieving 1
Grief: the emotional numbness, disbelief, separation anxiety,
despair, sadness, and loneliness that accompany the loss of
loved one.
Pining for the lost person and separation anxiety are
important dimensions of grief.
• Intermittent, recurrent wish or need to recover the lost
person; and a focus on places and things associated with
the deceased.
Feelings of grief occur repeatedly after a loss.
• Become more manageable over time.
24
© McGraw Hill LLC
Grieving 2
Estimated 80%–90% of survivors experience normal or
uncomplicated grief reactions.
• By 6 months, the loss is accepted as reality, and
individuals become more optimistic about the future and
function competently in everyday life.
At 6 months after their loss, approximately 7%–10% of
survivors have difficulty moving on.
• Enduring despair that remains unresolved is known as
complicated grief or prolonged grief disorder.
• Greatest risk for a person who loses someone they were
emotionally dependent on.
25
© McGraw Hill LLC
Grieving 3
Another type of grief is disenfranchised grief:
an individual’s grief over a deceased person that is a socially
ambiguous loss that can’t be openly mourned or supported.
• Relationship that isn’t socially recognized; a hidden loss
such as an abortion; and circumstances that are
stigmatized.
• May intensify grief because the loss cannot be publicly
acknowledged.
• Often hidden or repressed and may be reawakened by
later deaths.
26
© McGraw Hill LLC
Grieving 4
Dual-process model of coping with bereavement
emphasizes two dimensions:
• Loss-oriented stressors focus on the deceased individual
and can include grief work and both positive and negative
reappraisal of the loss.
• Restoration-oriented stressors involve secondary
stressors that emerge as indirect outcomes of
bereavement.
Coping with loss and engaging in restoration can be carried
out simultaneously.
• Oscillation may occur over short term or longer term.
27
© McGraw Hill LLC
Grieving: Coping and Type of Death
Deaths that are sudden, untimely, violent, or traumatic are
likely to have more intense and prolonged effects on
survivors.
Coping process is more difficult.
Often accompanied by symptoms of post-traumatic stress
disorder (PTSD).
• Intrusive thoughts, flashbacks, nightmares, sleep disturbance,
concentration problems, and so on.
There is no ideal way to grieve.
• Healthy coping with death involves growth, flexibility, and
appropriateness within a cultural context.
28
© McGraw Hill LLC
Making Sense of the World
Stimulating individuals to try to make sense of their world is
one beneficial aspect to grieving.
• Close family members share with each other and
reminisce about family experiences.
When death is caused by accident or disaster, the effort to
make sense of it is pursued more vigorously.
• Bereaved want to put the death into a perspective they
can understand.
29
© McGraw Hill LLC
Losing a Life Partner 1
Spouses left behind after the death of an intimate partner
suffer profound grief.
• Often endure financial loss, loneliness, increased physical
illness, and psychological disorders, including depression.
Surviving spouses seek to cope with their loss in various
ways.
• Intensified religious and spiritual beliefs.
• Finding meaning in death.
30
© McGraw Hill LLC
Losing a Life Partner 2
Women often experience better adjustment after their loss
due to:
• Larger network of friends.
• Closer relationships with relatives.
• Experience in taking care of themselves psychologically.
Older widows adjust more optimally than younger widows,
perhaps because the death of a partner is more expected.
Widowers are usually left with more money than widows and
are more likely to remarry.
31
© McGraw Hill LLC
Losing a Life Partner 3
Psychological and religious factors are related to the
psychological well-being of older adults following the loss of
a spouse.
Volunteering and helping behaviors also appear to reduce
feelings of loneliness.
Social support helps widows or widowers adjust to the death
of a spouse.
• Widow-to-Widow program provides support for newly
widowed women.
32
© McGraw Hill LLC
Forms of Mourning
In the United States in 2018, 53.1% of deaths were followed
by cremation.
• Americans have been moving away from public funerals
toward private funerals followed by a memorial ceremony.
Funeral industry has been a source of controversy.
• Help to provide a form of closure.
• Critics claim funeral directors are there to make money
and embalming is a grotesque practice.
Traditional forms of mourning vary greatly across cultures.
33
© McGraw Hill LLC
Review
• Describe the death system and its cultural and
historical contexts.
