Chapter Notes: Module 17

PSYC 200 Chapter Notes

Chapter 10: Death and Dying

This chapter deals with issues that are often challenging and even difficult to discuss.  Death is often a taboo topic.  The opening pages introduce a few practical issues related to death, specifically some of the major physical changes that occur in the weeks, days and hours leading up to death. The next few pages present some statistical and demographic information related to death. Since this is a life-span course, the perceptions of death across the stages of life are interesting to review (page 417).

I know that some students in this course interact professionally with death and dying every day. All of us have, or will, face these realities on a personal basis. Beginning  on page 418, curative, palliative, and hospice care are discussed, as well as specific topics addressed, including family caregivers, advanced directives, and cultural differences in end-of-life decisions. If you have never seriously considered matters related to euthanasia, the brief section will provide some initial information to consider.

As the remainder of the chapter unfolds, helpful insights are presented relative to religious practices after death, and sensitive matters about grief, bereavement and mourning. The pioneering work of Elizabeth Kubler-Ross and the five stages of grief are discussed beginning on page 426. Kubler-Ross provided a progression that should not be viewed as iron-clad or always true, but it does offer a sequence that may be helpful in understanding yourself and others. The chapter concludes with a brief section on challenges faced with the deaths of children and parents, and some supportive information related to the mourning process.

I would add a few other suggestions for helping children deal with death.   Some helpful hints include:  be honest with the child and respect their right to know; plan how you will communicate with the child and speak directly (use words like “death” and “die” to avoid misunderstandings—“losing” a loved one can be very confusing to a child; express your emotions honestly; acknowledge questions and use age-appropriate responses; and acknowledge normal, healthy grieving. 

Every adult makes their own decisions about how to interact with children regarding death, often based on cultural values or religious views.  I mentioned the potential confusion with the word “losing or lost”.  For the sake of discussion, I often suggest that adults also avoid other phrases like “passed away” (like using a bus pass?); “taken from us” (can we get him back?); “sleep in peace or eternal rest” (your child may be afraid to nap or fall asleep at  bedtime for fear of never  waking up); “long trip” (your child may fear future vacations or parental travel); and “they are happy now with the angels in heaven” (so why is everybody crying?). 

One research effort (Karen Kehl) analyzed 42 major articles dealing with the concept of “a good death.”  The attributes of a good death include:  being in control, being comfortable, sense of closure, affirmation/value of the dying person recognized, trust in care providers, recognition of impending death, beliefs and values honored, burden minimized, relationships optimized, appropriateness of death, and leaving a legacy and family care. 

Changing practices toward death can be seen in the increasing number of individuals who are choosing cremation instead of burial.  One survey ranked important considerations in choosing cremation:  saving money, saving land, simpler than traditional funeral, body not placed in earth, and personal preference for this life-ending event. 

Regarding funerals and other social aspects of mourning, I encourage family members to be personal and creative in planning memorial services.  Don’t let someone else dictate how you should best honor the memory of one you have loved. 

Parting thoughts and closing story:

Well, my friends, we come to the end of this chapter, book and course.  We have surveyed the life-span journey together, stopping along the way to highlight particular issues or concerns.   From before birth to after death, we have considered theoretical perspectives and practical dimensions.  As I have indicated before,  there have been times (including these topics in this last chapter) that I wish we could have sat together, face-to-face, and grappled with some of these important and sensitive matters.  However, I must also acknowledge how much I have appreciated the courageous honesty of so many students who have shared their thoughts, hopes, hurts, and insights in the weekly assignments.  I consider it a privilege and high honor to have been invited in to your ideas and experiences.  Thank you, also, for the quality and depth of many of your discussion forum entries. 

I always close my courses with this story.  It is about a wise man, they called him a lama, who lived high up on a mountain in Tibet.  Whenever the villagers in the valley below would be confronted with a difficult decision or confusion or trial, they would come see the lama, pose the situation, he would respond, and they would leave satisfied.  One time, a group of teenagers decided they wanted to embarrass the lama—so they devised a trap.  One of them would approach the lama with a hummingbird cupped in his hands and they would ask the lama, “Is this hummingbird alive or is it dead?”  If the lama said the bird was alive, they would crush the bird and show it was dead.  If the lama said the bird was dead, they would open their hands and the bird would fly free.  They had him either way.  So, one day they gathered a crowd and they all made the trek up the mountain.  With a hummingbird cupped in their hands, they said, “Oh wise lama, is this hummingbird alive or is it dead?”  And the lama answered quietly, “That is entirely in your hands.”

What we do with today, with our yesterdays and our tomorrows, is in our hands.  I am grateful for your hands and I trust you will use them in kind and loving ways that will change the world for good.