Developmental psychology

Assignment 04

Submitted by: Muqadas Zulfiqar (064), Zaib Fatima (022), Ayesha Nasir (002) &
Zunaira Abbas (050)

Section: B
Semester: 6th

Submitted to: Ms Sana Aslam

Submission date: June 9, 2023

This Photo by Unknown Author is

licensed under CC BY-SA

Humanities Department
COMSATS University Islamabad, Lahore Campus
 Topic: Death, Dying and Grieving

Death system and cultural variations:

 People, death in inevitable, everyone is involved with death at some point, either their own

death or the death of others. Some individuals have a more systematic role with death, such

as those who work in the funeral industry and the clergy, as well as people who work in life-

threatening contexts such as firemen and policemen.

 Places or contexts, these include hospitals, funeral homes, cemeteries, hospices, battlefields,

and memory (such as the Vietnam Veterans Memorial Wall in Washington, D.C.)

 Times, death involves times or occasions such as Memorial Day in the United States and the

Day of the Dead in Mexico-- w h i c h are times to honor those who have died. Also,

anniversaries of disasters such as D-Day in World War I, 9/11/2001, and Hurricane Katrina

in 2005, as well as the 2004 tsunami in Southeast Asia that took approximately 100,000 lives

are times when those who died are remembered in special ways such as ceremonies.

 Objects: Many objects in a culture are associated with death, including caskets, various

black objects such as clothes, arm bands, and hearses. Symbols: Symbols such as a skull and

crossbones, as well as last rites in the Catholic religion and various religious ceremonies, are

connected to death.

Changing historical

 One historical change involves the age group in which death most often strikes. Two hundred

years ago, almost one of every two children died before the age of 10, and one parent died

before children grew up. Today, death occurs most often among older adults (Lamb, 2003).

Life expectancy has increased from 47 years for a person born in 1900 to 78 years for
 someone born today (U.S. Census Bureau, 2006). In 1900, most people died at home, cared

for by their family. As our population has aged and become more mobile, older adults die

apart from their families. In United States today, more than 80 percent of all deaths occur in

institutions or hospitals. The care of a dying older person has shifted away from the family

and minimized our exposure to death and its painful surroundings.

Issues in death

 Twenty-five years ago, determining someone was dead was simpler than it is today. The end

of certain biological functions, such as breathing and blood pressure, and the rigidity of the

body (Rigour mortis) were considered to be clear signs of death. In the past several decades,

defining death has become more complex (Kendal &others, 2007; Quasar &others, 2007).

 Brain death is a neurological definition of death, which states that a person is brain dead

when all electrical activity of the brain has ceased for a specified period of time. A flat EEG

(electroencephalogram) recording for a specified period of time is one criterion of brain

death. The higher portions of the brain often die sooner than the lower portions. Because the

brain's lower portions monitor heartbeat and respiration, individuals whose higher brain areas

have died may continue breathing and have a heartbeat. The definition of brain death

currently followed by most physicians includes the death of both the higher cortical functions

and the lower brain stem functions (Trout, 2007).Some medical experts argue that the

criteria.

Decision regarding life, death and health

Physicians' concerns over malpractice suits and the efforts of people who support the-

living will concept have produced natural death legislation in many states. For example,
California’s Natural Death Act permits individuals who have been diagnosed by-two physicians

as terminally ill to sign an advanced directive, which states that life- sustaining procedures shall

not be used to prolong their lives when death is imminent(Chovan, 2007; Tice, 2007). An

advanced directive must be signed while the individual still is able to think clearly (Wareham,

McCallin, & Diesfeld, 2005). Laws in al fifty states now accept advanced directives as reflecting

an individual's wishes.

Enthusiasm

The act of painlessly ending lives of persons who are suffering from it able diseases or

severe disabilities; sometimes called ‘mercy killing.’

1. Passive euthanasia occurs when a person is allowed to die by withholding available

treatment, such as withdrawing a life- sustaining device. For example, this might involve

turning off the respiratory or a heart-lung machine.

2. Active euthanasia occurs when death is deliberately induced as when a lethal dose of a drug

is injected.
Better care for dying individual

Death in America is often lonely, prolonged, and painful (Schroepher, 2007). Dying

individuals often get too little or too much care. Scientific advances sometimes have made dying

harder by delaying the inevitable (Kaufman, 2005). Also, even though painkillers are available,

too many people experience severe pain during the last days and months of life (Lo &

Rubenfeld, 2005). Many health-care professionals have not. Been trained to provide adequate

end-of-life care or to understand its importance. In 1997, a panel of experts recommended that

regulations be changed to make it easier for physicians to prescribe painkillers for dying patients

who need them (Institute of Medicine, 1997).