• Evaluate issues in determining death and
decisions regarding death.
• Discuss the causes of death and suicide at
different points in development.
• Explain the psychological aspects involved in
facing one’s own death and the contexts in which
people die.
• Identify ways to cope with the death of another
person.
34
Because learning changes everything.®
www.mheducation.com
© McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.
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**## SantrockTopical11e_Chapter17DeathDyingandGrievingcopy.pdf**
Because learning changes everything.®
A Topical Approach to
Life-Span Development
11th Edition
John W. Santrock
Chapter 17
Death, Dying, and Grieving
© McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.
© McGraw Hill LLC
Learning Goals
Describe the death system and its cultural and historical
contexts.
Evaluate issues in determining death and decisions regarding
death.
Discuss the causes of death and suicide at different points in
development.
Explain the psychological aspects involved in facing one’s
own death and the contexts in which people die.
Identify ways to cope with the death of another person.
2
© McGraw Hill LLC
The Death System and Its Cultural Variations 1
Components of death systems across cultures:
• People—everyone is involved in death at some point.
• Places or contexts—hospitals, funeral homes, cemeteries,
hospices, battlefields, memorials.
• Times—time/occasions set aside to honor those who
have died.
• Objects—many objects in a culture are associated with
death.
• Symbols—symbols and religious ceremonies are
connected to death.
3
© McGraw Hill LLC
The Death System and Its Cultural Variations 2
In the United States, it is not uncommon to reach adulthood
without having seen someone die.
Most societies have philosophical or religious beliefs about
death.
• Rituals that deal with death.
In most societies, death is not viewed as the end of
existence.
• Spiritual body believed to live on.
• Perspective favored by most Americans.
4
© McGraw Hill LLC
The Death System and Its Cultural Variations 3
Forms of death avoidance and denial in the United States:
• Funeral industry glosses over death and fashions lifelike
qualities in the dead.
• Adoption of euphemistic language for death that implies
forever.
• Persistent search for a fountain of youth.
• Rejection and isolation of the aged, who may remind us
of death.
• Adoption of the concept of a pleasant and rewarding
afterlife, suggesting that we are immortal.
• Medical community’s emphasis on prolonging biological
life instead of diminishing human suffering.
5
© McGraw Hill LLC
Changing Historical Circumstances
Today, death occurs most often among older adults.
• Two hundred years ago, nearly half of all children died
before the age of 10.
Larger number of older adults today die apart from their
families.
• More than 80% of deaths occur in institutions or hospitals.
• Minimizes exposure to death and painful surroundings.
6
© McGraw Hill LLC
Defining Death and Life/Death Issues
In the past, the end of certain biological functions were
considered clear signs of death.
• Breathing, blood pressure, rigidity of body (rigor mortis).
Brain death: a neurological definition of death.
• Person is brain dead when all electrical activity of the brain
ceases for a specific period of time.
• Higher brain regions may die but lower portions may allow
for continued breathing and a heartbeat.
• Current definition among most physicians includes death
of both the higher cortical functions and the lower brain
stem functions.
7
© McGraw Hill LLC
Decisions Regarding Life, Death, and Health Care 1
Advance care planning is the process of patients thinking
about and communicating their preferences for end-of-life
care.
Laws in all 50 states now accept an advance directive, such
as a living will.
Advance directive states preferences such as whether life-
sustaining procedures may be used to prolong life.
Living will: designed to be completed while the individual
can still think clearly.
• Expresses desires regarding extraordinary medical procedures that
may sustain life when medical situation becomes hopeless.
8
© McGraw Hill LLC
Decisions Regarding Life, Death, and Health Care 2
Euthanasia: the act of painlessly ending the lives of
individuals who are suffering from an incurable disease or
severe disability.
• Passive euthanasia: when a person is allowed to die by
withholding available treatment, such as withdrawing a
life-sustaining device.
• Active euthanasia: when death is deliberately induced,
as when a legal dose of a drug is injected.
9
© McGraw Hill LLC
Decisions Regarding Life, Death, and Health Care 3
Assisted suicide is now legal in six countries.
• In the United States, it is allowed in California, Colorado,
Hawaii, Maine, New Jersey, Oregon, Vermont, New
Mexico, Washington, and Washington, DC.
