Study Guide for The Last Dance: Encountering Death & Dying, 4th ed., by Lynne Ann DeSpelder & Albert Lee Strickland

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Trace the history of death education by citing at least five influential books and at least one professional organization.

2. Contrast nineteenth- and twentieth-century death customs.

3. List and describe at least four factors that have contributed to changes in death customs from the nineteenth to the twentieth century.

4. Compare the death rate at the turn of the century with that of today.

5. Trace the changing causes of death from the turn of the century through today, paying particular attention to the effects of the epidemiologic transition.

6. Explain the ways in which language and humor can be used to distance people from the reality of death.

7. Describe the ways in which the media portray death, citing at least one statistic regarding the amount of coverage.

8. Describe how television portrayals of violent death reflect the "mean world" syndrome.

9. Explain and illustrate how attitudes toward death are expressed through the arts.

10. Suggest reasons for studying death and dying, using both the discussion in the text and your own experience.

11. Discuss the impact of AIDS on attitudes toward death.

12. Identify three kinds of "death talk" and explain the function of each using specific examples.

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Compare four different cultural explanations of how death came to be.

2. Contrast Hopi and Cocopa funeral rituals. Decide which is more positive in your opinion and explain why.

3. Explain the meanings of the LoDagaa death ceremonies including the practices surrounding mourning restraints, the mourning companion, and grave digging. Compare the LoDagaa rituals with ours.

4. Analyze the apparent ambivalence of Mexican attitudes toward death as revealed in customs surrounding the Day of the Dead.

5. Develop a brief historical summary based on Ariès' work concerning the ways death has been viewed for the past thousand years or so in the Western world, including at least four distinctive periods.

6. Describe the origin and evolution of the Dance of Death.

7. Contrast the views of death in the seventeenth, eighteenth, and early nineteenth centuries with those of today.

8. Describe the functions of the butsudan in Japanese society.

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Name the three components of a mature understanding of death.

2. Explain Speece and Brent's idea of "noncorporeal continuity."

3. Discuss how each of the following theoretical perspectives provides insight into the way that a society copes with death: structural-functionalism, symbolic interactionism, and social learning.

4. List each of the agents of socialization and briefly explain their contribution to an individual's understanding of death.

5. Give some examples of how early experiences with death can shape an individual's later view of death.

6. Distinguish between the "healthy-minded" and "morbidly-minded" arguments regarding the presence of a fear of death in human beings.

7. Explain the concept of teachable moments.

8. Evaluate death education for children and suggest ways of introducing children to the topic of death.

9. Contrast the European and Asian views of individuality, paying particular attention to the resulting differences in death-related beliefs and customs.

10. Discuss how subcultural differences in death customs can be comforting or anxiety producing.

11. Using the cultural diversity of Hawaii's residents, provide examples of enduring traditional death customs.

12. What roles do food and flowers play in Hawaiian death customs?

13. Determine how assimilation and accommodation serve to influence the death customs of a society.

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Identify three social forces that are driving up the cost of health care.

2. Analyze the impact of DRGs and related forms of prospective payment on the American health care system, especially care of the dying.

3. Identify and discuss three challenges for contemporary hospices.

4. Describe the conventional approach to treatment of the dying in hospitals. Compare this description to an idealized model that could be instituted.

5. Describe the five strategies identified by Robert Kastenbaum that staff members may use when responding to a patient's desire to discuss death.

6. Evaluate the importance of the patient-caregiver relationship, including the impact of medical paternalism.

7. State at least three reasons why caregivers may experience stress in caring for the dying. Discuss how caregivers can decrease this stress.

8. Contrast the roles, types of care, and philosophical differences between hospice and hospital care.

9. Describe at least three different ways of~delivering hospice or palliative care.

10. Describe how communication skills can help caregivers meet the needs of families of dying patients.

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Summarize how the statistics relative to cancer and heart disease changing.

2. Identify the financial, personal, social, and psychological costs of life-threatening illness.

3. Describe the possible reactions of the patient, friends, and family to news of a life-threatening diagnosis.

4. Suggest at least five different ways of coping with life-threatening illness.

5. Compare the four patterns of family interaction identified by Glaser and Strauss and analyze the pros and cons of each.

6. Assess the relative benefits of surgery, radiation therapy, and chemotherapy in treating cancer and describe how each functions to eradicate cancer cells.

7. Evaluate the role of symbolic healing techniques in an overall treatment plan.

8. Identify and give examples of three basic approaches to pain management.

9. Describe methods of helping a loved one who has a life-threatening illness.

10. Describe and give examples of social support for people with life-threatening illness.

11. Differentiate the social role of dying patients from that of patients who anticipate recovery.

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Name at least five medical technologies that have contributed to a longer lifespan for some individuals.

2. Evaluate the roles of autonomy, beneficence, and justice in medical decision making.

3. Define the terms self-determination and informed consent and name the three principles of informed consent.

4. Describe changes in the climate of truth telling since the 1950s.

5. Evaluate the options of care for hopelessly ill or comatose patients, attending to ethical considerations.

6. Assess each side of the issue of euthanasia and construct a convincing position statement for each.

7. Develop a position on the question of a seriously deformed infant's right to life, and discuss its ramifications.

8. Describe the relationship between organ transplantation and the way that death is defined and determined.

9. Contrast traditional methods of defining death with newer definitions.

10. Identify Robert Veatch's four approaches to defining and determining death. Which do you find most helpful and least helpful? Explain your response.

