Hello All,Lots of questions to address, this week, on death and bereavement. I want to begin this thread with a friends personal story (which is a response to one of the questions for this week’s post

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Hello All,

Lots of questions

to address, this week, on death and bereavement. I want to begin this thread with a friends personal story (which is a response to one of the questions for this week’s post):

Many years ago, I was suddenly transferred to another school (elementary) to cover for a teacher who was diagnosed with colon cancer as she was missing quite a few days of work because she was in treatment. Long story cut short, she opted to continue teaching (yes, with me there which was awkward); she would go to chemo and then come to work.  She was sick (many side effects with her treatment which was aggressive),  she had trouble sitting, she had trouble staying awake during group teaching, she was short tempered with the kids (and me), and made it clear that  this was her classroom, not mine and I was expected to work with the kids elsewhere (special ed program). I also felt like a 5th wheel in that this wasn’t my home school and I was only there to help (I think the principal was worried something would happen so wanted another teacher in the room). Wow – I was so torn. I knew she had end stage cancer; I knew she would probably not survive the school year but the principal wasn’t about to send her home so I was in this really strange situation. And, I felt incredibly guilty getting angry with her.  Not being experienced with anything like this before, I had to do some serious soul searching with my own feelings since I was miserable. So…I gave her situation some thought and decided to ‘suck it up,’ and just come in, every day, cheery, takes my kids, go somewhere else and leave the minute I could. I didn’t even interact with her, not really. She only spoke to me if she had to. It was if I was her reminder of how sick she was (her family really wanted her home). Then, suddenly, I was sent back to my other school. This teacher died about 2 months later. So, then,I stepped in for another teacher (yes, same year but at my school) who had breast cancer and she had recently discovered that she was out of remission. But, in this situation, she wanted me to work with her kids, visit her (she took a leave), and keep her updated on teacher gossip. She also was upbeat, lots of family support, but, just a different person and handled her cancer differently. She eventually came back to work, the next year, hopeful. She made it half way through the school year before she had to stop and then shortly after, died.

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Between the 2 situations, I was grateful, I had experienced the angry teacher, first, as she forced me to evaluate my own feelings and how to cope and respond. By the time I was stepping in for the other teacher, I had a much better handle on how I should approach the situation (letting her call the shots). Since then, I have had other colleagues with cancer and I approach each situation on an individual basis but have a much better understanding of my own feelings.

So…this week, I am asking you about your own feelings, not to pry, but allow for you to think about these kinds of situations, for yourself; and differentiate between family and work situations, specifically colleagues.

Hello All,Lots of questions to address, this week, on death and bereavement. I want to begin this thread with a friends personal story (which is a response to one of the questions for this week’s post
Chapter 13 Dying, Death, and Bereavement   I.   Death Anxiety              1.  Death anxiety is common in the general public, usually higher in women, and peaks in intensity in young adulthood and declining afterward. II.   End-of-Life Decisions                A.    Advance Directives                 1.   Advance directives  refers to various types of legal documents detailing wishes of individuals regarding end-of-life concerns.                 2.  Advance directives, such as living wills and durable power of attorney for health care, are designed to make the wishes of an individual known when that individual is incapacitated or cannot communicate.                                B.  Palliative Care and Hospice Programs                 1.   Palliative care is focused on treating symptoms and keeping an individual comfortable (American Cancer Society, 2008; NCI, 2000).                   2.      Hospice care                 a)   A type of palliative care                     C.   Euthanasia and Physician-Assisted Death                   1.    Passive euthanasia                  a)  Allows “nature to take its course”                       2.    Active euthanasia                 a)    Involves taking direct action to shorten a patient’s life                 b)    Is illegal                3.     Physician-assisted suicide                a)  Could be simply responding to a patient’s questions and explaining the dosage requirements or combinations of drugs that would cause death               b) Could involve the physician actually writing the prescription for such drugs (AGS, 2005)              c) Although active euthanasia is illegal, physician-assisted suicide is legal in Oregon and in some parts of the world III.      Close to Death                     A.  End-of-Life Research Issues                  1.  End-of-life research projects face numerous challenges              a).  Including convincing an IRB that the study is worth the potential Discomfort              b)  Locating qualified and willing participants                     B.  Psychological Changes                  1.  Kubler-Ross’ five stages of dying (denial, anger, bargaining, depression, and acceptance) was the standard portrayal of the dying experience, but it has fallen out of favor with those in the social and health sciences.                     C.   Interacting with Those Who are Dying               1.  When interacting with someone who is dying it is important to allow honest conversation about important matters, even if it is very emotional or in some other way uncomfortable.               2.  Rather than looking for an individual to follow a stage pattern, loved ones and health care professionals are encouraged to be present, listen, and be willing to engage in the difficult and emotional conversations.                      D. Physiological Changes                 1.  As an individual approaches death, there are expected physiological signs, such as less social interaction, decrease in appetite and bladder and bowel control, cool limbs, noisy breathing, muscle contractions, and an irregular heartbeat. IV.             Transitions                      A.  Marking the End of Life                    1. Following death, decisions need to be made regarding burial or cremation and, if desired, the type of funeral, memorial service, or public recognition of the deceased.                        B. Bereavement                      1.   During the bereavement process individuals must learn to cope with the gap in their lives left by the deceased.                        2.   For most people, the symptoms of bereavement start to ease and significant healing takes place in the first 6 months.                    3.   Generally, individuals in bereavement pass through phases of shock, avoiding separation, disorganization and despair, and reorganization and recovery, although there may be many individual differences and circumstances that may influence one’s thoughts, behaviors, and coping skills.                      C. Complicated Grief                     1.   Some individuals experience depression, anxiety, and prolonged and intense grieving called complicated grief. In Assignments Post Discussion: A few questions to ponder this week: what are your thoughts on death anxiety? Why do we distinguish between complicated grief and bereavement? What could be the impact on those individuals closest to the person experiencing complicated grief? And, on a personal level, how do you think you would respond if you discovered that someone you work closely with has a life ending situation (cancer, for example) but insists on continuing working until the last possible moment? Would you react differently if this was a family member (who wanted to continue working until the end)? These [personal] questions are not to pry but for you to have an opportunity to evaluate your own feelings on the subject.

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