• Those in favor of euthanasia argue death should be calm
and dignified, not full of suffering.
• Those against euthanasia stress it is murder; and many
religious individuals say it is against God’s will.
Too often, death in American is lonely, prolonged, and
painful.
10
© McGraw Hill LLC
Decisions Regarding Life, Death, and Health Care 4
Care providers are increasingly interested in helping
individuals experience a “good death.”
• Physical comfort, support from loved ones, acceptance,
and appropriate medical care.
Hospice: a program committed to making the end of life as
free from pain, anxiety, and depression as possible.
• Emphasizes palliative care—reducing pain and suffering
and helping individuals die with dignity.
• Today a majority of hospice programs are home-based.
11
© McGraw Hill LLC
A Developmental Perspective on Death
In the United States, deaths of older adults account for
approximately two thirds of the 2 million deaths that occur
each year.
• What is known about death, dying, and grieving is mainly
based on information about older adults.
• Youthful death is much less common.
12
© McGraw Hill LLC
Causes of Death
Death can occur at any point in the life span.
In infancy, sudden infant death syndrome (SIDS).
In childhood, most often due to accidents or illness.
• Major illnesses that cause death in children: heart disease, cancer,
birth defects.
Death in adolescence is most likely to occur because of
motor vehicle accidents, suicide, and homicide.
Older adults are more likely to die from chronic diseases.
• Often incapacitated before death, producing a long course of dying.
Many young and middle-aged adults die of illnesses such
as heart disease and cancer.
13
© McGraw Hill LLC
Suicide
Suicide risk factors:
• Serious physical illness.
• Mental disorders.
• Feelings of hopelessness.
• Social isolation.
• Failure in school and work.
• Loss of loved ones.
• Serious financial difficulties.
• Drug use.
• Prior suicide attempt.
14
© McGraw Hill LLC
Suicide: Adolescence 1
Suicidal behavior escalates in adolescence and further
increases in emerging adulthood.
• Second leading cause of death among adolescents in the
United States.
Far more adolescents think about or attempt suicide
unsuccessfully than actually die by it.
Suicidal behavior varies by both gender and ethnicity.
• Females make more attempts.
• Native Americans have the highest rates.
15
© McGraw Hill LLC
Suicide: Adolescence 2
Depression is the most frequently cited factor associated with
adolescent suicide.
• Sense of hopelessness, low self-esteem, high self-blame.
In some instances, suicides occur in clusters.
• “Copycat” suicides raise the issue of whether suicides
should be reported in the media.
16
© McGraw Hill LLC
Suicide: Adulthood and Aging
Suicide is increasing among U.S. adults.
Females are three times more likely to attempt suicide; but
males are four times more likely to die by suicide.
Older adult most likely to die by suicide is male, lives alone,
has lost his spouse, and is experiencing failing health.
• Perceiving oneself as burdensome may contribute.
• Protective factors include a supportive network of family
and friends, emotional control, and comfort from religion.
17
© McGraw Hill LLC
Figure 2 What to Do and What Not to Do When Someone
Is Likely to Attempt Suicide
What to do
Ask direct, straightforward questions in a
calm manner: “Are you thinking about
hurting yourself?”
Assess the seriousness of the suicidal
intent by asking questions about feelings,
important relationships, who else the
person has talked with, and the amount of
thought given to the means to be used. If
a gun, pills, a rope, or other means have
been obtained and a precise plan has
been developed, clearly the situation is
dangerous. Stay with the person until help
arrives.
Be a good listener and be very supportive
without being falsely reassuring.
Try to persuade the person to obtain
professional help and assist them in
getting this help.
What not to do
Do not ignore the warning signs.
Do not refuse to talk about suicide if a
person approaches you about it.
Do not react with humor, disapproval, or
repulsion.
Do not give false reassurances by saying
such things as “Everything is going to be
OK.” Also do not give out simple answers
or platitudes, such as “You have
everything to be thankful for.”
Do not abandon the individual after the
crisis has passed or after professional
help has commenced.
18
© McGraw Hill LLC
Facing One’s Own Death 1
As we age, values concerning our most important uses of
time change.
When asked how they would want to spend a remaining 6
months of life:
• Younger adults prioritize travel and making
accomplishments.
• Older adults prioritize inner-focused activities such as
contemplation and meditation.
