DEATH & DYING

GROUP 8

Mutiara Nur Fadillah (09190000033)

Putri Reza Utari (09190000021)
Raden Ajeng Anita Nur Erina (09190000045)
Zahra Aulia (09190000058)
Dita Ayu Pratiwi (09190000048)

PROGRAM STUDI SI KEPERAWATAN

UNIVESITAS INDONESIA MAJU (UIMA)
2022
 PREFACE

Praise and gratitude to the presence of God Almighty, because of the abundance of His guidance
the author was able to complete a paper on "Death & Dying” well, in order to fulfill the task of
the introductory course. The author realizes that the writing of this paper is not only due to the
ability and effort of the author, but also thanks to the help and guidance of various parties.

The author realizes that this paper is still far from perfect. Therefore, all criticisms and
suggestions that are constructive from readers are very much expected for the perfection of this
simple paper. The author hopes that this paper can be useful for readers in general and writers in
particular.

Depok, 11 April 2022

Author

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 TABLE OF CONTENT

PREFACE 2
TABLE OF CONTENT 3
CHAPTER I 3
INTRODUCTION 3
1.1 Background of Paper 4
2.1 Question of The Problem 4
3.1 Objective 4
CHAPTER II 5
DEATH & DYING 5
A. CONVERSATION: CULTURE INFLUENCE HANDLING THE PATIENT 5
a. DEFINITION OF DEATH 6
b. STAGES OF DYING 6
c. PHYSICAL SIGNS OF DYING 7
d. CHANES BODY AFTER DEATH 8
e. HOSPICE AND PALLIATIVE CARE 8
f. COMPONENTS OF HOSPICE CARE PROGRAMME 8
g. PALLIATIVE CARE 9
h. MANAGEMENT OF DYING PATIENT 9
i. NURSING CARE OF A DYING INDIVIDUAL 10
B. WORD POWER: WORDS CONNECTED WITH DEATH & DYING 10
C. VOCABULARY BUILDING 12
D. READING TIME 12
E. NEWS READING 14
A. Definition from gerund 17
B. Types of Gerund 17
C. Use of Gerund 17
DAFTAR PUSTAKA 22

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 CHAPTER I

INTRODUCTION

1.1 Background of Paper

2.1 Question of The Problem

1. What is the definition of death ?
2. What is the definition of dying ?
3. What the definition of simple present tense
4. What the formula from simple present tense

3.1 Objective
1. To know definition of death
2. To know definition of dying
3. To know definition of simple present tense
4. To know formula from simple present tense

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 CHAPTER II

DEATH & DYING

A. CONVERSATION: CULTURE INFLUENCE HANDLING THE PATIENT

Practise the following dialogue with your colleague
Jane and Mary are nurses in a hospital. They are discussing the way to handle
patient's family who has some requests which are not allowed to do in the hospital. Here is
the dialogue.

Jane : Hi Jane. How are you doing?

Mary : Not bad, but actually I'm quite tired.

Jane : Really? You must try to keep your spirits up. Nurse is a job that you always want to
do, right?

Mary : That's true. Thanks Anyway, do you know the Spanish girl who got severe injuriesin
an accident?

Jane : Yes. Does something get worse?

Mary : No, she is getting better. The problem is her family. You know every day, many of
her family members come to this hospital.

Jane : That's normal I guess.

Mary : Yes, but there are two problems. First, they always come without paying attention to:
the visiting hours. We even tried to write the signs of it in Spanish. Second, they always ask
to put some foods in special location near the patient bed. Even though I know it's may be
very important for them, it's not allowed..

Jane : Yeah, I experienced such thing last month.

Mary : What did you do?

Jane : About their ignorance of the visiting hours, just try to for get it. Then, about the food, I
think the best approach is to place the holy fruit dish or food item in a sealed plastic bag,

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placing it exactly as the family specifies and explaining to them the perishable item's time
limitation depending on fermentation status and weather conditions.

