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By the end of this section, you will be able to:
  • Discuss hospice care
  • Describe the five stages of grief
  • Define living will and DNR

Every story has an ending. Death marks the end of your life story ( [link] ). Our culture and individual backgrounds influence how we view death. In some cultures, death is accepted as a natural part of life and is embraced. In contrast, until about 50 years ago in the United States, a doctor might not inform someone that they were dying, and the majority of deaths occurred in hospitals. In 1967 that reality began to change with Cicely Saunders, who created the first modern hospice    in England. The aim of hospice is to help provide a death with dignity and pain management in a humane and comfortable environment, which is usually outside of a hospital setting. In 1974, Florence Wald founded the first hospice in the United States. Today, hospice provides care for 1.65 million Americans and their families. Because of hospice care, many terminally ill people are able to spend their last days at home.

A cemetery with many gravestones among the grass and trees is shown.
In some cultures, people’s bodies may be buried in a cemetery after death. (credit: Christina Rutz)

Research has indicated that hospice care is beneficial for the patient (Brumley, Enquidanos,&Cherin, 2003; Brumley et al., 2007; Godkin, Krant,&Doster, 1984) and for the patient’s family (Rhodes, Mitchell, Miller, Connor,&Teno, 2008; Godkin et al., 1984). Hospice patients report high levels of satisfaction with hospice care because they are able to remain at home and are not completely dependent on strangers for care (Brumley et al., 2007). In addition, hospice patients tend to live longer than non-hospice patients (Connor, Pyenson, Fitch, Spence,&Iwasaki, 2007; Temel et al., 2010). Family members receive emotional support and are regularly informed of their loved one’s treatment and condition. The family member’s burden of care is also reduced (McMillan et al., 2006). Both the patient and the patient’s family members report increased family support, increased social support, and improved coping while receiving hospice services (Godkin et al., 1984).

How do you think you might react if you were diagnosed with a terminal illness like cancer? Elizabeth Kübler-Ross (1969), who worked with the founders of hospice care, described the process of an individual accepting his own death. She proposed five stages of grief: denial, anger, bargaining, depression, and acceptance. Most individuals experience these stages, but the stages may occur in different orders, depending on the individual. In addition, not all people experience all of the stages. It is also important to note that some psychologists believe that the more a dying person fights death, the more likely he is to remain stuck in the denial phase. This could make it difficult for the dying person to face death with dignity. However, other psychologists believe that not facing death until the very end is an adaptive coping mechanism for some people.

Whether due to illness or old age, not everyone facing death or the loss of a loved one experiences the negative emotions outlined in the Kübler-Ross model (Nolen-Hoeksema&Larson, 1999). For example, research suggests that people with religious or spiritual beliefs are better able to cope with death because of their hope in an afterlife and because of social support from religious or spiritual associations (Hood, Spilka, Hunsberger,&Corsuch, 1996; McIntosh, Silver,&Wortman, 1993; Paloutzian, 1996; Samarel, 1991; Wortman&Park, 2008).

A prominent example of a person creating meaning through death is Randy Pausch, who was a well-loved and respected professor at Carnegie Mellon University. Diagnosed with terminal pancreatic cancer in his mid-40s and given only 3–6 months to live, Pausch focused on living in a fulfilling way in the time he had left. Instead of becoming angry and depressed, he presented his now famous last lecture called “Really Achieving Your Childhood Dreams.” In his moving, yet humorous talk, he shares his insights on seeing the good in others, overcoming obstacles, and experiencing zero gravity, among many other things. Despite his terminal diagnosis, Pausch lived the final year of his life with joy and hope, showing us that our plans for the future still matter, even if we know that we are dying.

Summary

Death marks the endpoint of our lifespan. There are many ways that we might react when facing death. Kübler-Ross developed a five-stage model of grief as a way to explain this process. Many people facing death choose hospice care, which allows their last days to be spent at home in a comfortable, supportive environment.

Personal application questions

Have you ever had to cope with the loss of a loved one? If so, what concepts described in this section provide context that may help you understand your experience and process of grieving?

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If you were diagnosed with a terminal illness would you choose hospice care or a traditional death in a hospital? Why?

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Questions & Answers

what is the meaning of an idiosyncratic pattern
Krystle Reply
I am here for the first time just here to learn...
michael Reply
hi I'm new on here first time
Lisa
hello
GOPAL
hi,am new here
jennifer
what is this group all about
jennifer
Suppose an individual with OCD experiences obsessive thoughts about germs, contamination, and disease whenever she encounters a doorknob. What might have constituted a viable unconditioned stimulus? 
la Reply
What are factors that influence learning?
Enos Reply
Environment Heredity(I am not sure about heredity)
Tusita
Helpful. .. thanks
Enos
Sure, anytime
Tusita
I have other questions also
Enos
Based on the factors affecting learning, how do we improve learning
Enos
I think that addressing that everyone learns in their own time
James
Peer group influence can also be another reason
Sorie
Also knowing what's going on at home. what pressure are the parents putting on them.
James
am I close or no
James
also is there a lack of care? going one more step. with peer groups do an activity that shows how much they have in common
James
under what schedule of reinforcement do animals learn from ?
Phelisa Reply
the role of emotional intelligence in a courtship behavior
Caren Reply
1
describe the task and roles of industrial psychologist in solving the problems
Solomzi Reply
hi I'm Vaishnavi and I'm new to psychology:)
Vaishnavi Reply
what is motivation
Muhammad Reply
getting passionate about something and strive for success
Leanne
observation and method based
Winter Reply
the meaning of science
Winter
soul is the Greek word for psyche
Winter
psychology is scientific research of the human brain.
Winter
Psychology is a study of human mind and behaviour
Vaishnavi
psychology is a social science which aim at studying the mind as it affect the behavior of an individual.
Prince
write and explain four psychosexual stages of personality development
MPHID Reply
I'm asking on behalf of someone How can a guy get over his weakness for girls? Like the person have soft spot for every girl and he thinks he love them then suddenly stuff change.... Like a switch
Ajayi Reply
yes
Beverly
whats the age of the boy?
Beverly
16 or 17
Ajayi
lol. it gets over with time. it's not something that can be changed instantly. and for teenagers.. anyone of opposite sex is a tasty lollipop.
Alex
yes in time it will go away but could also take years
Beverly
maybe because he doesn't really have mind of making decisions at the moment on what he need and what he doesn't want
Nwokwu
maybe he's trying to find someone to love because he's either lacked loved and feel that's the only way to feel loved or he's lonely and feels a girl can make it better . either he's got deal with the core issue
Jonan
its natural. I think it should be like this. girls also have weakness toward guys. but you can overcome on few things like concept of beauty. first step is realisation which will grow in you. also discipline help in these things.
Sujeet
what are cluster A disease?
Saee Reply
because psychology is a natural science as well as a science. it's a interdisciplinary subject
Kamakshi Reply
yes absolutely we cabt out Psychology completely into science dur to its various measuring aspects
utkarsh
cannot* put*
utkarsh
Assess the relationship between heredity and environment in human development
Newman Reply

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Source:  OpenStax, Psychology. OpenStax CNX. Feb 03, 2015 Download for free at https://legacy.cnx.org/content/col11629/1.5
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