Most dying individuals want to make some decisions about
their own life and death and may want to complete unfinished
business.
19
© McGraw Hill LLC
Facing One’s Own Death 2
Kübler–Ross’ stages of dying:
• Denial and isolation—denies death is taking place.
• Anger—anger, resentment, rage, and envy.
• Bargaining—develops a hope that death can be delayed.
• Depression—perceives the certainty of death.
• Acceptance—develops a sense of peace, acceptance of
one’s own fate, and often a desire to be left alone.
Not demonstrated by independent research; and fail to take
into account individual situations.
• Some psychologists prefer to describe them not as stages
but as potential reactions.
20
© McGraw Hill LLC
Perceived Control and Denial
Perceived control may work as an adaptive strategy for some
older adults facing death.
• When individuals believe they can prolong their life, they
become more alert and cheerful.
Denial can be an adaptive or a maladaptive approach to
death.
• Can insulate people from having to cope with intense
feelings of anger and hurt.
• Can keep them from having a life-saving operation.
21
© McGraw Hill LLC
The Contexts in Which People Die
More than 50% of Americans die in hospitals, and nearly
20% die in nursing homes.
Hospitals offer important advantages to the dying individual:
• Professional staff members are readily available.
• Medical technology may prolong life.
Most individuals say they would rather die at home.
• Many worry, however, about being a burden, about limited
space, and about the competency and availability of
emergency medical treatment.
22
© McGraw Hill LLC
Communicating With a Dying Person
Most psychologists stress the importance of dying individuals
knowing that they are dying.
Advantages of an open awareness of dying:
• Can close their lives according to their own ideas about
dying.
• Opportunity to complete plans or projects, make
arrangements for survivors, and participate in decisions
about funeral and burial.
• Opportunity to reminisce, converse with others, and end
life conscious of what life has been like.
• Better understanding of what is happening and what
medical staff is doing.
23
© McGraw Hill LLC
Grieving 1
Grief: the emotional numbness, disbelief, separation anxiety,
despair, sadness, and loneliness that accompany the loss of
loved one.
Pining for the lost person and separation anxiety are
important dimensions of grief.
• Intermittent, recurrent wish or need to recover the lost
person; and a focus on places and things associated with
the deceased.
Feelings of grief occur repeatedly after a loss.
• Become more manageable over time.
24
© McGraw Hill LLC
Grieving 2
Estimated 80%–90% of survivors experience normal or
uncomplicated grief reactions.
• By 6 months, the loss is accepted as reality, and
individuals become more optimistic about the future and
function competently in everyday life.
At 6 months after their loss, approximately 7%–10% of
survivors have difficulty moving on.
• Enduring despair that remains unresolved is known as
complicated grief or prolonged grief disorder.
• Greatest risk for a person who loses someone they were
emotionally dependent on.
25
© McGraw Hill LLC
Grieving 3
Another type of grief is disenfranchised grief:
an individual’s grief over a deceased person that is a socially
ambiguous loss that can’t be openly mourned or supported.
• Relationship that isn’t socially recognized; a hidden loss
such as an abortion; and circumstances that are
stigmatized.
• May intensify grief because the loss cannot be publicly
acknowledged.
• Often hidden or repressed and may be reawakened by
later deaths.
26
© McGraw Hill LLC
Grieving 4
Dual-process model of coping with bereavement
emphasizes two dimensions:
• Loss-oriented stressors focus on the deceased individual
and can include grief work and both positive and negative
reappraisal of the loss.
• Restoration-oriented stressors involve secondary
stressors that emerge as indirect outcomes of
bereavement.
Coping with loss and engaging in restoration can be carried
out simultaneously.
• Oscillation may occur over short term or longer term.
27
© McGraw Hill LLC
Grieving: Coping and Type of Death
Deaths that are sudden, untimely, violent, or traumatic are
likely to have more intense and prolonged effects on
survivors.
Coping process is more difficult.
Often accompanied by symptoms of post-traumatic stress
disorder (PTSD).
• Intrusive thoughts, flashbacks, nightmares, sleep disturbance,
concentration problems, and so on.
There is no ideal way to grieve.
• Healthy coping with death involves growth, flexibility, and
appropriateness within a cultural context.