Mary : Did it work?

Jane : Yes, it did. They accepted it. And it is very important to remember to ask the family
what they want you to do with this item when the time is over.

Mary : Alright. I'll try to talk about it with them. Thanks a lot Jane. You're really helpful.

Jane : You're welcome.

a. DEFINITION OF DEATH

Death is defined as:

1. cessation of heart-lung function, or of whole brain function, or of higher brain

function.
2. "either irreversible cessation of circulatory and respiratory functions or irreversible
cessation of all functions of the entire brain, including the brain stem" -(The
President's Commission for the study of Ethical problems in Medicine and
Biomedical and Behavioural Research, US, 1983).
b. STAGES OF DYING
Kubler-Ross (1969) theory of the stages of grief when an individual is dying has
gained wide acceptance in nursing and other disciplines. The stages of dying, much like
the stages of grief, may overlap, and the duration of any stage may range from as little as
a few hours to as long as months. The processes vary from person to person. Some
people may be in one stage or such a short time that it seems as if they skipped that
stage. Sometimes the person returns to a previous stage. According to Kabler-Ross, the
five stages of dying are as follows:
1. Denial
a. On being told that one is dying, there is an initial reaction of shock
b. The patient may appear dazed at first and may then refuse to believe the
diagnosis or deny that anything is wrong.

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 c. Some patients never pass beyond this stage and may go from doctor to doctor
until they find one who supports their position.
2. Anger

a. Patients become frustrated, irritable and angry that they are sick.
b. A common response is: "Why me?"
c. They may become angry at God, their fate, a friend, or a family member.
d. The anger may be displaced onto the hospital staff or the doctors who are
blamed for the illness.
3. Bargaining
The patient may attempt to negotiate with physicians, friends or even God,
that in return for a cure, the person will fulfill one or many promises, such as giving
to charity or reaffirm an earlier faith in God.
4. Depression
a. The patient shows clinical signs of depression-with drawal, psychomotor
retardation, sleep disturbances, hopeless ness and possibly suicidal ideation.
b. The depression may be a reaction to the effects of the illness on his or her life or
it may be in anticipation of the approaching death.
5. Acceptance
a. The patient realizes that death and accepts the universality of the experience
b. Under ideal circumstances, the patient is courageousand is able to talk about his
or her death as he as she faces the unknown.
c. People with religious beliefs and those who convinced of life after death can
find comfort these beliefs (Zisook Downs, 1989)

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c. PHYSICAL SIGNS OF DYING
Dying is a different experience for everyone involved. Here some signs of dying
which must understood by every nurse
1. Confusion-about time, place, and identity of loved visions of people and places that
are not present
2. A decreased need for food and drink, as well as loss of appetite.
3. Drowsiness-an increased need for sleep unresponsiveness.
4. Withdrawal decreased socialization.
5. Loss of bowel bladder control-caused relaxing muscles in the pelvic area
6. Skin becomes cool to the touch
7. Rattling or gurgling sounds while breathing or breathing that irregular and shallow,
decreased number of breaths per minute, or breathing that switches between rapid
and slow.
8. Involuntary movements (called myoclonus), changes heart rate, and loss reflexes in
the legs and arms mean that the end of life is near.
d. CHANGES BODY AFTER DEATH
1. RIGOR MORTIS : body becomes stiff within 4 hours after death as a result of
decreased ATP production, ATP keeps muscles soft and supple.
2. Algor Mortis: Temperature decreases by a few degrees each hour, The skin loses its
elasticity and will tear easily.
3. Livor Mortis: Dependant parts of body become discoloured. The patient will likely
be lying on their back, their backside being the 'dependant' body part. The
discoloration is a result of blood pooling, as the haemoglobin breaks down.
e. HOSPICE AND PALLIATIVE CARE
Hospice is a specialized program that addresses the needs of the catastrophically ill
and their loved ones particularly accepted in US and West. A team approach is provided
in hospice that may involve physicians, nurses, social workers, clergy, home health aids,
volunteers, therapists and family caregivers. Hospice workers can help a dying person
manage pain, provide medical services and offer family support through every stage of
the process, from diagnosis to bereavement.