Hospice: A program committed to making end of life as free from pain, anxiety, and depression

as possible. The goals of Hospice trust with those of a hospital, which are disease and prolong

life.

Palliative care: Emphasized in hospice involves reducing pain and suffering a dying individual’s

die with dignity.

Causes of Death
 Death can occur at any point in the human life span. Death can occur during pre- natal

development through miscarriages or stillborn births. Death can also occur during the birth

process or in the first few days after birth, which usually happens because of a birth defect or

because infants have not developed adequately to sustain life outside the uterus. "Physical

Development and Biological Aging." we described sudden infant death syndrome (SIDS), in

which infants stop breathing, usually during the night, and die without apparent cause (Hunt

&Hauck, 2006). SIDS currently is the leading cause of infant death in the United States, with the

risk highest at 2 to 4 months of age (NICHD, 2007).

In childhood, death occurs most often because of accidents or illness. Accidental death

in childhood can be the consequence of such things as an automobile accident, drowning,

poisoning, fire, or a fall from high place. Major illnesses that cause death in children are heart

disease, cancer, and birth defects.

Compared with childhood, death in adolescence is more likely occur because of motor

vehicle accidents, suicide, and homicide. Many motor vehicle accidents that cause death in

adolescence are alcohol-related. We examine suicide in greater depth shortly.

Older adults are more likely to die from chronic diseases, such as heart disease and

cancer, whereas younger adults are more likely to die from accidents. Older adults' diseases often

incapacitate before they kill, which produces a course of dying that slowly leads to death. Of

course, many young and middle-aged adults die of diseases, such as heart disease and cancer.

Attitudes towards death at different points in the life span

According to Hayslip and Hansson, children's attitudes towards death depend on their

developmental stage and their cultural and religious background.

 In early childhood, children may not fully understand the concept of death and may see it as

temporary or reversible. They may also have a magical thinking that death is caused by a

person's thoughts or actions.

 In middle childhood, children may have a more realistic understanding of death, but may

still struggle with the concept of permanence. They may also have a lot of questions about

death and what happens after someone dies.

 Early Adolescence (ages 12-14), Adolescents at this age may have a more realistic

understanding of death, but may still struggle with the concept of permanence. They may

also have a lot of questions about death and what happens after someone dies.

 Middle Adolescence (ages 15-17) Adolescents at this age may have a more mature

understanding of death and may be able to think about death in a more abstract way. They

may also have a better understanding of their own mortality and may begin to think about

their own death.

 Late Adolescence (ages 18-21) Adolescents at this age may have a more developed

understanding of death and may be better able to cope with the emotions that come with

losing a loved one. They may also begin to think about death in a more philosophical or

spiritual way.

It's important for parents and caregivers to be honest with adolescents about death and to

answer their questions in an age-appropriate way. Adolescents may also need help coping with

the emotions that come with losing a loved one. Providing a safe and supportive environment for

adolescents to express their feelings about death can help them process their grief and develop

healthy coping skills.

 Early Adulthood (ages 22-39) Adults at this age may be focused on building their careers

and starting families, and may not think about death as much. However, they may begin to

think about their own mortality as they experience life changes such as getting married or

having children.

 Middle Adulthood (ages 40-64) Adults at this age may begin to think more about their own

mortality and may experience a midlife crisis as they reflect on their life and

accomplishments. They may also begin to experience the loss of parents or other loved ones.

 Late Adulthood (ages 65 and older): Adults at this age may be more accepting of death and

may think about it more often. They may also experience multiple losses of loved ones and

may begin to think about their own legacy and how they will be remembered.

It is important for adults to think about their own wishes for end-of-life care and to

communicate these wishes to their loved ones. Adults may also need help coping with the

emotions that come with losing a loved one or facing their own mortality. Providing a safe and

supportive environment for adults to express their feelings about death can help them process

their grief and develop healthy coping skills.

Suicide

Risk factors for Suicide;

 Physical illness

 Feelings of hopelessness

 Social isolation

 Failure in school and work

 Loss of loved one

  Serious financial difficulties

 Drug Use

 Depression

Adolescence

Suicide cases rare in childhood but escalate in adolescence.

The National Center for Health Statistics (NCHS) published a report in 2002 titled

"Deaths: Final Data for 2000," which included information on suicide rates in the United States.