28
© McGraw Hill LLC
Making Sense of the World
Stimulating individuals to try to make sense of their world is
one beneficial aspect to grieving.
• Close family members share with each other and
reminisce about family experiences.
When death is caused by accident or disaster, the effort to
make sense of it is pursued more vigorously.
• Bereaved want to put the death into a perspective they
can understand.
29
© McGraw Hill LLC
Losing a Life Partner 1
Spouses left behind after the death of an intimate partner
suffer profound grief.
• Often endure financial loss, loneliness, increased physical
illness, and psychological disorders, including depression.
Surviving spouses seek to cope with their loss in various
ways.
• Intensified religious and spiritual beliefs.
• Finding meaning in death.
30
© McGraw Hill LLC
Losing a Life Partner 2
Women often experience better adjustment after their loss
due to:
• Larger network of friends.
• Closer relationships with relatives.
• Experience in taking care of themselves psychologically.
Older widows adjust more optimally than younger widows,
perhaps because the death of a partner is more expected.
Widowers are usually left with more money than widows and
are more likely to remarry.
31
© McGraw Hill LLC
Losing a Life Partner 3
Psychological and religious factors are related to the
psychological well-being of older adults following the loss of
a spouse.
Volunteering and helping behaviors also appear to reduce
feelings of loneliness.
Social support helps widows or widowers adjust to the death
of a spouse.
• Widow-to-Widow program provides support for newly
widowed women.
32
© McGraw Hill LLC
Forms of Mourning
In the United States in 2018, 53.1% of deaths were followed
by cremation.
• Americans have been moving away from public funerals
toward private funerals followed by a memorial ceremony.
Funeral industry has been a source of controversy.
• Help to provide a form of closure.
• Critics claim funeral directors are there to make money
and embalming is a grotesque practice.
Traditional forms of mourning vary greatly across cultures.
33
© McGraw Hill LLC
Review
• Describe the death system and its cultural and
historical contexts.
• Evaluate issues in determining death and
decisions regarding death.
• Discuss the causes of death and suicide at
different points in development.
• Explain the psychological aspects involved in
facing one’s own death and the contexts in which
people die.
• Identify ways to cope with the death of another
person.
34
Because learning changes everything.®
www.mheducation.com
© McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.
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**## SantrockTopical11e_Chapter17DeathDyingandGrievingcopy.pdf**
Because learning changes everything.®
A Topical Approach to
Life-Span Development
11th Edition
John W. Santrock
Chapter 17
Death, Dying, and Grieving
© McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.
© McGraw Hill LLC
Learning Goals
Describe the death system and its cultural and historical
contexts.
Evaluate issues in determining death and decisions regarding
death.
Discuss the causes of death and suicide at different points in
development.
Explain the psychological aspects involved in facing one’s
own death and the contexts in which people die.
Identify ways to cope with the death of another person.
2
© McGraw Hill LLC
The Death System and Its Cultural Variations 1
Components of death systems across cultures:
• People—everyone is involved in death at some point.
• Places or contexts—hospitals, funeral homes, cemeteries,
hospices, battlefields, memorials.
• Times—time/occasions set aside to honor those who
have died.
• Objects—many objects in a culture are associated with
death.
• Symbols—symbols and religious ceremonies are
connected to death.
3
© McGraw Hill LLC
The Death System and Its Cultural Variations 2
In the United States, it is not uncommon to reach adulthood
without having seen someone die.
Most societies have philosophical or religious beliefs about
death.
• Rituals that deal with death.
In most societies, death is not viewed as the end of
existence.
• Spiritual body believed to live on.
• Perspective favored by most Americans.
4
© McGraw Hill LLC
The Death System and Its Cultural Variations 3
Forms of death avoidance and denial in the United States:
• Funeral industry glosses over death and fashions lifelike
qualities in the dead.
• Adoption of euphemistic language for death that implies
forever.
• Persistent search for a fountain of youth.
• Rejection and isolation of the aged, who may remind us
of death.
• Adoption of the concept of a pleasant and rewarding
afterlife, suggesting that we are immortal.
• Medical community’s emphasis on prolonging biological
life instead of diminishing human suffering.
5
© McGraw Hill LLC
Changing Historical Circumstances
Today, death occurs most often among older adults.
• Two hundred years ago, nearly half of all children died
before the age of 10.