11. Design your own proposal for defining and determining death, pointing out its strengths and weaknesses. Be sure to state who should be involved in making a determination of death.

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Differentiate between bereavement, grief, and mourning.

2. List Erich Lindemann's three primary tasks in managing grief.

3. Give examples of physical, perceptual, and emotional symptoms of grief.

4. Describe the Freudian theory of grief.

5. Contrast Geoffrey Gorer's model of the phases of grief with those of James Kavanaugh and Beverly Raphael.

6. Identify the four tasks of mourning postulated by William Worden.

7. Name illnesses that survivors may experience and explain why bereaved persons are physiologically at higher risk.

8. List factors that may result in a high-grief bereavement.

9. Explain the phenomenon of anticipatory grief and give an example of a situation in which it might occur.

10. Define the term unfinished business as applied to grief and its resolution.

11. Evaluate the advice for the bereaved given in the chapter, adding at least one further suggestion for optimizing bereavement as an opportunity for growth.

12. List and evaluate at least three coping mechanisms for survivors.

13. Imagine you are a professional who will soon meet with a newly bereaved person. What information about the circumstances of the bereavement would be important for you to have before the meeting? What emotions or behaviors might cause you to feel uncomfortable in the situation? What kind of resolution would you like to see this person make and how soon?

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Describe the psychosocial functions of death notification and funeral rites. Identify how these social activities fulfill the psychological needs of the bereaved.

2. Summarize the major criticisms of the American funeral and assess their validity.

3. Describe the major requirements of the FTC Funeral Rule.

4. Describe the four categories of charges that make up the total cost of a funeral and body disposition.

5. Compare the various methods of body disposition and discuss the advantages and disadvantages of each.

6. Explain the functions of cremation and memorial societies and contrast them with conventional practices.

7. Define the purpose of the funeral, and assess current funeral practices in light of that definition.

8. Write a detailed description of the funeral you would plan for yourself, giving reasons for your choices.

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Compare and contrast the Uniform Determination of Death Act proposed by the President's Commission with earlier proposals for determining death. Do you think the Commission's proposal is an improvement? Why or why not?

2. Summarize the contents of an advance directive, such as the living will.

3. Explain the stipulations found in the Durable Power of Attorney for Health Care described in the text or in similar legislation enacted in your state.

4. Take a stand on the living will that will allow you to support or refute each of the letters to the editor reprinted in the text.

5. Prepare a list of reasons that people may express for choosing organ donation.

6. Summarize the information included on a death certificate and analyze its purpose.

7. Trace the duties of the coroner from historical times to the present.

8. Contrast the training and qualifications of coroners and medical examiners.

9. State at least four reasons for performing autopsies.

10. Summarize the laws regulating body disposition.

11. Assess the psychological, social, and economic value of preparing a will.

12. List and describe three legal stages with respect to the financial affairs and other legal matters pertaining to a terminally ill patient.

13. Name and define four different kinds of wills. Explain what type of information is generally included in a will and define the term codicil.

14. Describe in detail what is meant by the word probate.

15. Discuss the duties of the administrator or executor of an estate.

16. Summarize common practices regarding intestate succession.

17. Differentiate between estate and inheritance taxes. Discuss ways of lessening the impact of each on an estate.

18. Look up your state's inheritance tax rates and be prepared to describe them in class. Do these rates seem fair? Why or why not?

19. Differentiate between a mutual insurance company and a stock company and between a term and a whole life policy (ordinary or straight life). Discuss whether you think insurance policies are an important part of estate planning. Why or why not?

20. Describe the role of death benefits in estate planning and give examples of two types.

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Describe the Freudian view of death anxiety in children, giving particular attention to the separation-individuation processes.

2. Explain how Erikson's theory of psychosocial development in terms of the issues most relevant to children at different times in their lives.

3. Identify Piaget's stages of cognitive development and explain how each stage relates to a particular way of understanding death.

4. Discuss historical changes in the major causes of death in childhood and adolescence. Suggest how the death rates due to present major causes might be reduced.

5. Describe and give examples of the developmental phases as related to terminally ill children's understandings and fears.

6. List and evaluate at least four mechanisms that children use to cope with terminal illness.

7. Explain how children of differing ages understand the concept of death and describe how these understandings relate to helping children cope with bereavement.

8. Discuss the range of emotions children might experience after the death of a pet, parent, or sibling.

9. Develop a detailed plan for helping a child through the initial period following a specific type of bereavement.

10. Imagine that a fifth-grade teacher has called on you as someone knowledgeable on the topic of death and dying. There is a child in class whose mother is dying; the children know about it and are expressing feelings of anxiety. You have been invited to come and flak to the children about death and dying. Would you go? Why or why not? if you went what would you say? if you did not go, what advice would you give to the teacher? Provide a detailed answer.

