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Death & dying theories
1. Add a Slide Title - 3
DEATH & DYING THEORY 13/7/2017
2. Death & Dying Theory
Presented by: N/C Sana Sultan
Faculty: Maj. Farhat Jabeen
3. Ground Rules
Be attentive
Please switch off your laptops
Don’t talk & leave the room during presentation
Ask questions without any hesitation at the end of
presentation
DEATH & DYING THEORY 33/7/2017
4. Objectives
At the end of presentation the learner will be able to:
Introduce death & dying
Define loss& grief , bereavement & mourning , death &
dying
Explain death & dying theory of Kubler Ross
Describe additional theoretical models
Enlist physical signs of dying
Enumerate physical signs of death
DEATH & DYING THEORY 43/7/2017
5. Objectives
Enlist fear of dying person
Describe care of dying person
Elaborate changes in body after death
Explain last office
DEATH & DYING THEORY 3/7/2017 5
6. Introduction
Death remains a great mystery, one of the central issues with
which religion, philosophy and science have wrestled since the
beginning of human history. we tend to view death as a feared
enemy that can and should be defeated by modern medicine and
machines. Only knowing & accepting the death can reduce the
fear
DEATH & DYING THEORY 3/7/2017 6
7. Loss & Grief
Loss
The experience of parting (seperating) with an object, person, or
relationship that one values
(Craven & Hirnle, 2009)
Grief
Psychological and physiologic responses a person experiences
after the loss of a significant person, object, or relationship.
(Craven & Hirnle, 2009)
DEATH & DYING THEORY 73/7/2017
8. Bereavement & Mourning
Bereavement
It is a state of desolation (unhappiness) that occurs as the result
of a loss. Bereavement is the subjective response
(Craven & Hirnle, 2009)
Mourning
Mourning encompasses the socially prescribed behaviors after
the death of a significant other. Mourning behaviors are socially
conventional (based on) bereavement behaviors.
DEATH & DYING THEORY 83/7/2017
9. Death & Dying
Death
Irreversible cessation of all functions of the entire brain,
including the brain stem
Dying
A process that from a medical point of view begins when a
person has a disorder that is untreatable inevitably ends in
death or the final stages of a fatal disease
DEATH & DYING THEORY 3/7/2017 9
10. Development of Concept Of Death
Age Beliefs / Attitudes
Infants to 5 years Do not understand death, belief that it is reversible
& temporary
5 to 9 years Death is final , can be avoided wishes & unrelated
actions are responsible
9 to 12 years Understand own mortality interest in after life &
fear of death
12 to 18 years Fears and fantasizes avoidance
18 to 45 years Increased attitude towards death
45 to 65 years Accepts mortality
65 + years Multiple meanings; encounters and fears
DEATH & DYING THEORY 3/7/2017 10
12. Biographic Sketch of Kubler_Ross
Swiss-American psychiatric
1963 accepted a position at the University of Colorado School
of Medicine
Completed her training in psychiatry in 1963
Pioneer in near death studies and the author of the
groundbreaking book On Death and Dying (1969)
1977 in Escondido, California, near San Diego, she founded
"Shanti Nilaya" (Home of Peace)
DEATH & DYING THEORY 123/7/2017
13. Stages of Grief
Acronym 'DABDA'.
Denial
Anger
Bargaining
Depression
Acceptance
DEATH & DYING THEORY 133/7/2017
14. Stages of Grief Contd…
Denial
A healthy response to a stressful situation, and it act as a
temporary buffer to help protect individual.
“This can’t be happening to me”
Anger
A person become angry, resentful, and hostile. Anger may
be directed to love ones and expressed through shouting,
complaining, and bitterness.
“Why is this happening to me”
DEATH & DYING THEORY 143/7/2017
15. Stages of Grief Contd…
Bargaining
Typically occurs throughout the dying process. Before a
loss, it seems like you will do anything if only your loved
one would be spared, you bargain to prolong life.