Larger number of older adults today die apart from their
families.
• More than 80% of deaths occur in institutions or hospitals.
• Minimizes exposure to death and painful surroundings.
6
© McGraw Hill LLC
Defining Death and Life/Death Issues
In the past, the end of certain biological functions were
considered clear signs of death.
• Breathing, blood pressure, rigidity of body (rigor mortis).
Brain death: a neurological definition of death.
• Person is brain dead when all electrical activity of the brain
ceases for a specific period of time.
• Higher brain regions may die but lower portions may allow
for continued breathing and a heartbeat.
• Current definition among most physicians includes death
of both the higher cortical functions and the lower brain
stem functions.
7
© McGraw Hill LLC
Decisions Regarding Life, Death, and Health Care 1
Advance care planning is the process of patients thinking
about and communicating their preferences for end-of-life
care.
Laws in all 50 states now accept an advance directive, such
as a living will.
Advance directive states preferences such as whether life-
sustaining procedures may be used to prolong life.
Living will: designed to be completed while the individual
can still think clearly.
• Expresses desires regarding extraordinary medical procedures that
may sustain life when medical situation becomes hopeless.
8
© McGraw Hill LLC
Decisions Regarding Life, Death, and Health Care 2
Euthanasia: the act of painlessly ending the lives of
individuals who are suffering from an incurable disease or
severe disability.
• Passive euthanasia: when a person is allowed to die by
withholding available treatment, such as withdrawing a
life-sustaining device.
• Active euthanasia: when death is deliberately induced,
as when a legal dose of a drug is injected.
9
© McGraw Hill LLC
Decisions Regarding Life, Death, and Health Care 3
Assisted suicide is now legal in six countries.
• In the United States, it is allowed in California, Colorado,
Hawaii, Maine, New Jersey, Oregon, Vermont, New
Mexico, Washington, and Washington, DC.
• Those in favor of euthanasia argue death should be calm
and dignified, not full of suffering.
• Those against euthanasia stress it is murder; and many
religious individuals say it is against God’s will.
Too often, death in American is lonely, prolonged, and
painful.
10
© McGraw Hill LLC
Decisions Regarding Life, Death, and Health Care 4
Care providers are increasingly interested in helping
individuals experience a “good death.”
• Physical comfort, support from loved ones, acceptance,
and appropriate medical care.
Hospice: a program committed to making the end of life as
free from pain, anxiety, and depression as possible.
• Emphasizes palliative care—reducing pain and suffering
and helping individuals die with dignity.
• Today a majority of hospice programs are home-based.
11
© McGraw Hill LLC
A Developmental Perspective on Death
In the United States, deaths of older adults account for
approximately two thirds of the 2 million deaths that occur
each year.
• What is known about death, dying, and grieving is mainly
based on information about older adults.
• Youthful death is much less common.
12
© McGraw Hill LLC
Causes of Death
Death can occur at any point in the life span.
In infancy, sudden infant death syndrome (SIDS).
In childhood, most often due to accidents or illness.
• Major illnesses that cause death in children: heart disease, cancer,
birth defects.
Death in adolescence is most likely to occur because of
motor vehicle accidents, suicide, and homicide.
Older adults are more likely to die from chronic diseases.
• Often incapacitated before death, producing a long course of dying.
Many young and middle-aged adults die of illnesses such
as heart disease and cancer.
13
© McGraw Hill LLC
Suicide
Suicide risk factors:
• Serious physical illness.
• Mental disorders.
• Feelings of hopelessness.
• Social isolation.
• Failure in school and work.
• Loss of loved ones.
• Serious financial difficulties.
• Drug use.
• Prior suicide attempt.
14
© McGraw Hill LLC
Suicide: Adolescence 1
Suicidal behavior escalates in adolescence and further
increases in emerging adulthood.
• Second leading cause of death among adolescents in the
United States.
Far more adolescents think about or attempt suicide
unsuccessfully than actually die by it.
Suicidal behavior varies by both gender and ethnicity.
• Females make more attempts.
• Native Americans have the highest rates.
15
© McGraw Hill LLC
Suicide: Adolescence 2
Depression is the most frequently cited factor associated with
adolescent suicide.
• Sense of hopelessness, low self-esteem, high self-blame.