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f. COMPONENTS OF HOSPICE CARE PROGRAMME
1. Client and family as the unit of care
2. Co-ordinated home care with access to available inpatient and nursing home beds
3. Control of symptoms(physical, sociological, psychological and spiritual)
4. Physician directed services
5. Provision of an Interdisciplinary care team of physicians, nurses, spiritual advisers,
social workers and counsellors.
6. Medical and nursing services available at all times
7. Bereavement follow up after a client's death
8. Use of trained volunteers for frequent visitation and respite support
9. Acceptance into the programme on the basis of health care needs rather than the
ability to pay
g. PALLIATIVE CARE
1. Palliative care is the active total care of patients whose disease is not responsive to
curative treatment (World-Health Organization).
2. The relief of suffering is one of the central goals of palliative care in terminal
illnesses.
3. Control of pain, of other symptoms and of psychological, social and spiritual
problems is paramount.
4. The goal of palliative care is the achievement of the best possible quality of life for
patients and their families.
5. Palliative care is a special care, which affirms life and regards dying as a normal
process, neither hästens nor post-pones death, provide relief from pain and other
distressing symptoms, integrates the psychological and spiritual aspects of patient
care and offers a support system to help patients live an actively as possible until
death and helps the family cope during the patient's illness and in their own
bereavement
h. MANAGEMENT OF DYING PATIENT

Cassen (1991) suggests seven essential features in the management of the dying patient:

1. Concern: Empathy, compassion, and involvement are essential.

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 2. Competence: Skill and knowledge can be as reassuring as warmth and concern.
3. Communication: Allow patients to speak their minds and get to know them.
4. Children: If children want to visit the dying, it is generally advisable; they bring
consolation to dying patients.
5. Cohesion: Family cohesion reassures both the patient and family.
6. Cheerfulness: A gentle, appropriate sense of humour can be palliative; a sombre or
anxious demeanour should be avoided.
7. Consistency: Continuing, persistent attention is highly valued by patients who often
fear that they are a burden and will be abandoned; consistent physician involvement
mitigates these fears.
i. NURSING CARE OF A DYING INDIVIDUAL

The person who deals with the dying patient must commit (Schwartz and Karasu, 1997)
to:

1. deal with mental anguish and fear of death

2. try to respond appropriately to patient's needs by listening carefully to the complaints
3. be fully plespared to accept their own counter transferences. as doubts, guilt and
damage to their narcissism are encountered.
4. developing a sense of control and efficacy.
5. encouraging peer groups for families coping with bereavement
6. developing increased resourcefulness in dealing with related situations
7. recognizing that a moderate level of death anxiety is acceptable
8. improving our understanding of pain and suffering will also improve communication
and effective interaction

B. WORD POWER: WORDS CONNECTED WITH DEATH & DYING

WORDS MEANING

Acceptance Penerimaan

Anger Kemarahan

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Autopsy/post-mortem Autopsi

Bargaining Penawaran

Bereavement Kehilangan

Body/corpse Jasad

Burial Penguburan

Cemetery Tempat pemakaman

Coffin Petimati

Coma Dalam kondisi koma

Cremation Kremasi

Death Kematian

Death certificate Suratkematian

Denial Penolakan

Depression Depresi

Diagnose Mendiagnosis

Diagnosis Diagnosis

Die/pass away Meninggal

Dying Kondisi menjelang ajal (sekarat)