According to the report, suicide was the 11th leading cause of death in the US in 2000, with a

total of 29,350 suicides (NCHS, 2002). The suicide rate was highest among males and among

individuals aged 25-44 years old. The report also noted that suicide rates varied by race and

ethnicity, with the highest rates among non-Hispanic white individuals.

Risk factors for Suicide in Adolescence;

 Homosexual V/S Heterosexual adolescents

 Family instability and unhappiness

 Social Pressure

 Abuse

 Genetic factor

 Psychological factor

Adulthood and Aging

 Suicide rates remain stable during early and middle adulthood, and then increase in late

adulthood. For All age groups, males are more likely to commit suicide than females. Those

males commit suicide

 Who live alone

 Has lost his spouse

 Experiencing failing health / Poor health

 Unemployed

 Relationship problems

Older adults less likely communicate their suicide intentions than are younger adults and

adolescents and make fewer attempts. When they commit suicide, they use such methods that

more often succeed.

Kubler-Ross’ Stages of Dying

Denial and Isolation

 First stage of dying

 Person denies that death is really going to take place. Person may say that it can’t be me.

‘It’s not me’.

 Denial is usually a temporary defense.

 It is eventually replaced with increased awareness when the person is confronted with

such matters as financial considerations, unfinished business and worry about surviving

family members.
Anger

 Second stage of dying

 Dying person recognizes that denial can no longer be maintained.

 Denial gives way to anger, resentment, rage and envy.

 The dying person’s question is “why me?”

 The person doesn’t care himself or herself as anger may become displaced and projected

onto physicians, nurses and doctors, family members or even God.

 The realization of loss is great and those who symbolize life, energy and competent

functioning are especially salient targets of the dying person’s resentment and jealousy.

Bargaining

 Third stage of dying

 Person develops the hope that death can somehow be postponed or delayed. Some

persons enter into the bargaining or negotiation with God, as they try to delay their death.

 Psychologically the person is saying, ‘yes, me but’ in exchange for a few more days,

weeks or months of life, the person promises to lead a reformed life dedicated to God or

to the service of others.

Depression

 Fourth stage of dying

  Dying person comes to accept the certainty of death.

 A period of depression or preparatory grief may appear.

 The dying person may become silent, refuse visitors, and spend much of time crying or

grieving.

 This period is normal and is an effort to disconnect the self from love objects.

 Attempts to cheer up the dying person at this stage should be discouraged, says Kubler-

Ross’, because the dying person has a need to contemplate impending death.

Acceptance

 Fifth stage of dying

 Person develops a sense of peace, an acceptance of one’s fate, and a desire to be alone.

 Feelings and physical pain may be virtually absent.

 Kubler-Ross defined this stage as the end of the dying struggle, the final resting stage

before the death.

 Problems with Kubler-Ross approaches

The stage interpretation neglected the patient’s situations, including

 relationship support,

 specific effects of illness,

 family obligations and

  Institutional climate in which they were interviewed.

Perceived Control and Denial

 When individuals lead to believe that they can influence and control events such as

prolonging their lives, they may become more alert and cheerful.

 Denial may be a fruitful way to approach death for some individual and can be adaptive

or maladaptive.

 Denial can be used to avoid the effect of shock by delaying the necessity of dealing with

one’s death.

 Denial can insulate the individual from having to cope with intense feelings of anger and

hurt.

The Contexts in Which People Die

  For dying individuals, the context in which they die is important. More than 50% of the

Americans die in hospitals, and 20% die in nursing homes. Some people spend their final

days in isolation and fear.

 Hospitals offer several important advantages to the dying persons, for example

professional staff members are readily available, and the medical technology present may

prolong life. But a hospital may not be the best place for many people to die.

 Many feel that they will be a burden at homes, that there is limited space there, and that

dying at home may alert relationships.

 Individual who are facing death also worry about the competency and availability of

emergency medical treatment if they remain at home.

Loss can come in many forms in our lives including divorce, a pet’ death, loss of a job but no

loss is greater than that which comes through the death of someone we love and care for, a

parent, sibling, spouse, relative or friend. In the ratings of life stresses that require the most

adjustment, death of a spouse is given the highest number.

Communicating With a Dying Person

Many psychologists stress that it is important for a dying person to know that they are dying

and that others know they are dying so that they can interact and communicate with each other

on the basis of mutual knowledge.