Depression
Feels as though it will last forever but It is the an
appropriate response of great loss not a mental
illness
DEATH & DYING THEORY 153/7/2017
16. Stages of Grief Contd…
Acceptance
Reality that our loved one is physically
gone and recognizing that this new
reality is the permanent reality
DEATH & DYING THEORY 163/7/2017
18. Criticisms Of Kubler-ross Theory
There exists no real evidence that stages are present in coping
with death
No evidence that people coping with their impending death
move through all of stages one through five
The limitations on the method of research employed by Kubler-
Ross have not been adequately considered
Stage Theory tends to prescribe rather than describe
DEATH & DYING THEORY 3/7/2017 18
19. Criticisms Of Kubler-ross Theory Contd…
Environmental factors
A person's whole life may be over-looked in favor of the stages
they are supposed to be going through
DEATH & DYING THEORY 3/7/2017 19
21. Charles A Corr
A social psychologist and recent researcher who wants to
help caregivers, researchers, and educators move beyond
limitations of the stage theory
Individual coping strategies
Patient empowerment
Practical guidelines for the dying patient
DEATH & DYING THEORY 3/7/2017 21
22. Debbie Messer Zlatin
She took focus away from how the observer deals with dying
process and tried to learn how the dying person interprets his/her
own reality
Exploratory study
Life themes
Importance of integration of themes
DEATH & DYING THEORY 3/7/2017 22
23. William McDougall
A researcher, founder of field of social psychology. He kept a
journal of his own terminal illness, and provided an intellectual
approach
Need to avoid increasing pain & to remain alert and mentally fit
His intellect was the most inspired when his pain was most
intense. Therefore, he did not feel like he was defeated
He did not concentrate on emotions, nor did he attempt to
create a list of developmental tasks
stresses personal uniqueness because it is individual-centered.
DEATH & DYING THEORY 3/7/2017 23
24. DEATH & DYING THEORY 243/7/2017
Physical
Signs Of
Dying
Confusion
& Drowsines
Skin is
cold to
touch
Breathing
problems
Loss of
bowel or
bladder
control
Withdrawal
Decreased
appetite
25. Pronouncement Of Death
Absence of carotid pulses
Pupils are fixed and dilated
Absent heart sounds
Absent breath sounds
DEATH & DYING THEORY 3/7/2017 25
26. Fears of Dying Person
Fear of loneliness
Fear of sorrow
Fear of the unknown
Loss of self concept & body integrity
Fear of regression
Fear of suffering & pain
DEATH & DYING THEORY 3/7/2017 26
27. Taking Care Of Dying Person
Deal with mental anguish and fear of death
Listen carefully
Accept their own counter transferences, as doubts, guilt and
damage to their narcissism are encountered
Developing a sense of control and efficacy
Encouraging peer groups for families coping with
bereavement.
DEATH & DYING THEORY 3/7/2017 27
28. Taking Care Of Dying Person Contd…
Developing increased resourcefulness in dealing with death
related situations
Recognize level of death anxiety
Understanding of pain and suffering
Effective communication and interactions
DEATH & DYING THEORY 3/7/2017 28
29. Changes In Body After Death
Rigor Mortis
Body becomes stiff within 4 hours after death as a result of
decreased ATP production. ATP keeps muscles soft and
supple.
Algor Mortis
Temperature decreases by a few degrees each hour. The
skin loses its elasticity and will tear easily.
DEATH & DYING THEORY 293/7/2017
31. Changes In Body After Death Contd…
Livor Mortis
Dependent parts of body become discolored. The patient
will likely be lying on their back, their backside being the
'dependent' body part. The discoloration is a result of blood
pooling, as the hemoglobin breaks down.
DEATH & DYING THEORY 313/7/2017
32. Last Offices
“Procedures performed,
usually by a nurse ,to the
body of a dead person
shortly after death has been
confirmed They can vary
between hospitals and
between cultures”
DEATH & DYING THEORY 3/7/2017 32
33. Last Offices Contd…
Aims
To prepare the deceased for the mortuary (a funeral home or
morgue), respecting their cultural beliefs
Comply with legislation, in particular where the death of a
patient requires the involvement of a Procurator Fiscal aka.
Coroner
To minimize any risk of cross-infection to relative, health care
worker or persons who may need to handle the deceased
DEATH & DYING THEORY 3/7/2017 33
34. Last Offices Contd…
Procedure
Straighten the body
See that dentures are placed in the mouth if patient has any
Remove all appliances
Close the eyes and mouth when open
Bring the jaws together by placing a rolled towel under the chin
Bathe the body using the Lysol solution to rinse
DEATH & DYING THEORY 3/7/2017 34
35. Last Offices Contd…
Procedure contd…
Pack anus & Vagina (if female). If there is any discharge from
the nose and mouth, pack them too
Pad wrists with cotton and the tie the 2 wrists together
Pad the ankles and tie them together.
Wrap body with a sheet well & attach tag
Cover the prepared body with a sheet and notify the head
nurse or call for the messenger to take the body to the morgue
DEATH & DYING THEORY 3/7/2017 35
36. Conclusion
Terminally ill patients constitute a vulnerable group that
deserves specialized and sensitive care that addresses their
physical, psychosocial, and spiritual needs. This
comprehensive approach to care at the end of life requires
better understanding of the religious background of patients.
Improvement in the awareness of healthcare professionals
about Islamic teachings is likely to promote sensitive caring
for their Muslim patients.
DEATH & DYING THEORY 3/7/2017 36