Euthanasia/mercy killing Euthanasia

Fatal Fatal/mematikan

Frustrated Frustasi

Funeral Upacara kematian

Go downhill Kondisi Kesehatan semakin menurun

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Grief Dukacita/kesedihan

Hospice Rumah sakit untuk orang-orang yang sedang

sekarat

Irritated Terganggu

Life-sustaining treatment Pengobatan Untuk memperpanjang nyawa

Lose consciousness Kehilangan kesadaran

Mortuary Tempat penyimpanan mayat

Patient Pasien

Relative Sanak saudara/keluarga

Sleep disturbance Gangguan tidur

Stroke Stroke

Suicidal ideation Gagasan bunuh diri

Suicide Tindakan bunuh diri

Sympathy Simpati

The dying Orang yang tengah sekarat

Therapy Terapi

Treatment Perawatan/pengobatan

White linen cloth Kain kafan

Withdrawal Keinginan untuk menyendiri

Withholding/withdrawing treatment Penghentian perawatan

C. VOCABULARY BUILDING

Complete the following sentences with the following words or phrases

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 Funeral Body The dying Passed

Away Post-mortem Grief Hospice

1. A number of people attended his _____ last week. All of his family members looked so
sad since he ______ suddenly.
2. The ______ on the woman revealed that she had been poisoned.
3. The parents of the missing boy have been called by the police to identify the ______
4. The nurses were trying to comfort the patient who was overcome with _______
5. Linda is a nurse who has been working in a ______ for 10 years. She said that helping
_______ is not easy, but it is worth
D. READING TIME

Read the following article then answer the questions

Death is a cultural as well as a biological event. It is important for you to be aware of the
cultural and religious beliefs and customs of your dying patients and their family. This
guideline will help you to respond in an appointment way in order to provide a culturally-
aware service.

ISLAM

When a Muslim dies in hospital, the family may experience a great deal of anxiety if they
feel that healthcare staffs are unfamiliar with Muslim tradition. Firstly, it is important to put
on some gloves so that you do not touch the body directly. The face of the person who has
died should be turned toward Mecca. Straighten the arms and legs and close the mouth and
eyes. After death, the body is washed by family members of the same sex and is wrapped in
white linen cloth. According to Islamic tradition, a dead person should be buried as soon as
possible, prefer within 24 hours. A Muslim is always buried, never cremated. Post mortem
examinations are discouraged, unless they are required by law.

BUDDHISM

According to Buddhist beliefs, in death the consciousness departs from one life and begins
the journey into another new life For Buddhists, death is a process in which the

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 consciousness gradually separates from the body. This can take up to three days, which is
when death occurs. It is very important to provide as much peace and quiet for dying person
as possible. The more composed and calm the mind is at death, the greater the opportunity
for a better rebirth. Immediately following signs of physical Buddhists best peaceful
Traditionally, the body taken to the home, and period three prayers said and body is not The
deceased may be cremated or buried, depending on wished of family. Generally speaking,
post as the body considered less important mortems are acceptable after death.

Answer the following question.

1. Who should wash the body of a muslim?

2. What Islam's point of view about autopsy
3. Why do Buddhists believe that quietness should be kept when someone died?
4. What will Buddhists do with the body? Will it be buried or cremated?
5. Mention the other customs or beliefs that you know
6. Find out synonym the following words.
a. important :
b. anxiety :
c. put on :
d. provide :
e. deceased :
f. acceptable :

E. NEWS READING

Read the following news then answer the questions

The Dying Child: Room for Improvement End-Of-Life

Friday May 2016

Many paediatricians and paediatric subspecialists believe that their clinical care extends
from treating ill children through end-of-life care. However, are paediatricians actually
meeting the needs of families and their dying child? In a new study scheduled for publication

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in The Journal of Paediatrics, researchers surveyed bereaved parents and found that
paediatric end-of-life care needs improvement.

