Death Education

 Courses in death and dying offered at

many educational levels
 May be helpful for many career
choices
 Lecture format:
 Experiential format:
 role playing, discussions, guests,
field trips
 Goals of Death Education
 Increase understanding of physical,
psychological changes in dying
 Help individuals learn to cope with
death of loved ones
 Prepare informed consumers of
medical, funeral services
 Promote understanding of social,
ethical issues
 Death, Dying and Bereavement

• Normal
• Expected
• Healthy
• Necessary
• We will all encounter it at some
point
 Elisabeth Kübler-Ross
-Early in her career she worked with Holocaust
survivors
-Cicely Saunders was a nurse and physician who
influenced Kubler Ross and the rise of hospice work
and care for the dying.
-In 1985 she began work on a hospice center for
children and infant AIDS victims. The zoning was
blocked because of infection fears in the community.
-Much of our modern understanding of the dying
and grief process has come from the HIV/AIDS crisis
of the 1980’s and early 1990’s
 Kübler-Ross’s Theory
• Denial
• Anger
• Bargaining
• Depression
• Acceptance
 Evaluating Kübler-Ross
• Stages are not a fixed sequence, not
universal
• Does not allow for context
• May lead to caregiver insensitivity-some
people never achieve each stage
• Best seen as coping strategies
– Not rigid formula
 Grief Process
Traditional View Newer Model
Avoidance
 Denial – “emotional anesthesia”
 Anger Confrontation
– most intense grief
 Bargaining Restoration
 Depression – dual-process model of
coping with loss
 Acceptance – alternate between dealing
with emotions and with life
changes
 Factors That Influence
Thoughts About Dying and Bereavement:
Things to consider…
 Nature and course of illness or death
 Personality and coping style
 Behavior of family members and
health professionals
 Spirituality, religion, culture
 Traditional Places of Death
 Home:
 most preferred option: intimacy, loving care
 only about 25% die at home
 Hospital:
 intensive care unit can be depersonalizing
 comprehensive treatment programs optimal
 Nursing home:
 focus usually not on terminal care

 Most options can improve when combined with hospice or other

supportive care
 Hospice Approach
Comprehensive program of support for
dying and their families:
– patient and family as unit of care
– interdisciplinary team
– palliative (comfort) care
– home or homelike setting
– bereavement services
• Community Bereavement Services
 Other losses
Loss of a job or other opportunity
Loss of abilities
limb amputation
loss of senses
Physical decline
Infertility/pregnancy loss
Friendship loss
Pet loss
 Resolving Grief
 Give yourself permission to feel loss.
 Accept social support.
 Be realistic about course of grieving.
 Remember the deceased.
 When ready, invest in new activities and
relationships.
 Master new tasks of daily living.
 Grieving Prolonged Deaths
Prolonged, expected
• Anticipatory grieving: allows emotional preparation
• Reasons for death usually known
• Survivors may still experience shock
• Grief can still be profound
 Complicated Grief
Sudden, unanticipated
 Avoidance from shock and disbelief
 Survivor may not understand reasons
 Trauma may also be present
 Military/Combat Death
 Death as a result of crime or accident
 Medically traumatic death
 Suicide especially hard to bear
 Posttraumatic Stress Disorder Results
From Trauma
• Trauma and stressor-related disorders
– Posttraumatic stress disorder (PTSD): A mental
disorder that involves frequent nightmares,
intrusive thoughts, and flashbacks related to an
earlier trauma
– Around 7 percent of the population will
experience PTSD at some point in their lives, and
women are more likely to develop the disorder
• Adjustment disorder
 Difficult Grief Situations
• Parents losing a child
• Children or adolescents losing a parent or
sibling
• Adults losing an intimate partner
• Bereavement overload
– Local example
 Bereavement Care
• Individual
” or Family Counseling
• Trauma Therapy if necessary
• Support groups
– Community organizations
– Religious organizations
– Contacts through hospitals, doctors or therapists
– Funeral Homes may have on site volunteers or employees
trained to assist
– Employee Assistance Program
– School Guidance or Counseling Programs
 Offering Support
 Allow the person to grieve in their own time.
 Offer specific social support
 I’ll call you tomorrow around noon
 I’ll drop by after school…
 Here I made dinner…lets meet for lunch…
 Stamped envelopes for thank you cards
 Sympathy “I’m so sorry to hear about your….”
 Patient listening
 Remember the deceased. Don’t be afraid to talk about the person.
 Avoid clichés…
 I know how you feel
 it’s what God wanted…
 only the good die young
 you’ll get over it
 You’re young you’ll find love again
 you have other children….
 Children and adolescents

• Respond differently based on Cognitive and

Social/Emotional Development
• Young children need routine and play
• Older children need daily supports and
routines as well as ways to reach out, school,
family, friends
– Groups can work well for older children and young
adolescents
 In General
Do’s Don’ts
• Talk • Abuse drugs or alcohol
• Ask for help, reach out • Isolate excessively
• Write • Ignore advice from doctors
• Self care-sleep, eat, exercise or trusted loved one’s
properly
 Tips for Holidays and Special days

Practice self care

-Don’t overdue
-Don’t feel like you have to do everything as before
Make a plan but be flexible
-drive yourself to events if you can
-don’t feel you need to ‘do it all’
Consider trying some new routines
-arrange for a meal out or bring in food
-volunteer
Set aside time to remember your loved one
-set an empty place or photo on the table
-visit gravesite, place of worship or other special place