 The advantages of this open awareness are the:

 First, dying persons can close their live according to their own ideas about proper dying.
  Second, they may be able to complete some plans and projects, can make arrangements

for survivors, and can participate in decisions about a funeral.

 Third, dying individuals have the opportunity to reminisce, to converse with others who

have been important in their lives, and to end life conscious of what life has been like.

 Fourth, dying individuals have more understanding of what is happening within their

bodies and what the medical staff is doing to them.

Some experts note that communication should not focus on mental pathology but also should

focus on strengths of the individuals and focus on internal growth. The important support for a

dying individual may come not only from mental health professional, but also from nurses,

physicians and spouses.

Strategies for Communicating With a Dying Person

 Effective strategies for communicating with a dying person include:

 Dying individuals who are very frail often have little energy. If the dying person you are

visiting is very frail, you may not want to visit for very long.

 Eliminate distraction, for example if it is okay to turn off the TV. Realize that excessive

small talk can be a distraction.

 Don’t insist that the dying person feel acceptance about death if the dying person wants

to deny the reality of the situation. On the other hand, don’t insist on the denial if the

dying individual indicates acceptance.

 Allow the dying person to express guilt or anger, encourage the expression of feelings.
  Sometimes dying persons don’t have the access to other people. Ask the dying person if

there is anyone, he or she would like to see that you can contact.

 Talk with the individual when he or she wishes to talk. If this is impossible, make an

appointment and keep it.

Grieving

Grief is an emotional numbness, disbelief, separation anxiety. It is a complex and

evolving process with dimensions.

Dimension of grieving

1. Pining (wish to recover the lost person). It may diminish.

2. Separation anxiety (association with the things of lost person) as well as crying, depressive

symptoms. It may remain or increase.

3. Good family communication: Example, family members who did not communicate after the

loss had more negative effects of grief than those who communicated with each other to

resolve the loss.

Types of grief

Complicated grief: the term used to describe the grief involves enduring despair and is

unresolved over an extended period of time.

Disenfranchised grief: involving a deceased person that is a socially ambiguous loss that can’t

be openly mourned or supported.

Dual process model: a coping with bereavement. It has two main dimensions.
1) Lost oriented stressors (negative and positive appraisal of the loss)

2) Restoration oriented stressors (indirect outcomes of bereavement). Such as from wife to

widow, or mastering skills such as dealing with finances.

Coping and type of death

The impact of death on surviving individuals is strongly influenced by the circumstances

under which the death occurs. Deaths that are sudden or traumatic have more intense effects on

survivals and make coping process difficult for them such as PTSD.

Cultural diversity in healthy grieving: some approaches to grief are advised to break the

bond with the late person and move on Back to life but if they do not work on that then they are

in need of therapy. Example, we as Muslims are supposed to mourn only for three days after

losing our loved ones. In Egypt, people do express their sorrow through sharing with each other

about their trauma. In Bali, the sorrow is encouraged to laugh and be joyful.

Making sense of the world

When a death is caused by an accident or traumatic, making sense out of it is difficult.

We add some pieces to it to cope with it as soon as we can. A study says that making sense for a

traumatic event of death plays an important tact in the grieving of a violent loss. Such as,

homicide, suicide, people tend to go over again and again all of the events that led up to the

death.

Losing a life partner

 Those people who were left behind after the death of an intimate partner often suffer

profound grief and often face financial loss, loneliness, increased physical illness s and

psychological disorders e.g. depression.

A longitudinal study on 13,000 women had occurred. The women health initiative study if

widowhood and health. Following are the measurements used to assess the older women health

were: Physical health, mental health, health behaviors, and health outcomes

Forms of mourning

The funeral is an important aspect in many cultures. One decision facing the bereaved is

what to do with the body? We as Muslims bury the corpses. Cremation process is popular in

Japan, Canada and America. In a study people who were more religious derived more positive

psychological benefits and adjusted positively to the loss.

Traditional

examples: the Amish people live in family oriented societies. They handle all aspects of loss

virtually with each other. They live the same way their ancestors live such as at the time of death,

their neighbors assume the responsibility to notify others of the death

Strategies to move on
5 stages of grief:

Going through from stages of grief also help. The five stages – denial, anger, bargaining

(“what if” and “if only” statements), depression and acceptance – are often talked about as if

they happen in order, moving from one stage to the other.

Strategies:

Grieving your loss

Allow yourself to feel.

Prepare for painful reminders.

Moving on doesn't mean forgetting your loved one.

Lean on friends and family.

Focus on those who are “good listeners”.

Join a bereavement support group.