In some instances, suicides occur in clusters.
• “Copycat” suicides raise the issue of whether suicides
should be reported in the media.
16
© McGraw Hill LLC
Suicide: Adulthood and Aging
Suicide is increasing among U.S. adults.
Females are three times more likely to attempt suicide; but
males are four times more likely to die by suicide.
Older adult most likely to die by suicide is male, lives alone,
has lost his spouse, and is experiencing failing health.
• Perceiving oneself as burdensome may contribute.
• Protective factors include a supportive network of family
and friends, emotional control, and comfort from religion.
17
© McGraw Hill LLC
Figure 2 What to Do and What Not to Do When Someone
Is Likely to Attempt Suicide
What to do
Ask direct, straightforward questions in a
calm manner: “Are you thinking about
hurting yourself?”
Assess the seriousness of the suicidal
intent by asking questions about feelings,
important relationships, who else the
person has talked with, and the amount of
thought given to the means to be used. If
a gun, pills, a rope, or other means have
been obtained and a precise plan has
been developed, clearly the situation is
dangerous. Stay with the person until help
arrives.
Be a good listener and be very supportive
without being falsely reassuring.
Try to persuade the person to obtain
professional help and assist them in
getting this help.
What not to do
Do not ignore the warning signs.
Do not refuse to talk about suicide if a
person approaches you about it.
Do not react with humor, disapproval, or
repulsion.
Do not give false reassurances by saying
such things as “Everything is going to be
OK.” Also do not give out simple answers
or platitudes, such as “You have
everything to be thankful for.”
Do not abandon the individual after the
crisis has passed or after professional
help has commenced.
18
© McGraw Hill LLC
Facing One’s Own Death 1
As we age, values concerning our most important uses of
time change.
When asked how they would want to spend a remaining 6
months of life:
• Younger adults prioritize travel and making
accomplishments.
• Older adults prioritize inner-focused activities such as
contemplation and meditation.
Most dying individuals want to make some decisions about
their own life and death and may want to complete unfinished
business.
19
© McGraw Hill LLC
Facing One’s Own Death 2
Kübler–Ross’ stages of dying:
• Denial and isolation—denies death is taking place.
• Anger—anger, resentment, rage, and envy.
• Bargaining—develops a hope that death can be delayed.
• Depression—perceives the certainty of death.
• Acceptance—develops a sense of peace, acceptance of
one’s own fate, and often a desire to be left alone.
Not demonstrated by independent research; and fail to take
into account individual situations.
• Some psychologists prefer to describe them not as stages
but as potential reactions.
20
© McGraw Hill LLC
Perceived Control and Denial
Perceived control may work as an adaptive strategy for some
older adults facing death.
• When individuals believe they can prolong their life, they
become more alert and cheerful.
Denial can be an adaptive or a maladaptive approach to
death.
• Can insulate people from having to cope with intense
feelings of anger and hurt.
• Can keep them from having a life-saving operation.
21
© McGraw Hill LLC
The Contexts in Which People Die
More than 50% of Americans die in hospitals, and nearly
20% die in nursing homes.
Hospitals offer important advantages to the dying individual:
• Professional staff members are readily available.
• Medical technology may prolong life.
Most individuals say they would rather die at home.
• Many worry, however, about being a burden, about limited
space, and about the competency and availability of
emergency medical treatment.
22
© McGraw Hill LLC
Communicating With a Dying Person
Most psychologists stress the importance of dying individuals
knowing that they are dying.
Advantages of an open awareness of dying:
• Can close their lives according to their own ideas about
dying.
• Opportunity to complete plans or projects, make
arrangements for survivors, and participate in decisions
about funeral and burial.
• Opportunity to reminisce, converse with others, and end
life conscious of what life has been like.
• Better understanding of what is happening and what
medical staff is doing.
23
© McGraw Hill LLC
Grieving 1
Grief: the emotional numbness, disbelief, separation anxiety,
despair, sadness, and loneliness that accompany the loss of
loved one.
Pining for the lost person and separation anxiety are
important dimensions of grief.
• Intermittent, recurrent wish or need to recover the lost
person; and a focus on places and things associated with
the deceased.
Feelings of grief occur repeatedly after a loss.
• Become more manageable over time.