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Explain how each psychosocial stage of adulthood relates to the experience of loss.

2. Review your adult life and list the losses that have occurred, evaluating the relationship between the type of loss and the age at which it was experienced.

3. Describe why the death of a child may evoke a high-grief response from parents.

4. Distinguish between parental bereavements relative to the loss of the "perfect" child, stillbirth and perinatal death, abortion, sudden infant death syndrome, death preceded by a chronic illness, and the death of an adult child. Point out the kinds of peer support available for these losses.

5. Explain the effects of age and gender on spousal bereavement.

6. Assess how the death of a parent may affect the adult child.

7. Describe life-style possibilities for the aged, commenting on the impact of illness and institutionalization, and explain how older people may regard death and dying.

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Cite at least two statistics concerning the frequency of suicide.

2. Evaluate the four definitions of suicide given in the text.

3. Summarize the four types of suicide in the sociological model postulated by Emile Durkheim.

4. Describe the psychological model of suicide with attention to the role of ambivalence and its implications for caregivers.

5. List and analyze at least three cultural and three individual meanings of suicide.

6. Differentiate between intentioned, unintentioned, and subintentioned deaths, identifying at least two specific patterns in each category.

7. Identify and explain at least four possible motives for suicidal behavior.

8. Identify at least three motives for suicide at each stage of the lifespan: childhood, adolescence and young adulthood, middle adulthood, and late adulthood.

9. Describe the impact of the sociocultural environment on suicidal behavior, including both positive and negative influences.

10. Name at least four possible reasons for the increase in childhood and adolescent suicide.

11. Interpret the various meanings and factors influencing choice of suicidal method.

12. Describe the progression toward lethality of various methods of suicide.

13. Distinguish between suicide prevention, intervention, and postvention.

14. List and refute at least eight myths about suicide.

15. Assume that you are confronted by a person who tells you he or she is contemplating suicide. Make a list of the information you would like to obtain and discuss your plan of action for responding to this individual.

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Describe patterns of risk taking and suggest ways of managing risk.

2. Identify at least three factors that contribute to accidents.

3. Describe the effects of disaster on those who survive.

4. Explain how differential punishments for homicide may be based on the relationship of the killer to the victim.

5. Evaluate the argument that violence is contagious in American society.

6. List the pros and cons of capital punishment as you see them and assess your ideas. Are there alternatives? What are they?

7. Provide a concrete example for each of the factors favoring violence given in the text.

8. Describe the effects of war and its aftermath on combatants and noncombatants.

9. Give at least five examples of the needs and motives that contribute to war and suggest strategies that can work to reduce conflict.

10. Explain what is meant by the statement "Technological alienation is the most characteristic feature of the twentieth century war machine." Give examples.

11. Describe the impact of AIDS and other emerging diseases. Suggest ways of reducing the risk.

12. Describe the relationship between stress and illness.

13. Complete the Holmes and Rahe Social Readjustment Rating Scale. Total your score. Name at least five positive ways of coping with stress.

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Contrast the Hebrew and Hellenistic concepts of life after death.

2. Compare Pythagoras, Socrates, and Plato with respect to their views of life after death.

3. Trace the historical changes in the concept of life after death in the Christian tradition.

4. Summarize the main elements of Islamic belief about life after death.

5. Describe what is meant by the secularization of death, and give at least three examples of a secular understanding of immortality.

6. Summarize the Eastern view of immortality and describe how it differs from Western views.

7. Identify the central themes of the Hindu view of life after death.

8. Describe the Buddhist perspective of death, paying particular attention to the different meanings of karma, the two types of death, and transmigration.

9. Describe the composite picture of NDEs and discuss the frequency with which the various elements are experienced.

10. Explain at least three possible models for interpreting near-death experiences.

11. Summarize Russell Noyes and Raymond Kletti's three stages of NDEs.

12. Describe the therapeutic use of LSD with terminally ill patients.

13. Evaluate the "wall/door" metaphor and its implications. Which seems more correct to you? Explain your answer.

14. Describe the impact of religious or spiritual beliefs on the care of the dying.

KEY TERMS AND CONCEPTS

QUESTIONS FOR GUIDED STUDY AND EVALUATION

1. Compare and contrast your own feelings about taking a course in death and dying with those expressed by the students quoted in the text.

2. Suggest and evaluate at least three societal applications of death education.

3. Summarize the current state of death education and suggest areas that you think deserve further study.

4. Summarize the conditions associated with an appropriate death.

5. Interpret the poem "The Angel of Death" and explain what you think the author is saying about the relationship of death to life.

Lynne Ann DeSpelder, M.A., is an author, counselor, and full-time tenured instructor at Cabrillo College in Aptos, California. Certified by ADEC as a death educator and grief counselor, she lectures and conducts training programs for various professional, corporate, and community groups. Among her recent publications are The Last Dance: Encountering Death and Dying, 4th ed., and The Path Ahead: Readings in Death and Dying.

Post Office Box 1150,

Capitola, California 95010

Tel: (408) 479-6410

Fax: (408) 476-8294

E-mail: 72077.3125@compuserve.com

©DeSpelder & Strickland, 1999.