Dr. MalinLövgren and researchers from ErstaSköndal University College and Karolinska
Institute in Stockholm, Sweden, surveyed 48 parents of children who did not survive spinal
muscular atrophy (SMA) type I or II. SMA is a rare disorder characterized by slowly
progressing muscle weakness; most children with the most severe forms, type I and II, die
within the first two years of life without respiratory support. According to Dr. Lövgren, "This
survey aimed to explore the experiences and wishes of berealed parents concerning end-of-
life care for their child." The survey covered the time from diagnosis to after death, and
included questions about their experiences with end-of-life care and their perceived role in
decision making.

Thirty-two parents expressed wishes regarding where they wanted their child to die, half
of whom wanted their child to die at home instead of the hospital. All of those who wanted
their child to die in the hospital had their wishes fulfilled, but only 62% of those who wanted
their child to die at home got their wish. Siblings were rarely engaged in the process; only
four of 24 siblings received professional psychological support after the death of a brother or
sister. Although 83% of parents reported that health care staff said or did something in
connection with the death of the child that was remembered as being especially supportive or
considerate, more than 25% reported that health care staff did or said something distressing
at the end of life.

Although the results show that health care staffs typically provide strong support for
families, more work needs to be done Siblings have long been overlooked, and their need for
continued support should be addressed. "Health care staffs have found meaning and
satisfaction from their role in bereavement care but they experience logistical barriers, lack of
training, and lack of support," notes Dr. Lövgren. In general, everyday clinical practices may
need to be altered or even radically changed to ensure that both families and health care staff
receive the bereavement support they need.

Answer the following questions

1. What is spinal muscular atrophy (SMA)?

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 2. What is the aim of the research conducted by Dr. Lovgren and other researchers?
3. What should be done to the children whose brother or sister died?
4. Why do health care staffs still need to improve their work?
5. What is the general conclusion of the research?

F. SPEAKING TIME

Discuss the following matters with your colleagues

1. Tell about a case or cases of euthanasia you have heard in the news
2. In your opinion, do we have the right to choose when we are going to die? Give reasons
for your answer!
3. Do we have the right to choose when another person is going to die ? Give reasons for
your answer!

CHAPTER III
GERUND

A. Definition from gerund

A gerund is a form of a verb that is added with the letter -ing and functions as a noun or a
verb. The difference between the gerund and the present participle is that the gerund is a kind
of noun, but the present participle is a kind of adjective that has a medium meaning.
Therefore, although similar or the same in form, the two are very different in nature.

B. Types of Gerund
There are three kinds of gerunds, the types of gerunds are :
● Subject of sentence (subject sentence).
● Subjective complement (subject complement).
● Objective complement (object complement).

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 1. Subject of Sentence (subject of the sentence).
Example of sentences:
a. Smoking is not good for our health.
b. Singing is my hobby.
c. Playing sports is necessary to keep our body healthy.

2. Subjective Complement (subject complement)

Example of sentences:
a. His hobby is reading.
b. My favorite sport is ice skating.
c. Your chiefdelight is riding.

3. Objective Complement (object complement)

Example of sentences:
a. He likes hunting.
b. She likes shopping.

C. Use of Gerund
Based on the function we can divide the use of gerunds which means as nouns can be used as
follows:
1. As a compound word (compound nouns) or modifier (words that determine the
nature)
The use of the gerund as a compound word (compound nouns) or modifier (words that
determine the nature) which is placed in front of nouns (nouns) has the function of giving
properties that mean a tool or place (something used).

For example, as in the table below:

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Gerund Arti

Swimming pool Kolam renang

Reading book Buku bacaan

Dining room Ruang makan

Swimming suit Pakaian renang

Dining table Meja makan

Shopping bag Tas belanja

Living rooms Ruang tamu

Example of sentences:

a. This swimming pool is wide.

b. There are no shopping bags.
c. Please put the glass on the dining table.