24
© McGraw Hill LLC
Grieving 2
Estimated 80%–90% of survivors experience normal or
uncomplicated grief reactions.
• By 6 months, the loss is accepted as reality, and
individuals become more optimistic about the future and
function competently in everyday life.
At 6 months after their loss, approximately 7%–10% of
survivors have difficulty moving on.
• Enduring despair that remains unresolved is known as
complicated grief or prolonged grief disorder.
• Greatest risk for a person who loses someone they were
emotionally dependent on.
25
© McGraw Hill LLC
Grieving 3
Another type of grief is disenfranchised grief:
an individual’s grief over a deceased person that is a socially
ambiguous loss that can’t be openly mourned or supported.
• Relationship that isn’t socially recognized; a hidden loss
such as an abortion; and circumstances that are
stigmatized.
• May intensify grief because the loss cannot be publicly
acknowledged.
• Often hidden or repressed and may be reawakened by
later deaths.
26
© McGraw Hill LLC
Grieving 4
Dual-process model of coping with bereavement
emphasizes two dimensions:
• Loss-oriented stressors focus on the deceased individual
and can include grief work and both positive and negative
reappraisal of the loss.
• Restoration-oriented stressors involve secondary
stressors that emerge as indirect outcomes of
bereavement.
Coping with loss and engaging in restoration can be carried
out simultaneously.
• Oscillation may occur over short term or longer term.
27
© McGraw Hill LLC
Grieving: Coping and Type of Death
Deaths that are sudden, untimely, violent, or traumatic are
likely to have more intense and prolonged effects on
survivors.
Coping process is more difficult.
Often accompanied by symptoms of post-traumatic stress
disorder (PTSD).
• Intrusive thoughts, flashbacks, nightmares, sleep disturbance,
concentration problems, and so on.
There is no ideal way to grieve.
• Healthy coping with death involves growth, flexibility, and
appropriateness within a cultural context.
28
© McGraw Hill LLC
Making Sense of the World
Stimulating individuals to try to make sense of their world is
one beneficial aspect to grieving.
• Close family members share with each other and
reminisce about family experiences.
When death is caused by accident or disaster, the effort to
make sense of it is pursued more vigorously.
• Bereaved want to put the death into a perspective they
can understand.
29
© McGraw Hill LLC
Losing a Life Partner 1
Spouses left behind after the death of an intimate partner
suffer profound grief.
• Often endure financial loss, loneliness, increased physical
illness, and psychological disorders, including depression.
Surviving spouses seek to cope with their loss in various
ways.
• Intensified religious and spiritual beliefs.
• Finding meaning in death.
30
© McGraw Hill LLC
Losing a Life Partner 2
Women often experience better adjustment after their loss
due to:
• Larger network of friends.
• Closer relationships with relatives.
• Experience in taking care of themselves psychologically.
Older widows adjust more optimally than younger widows,
perhaps because the death of a partner is more expected.
Widowers are usually left with more money than widows and
are more likely to remarry.
31
© McGraw Hill LLC
Losing a Life Partner 3
Psychological and religious factors are related to the
psychological well-being of older adults following the loss of
a spouse.
Volunteering and helping behaviors also appear to reduce
feelings of loneliness.
Social support helps widows or widowers adjust to the death
of a spouse.
• Widow-to-Widow program provides support for newly
widowed women.
32
© McGraw Hill LLC
Forms of Mourning
In the United States in 2018, 53.1% of deaths were followed
by cremation.
• Americans have been moving away from public funerals
toward private funerals followed by a memorial ceremony.
Funeral industry has been a source of controversy.
• Help to provide a form of closure.
• Critics claim funeral directors are there to make money
and embalming is a grotesque practice.
Traditional forms of mourning vary greatly across cultures.
33
© McGraw Hill LLC
Review
• Describe the death system and its cultural and
historical contexts.
• Evaluate issues in determining death and
decisions regarding death.
• Discuss the causes of death and suicide at
different points in development.
• Explain the psychological aspects involved in
facing one’s own death and the contexts in which
people die.
• Identify ways to cope with the death of another
person.
34
Because learning changes everything.®
www.mheducation.com
© McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.
**IMG_1989.png**
This file is too large to display. [View in new window](https://www.sweetstudy.com/files/img-1989-png-10334407)
– 1
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