2. Gerund as head (a word or sentence that is located as described).

Examples are as in the table below:

Gerund Arti

Problem solving Pemecahan masalah

Negative thinking Pikiran yang negatif

General meeting Pertemuan umum

Swimming suit Pakaian renang

Stamp collecting Pengumpulan stempel

Test preparing Persiapan tes

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3. Used after the word “No”
The gerund behind the word "no" has a function to form a short sentence that states a
prohibition or warning.The use of the gerund after the word "no" in writing is always
marked with an exclamation point (!).

Formula: No + Gerunds

Example of sentences:

a. No parking!
b. No smoking!
c. No speaking!

4. Gerund after possessive adjective or possessive noun.

Example:
a. Yuanita's cooking is very delicious.
b. His speaking is not relevant to the fact.
c. His coming makes me happy.

5. Used in expressions (sayings)

Example of sentences:
a. Seeing is believing.
b. Kissing is loving.

6. After Preposition
The use of the gerund after preposition (after the preposition) is like the formula and
example sentences in the table below:

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Nomor
Rumus Contoh Kalimat

He thinks of studying abroad. (Dia (lk) berpikir belajar ke

luar negeri)
1 Verb + Preposition + Gerund
Denny gave up smoking before breakfast. (Denny berhenti

merokok sebelum sarapan.)

The boy is afraid of falling from the tree. (Bocah laki-laki itu

takut terjatuh dari pohon.)

Adjective + Preposition +
2
Gerund
Aren’t you ashamed of being so cruel? (Apakah kamu tidak

malu akan sifatmu yang sangat kejam itu?)

You have no reason for leaving so early. (Kamu tak punya

alasan untuk pergi begitu awal.)

3 Noun + Preposition + Gerund
I don’t like the idea of spending much money. (Aku tidak suka

ide menghabiskan uang banyak.)

He goes out without saying anything. (Dia (lk) keluar tanpa

4 Preposition + Gerund berkata sesuatu pun.)

They went home after eating. (Mereka pulang setelah makan.)

7. Gerund after certain verbs

Certain verbs use the following gerund are: admit, delay, resist, advice, deny, keep,
recall, risk, mention, stop, avoid, enjoy, mind, miss, regret, tolerate, finish, forget,
consider , practice, consider, remember, understand, complete, suggest, and so on.
Example of sentences:

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 a. They enjoy playing scrabble.
b. I don't stop speaking.
c. He postponed making a decision.

8. Used as an adverb / additional (appositive) in a sentence.

Example of sentences:
a. His hobby, diving, makes his body strong.
b. You have a bad habit, drinking alcohol.
c. That difficult work, sawing hardwood, makes him exhausted.

9. Gerund after a certain group of words (phrases)

Example phrases as in the following table:
Phrase tertentu Arti
It’s no use Tidak ada gunanya
It’s no good Tidak ada gunanya
Would you mind Apakah kamu tidak keberatan
There’s no harm in Tak ada ruginya
Have the pleasure of Senang sekali

Example of sentences:
a. I can't help liking the giri.
b. There is no harm in trying.
c. It's no use crying like a baby.

10. Used to express certain expressions (idiomatic expressions)

The use of gerunds to express certain expressions (idiomatic expressions) is to show
reaction activities.
Use the gerund formula to express idiomatic expressions: Go + Gerund.
Example words:
Idiomatic Expression Arti
Go swimming Pergi berenang
Go hunting Pergi berburu
Go running Pergi berolah raga
Goo climbing Pergi mendaki

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 example of sentences:

a. Let’s go climbing next week. (Mari kita pergi mendaki minggu depan.)
b. Do you go swimming with her? (Apakah kamu pergi berenang dengannya?)
c. She wants to go jogging in the morning. (Dia (pr) ingin pergi berlari di pagi hari.)

DAFTAR PUSTAKA

Mubaraq, Z. (2018, juli 28). Gerund. Dipetik april 11, 2022, dari intraxenglish:
https://www.intraxenglish.com/gerund/#:~:text=Gerund%20adalah%20bentuk%20kata%20kerja,kata
%20sifat%20memiliki%20arti%20sedangl

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