Death and Dying Family Focus On… Death and Dying
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N ATIONAL COUNCIL ON FAMILY RELATIONS Death and Dying Family Focus On… Death and Dying Issue FF12 IN FOCUS: Death as Normative in A Visible Death page F3 Family Life Death: A Family Event for Mexican Americans by Susan K. Hoppough, MSN, RN, Instructor; and Barbara Ames, Ph.D., CFLE, Professor, page F4 Department of Family and Child Ecology, College of Human Ecology, Michigan State University. Using Movies to Teach about Death and Dying he terrorist attacks of September institutionalized death, leaving the page F5 11, the graphic representation in home a sanitized and protected refuge. Tthe media, and the ensuing At the same time, physicians and family Death and Dying During Pregnancy: military response has put death in members avoided discussions of Perinatal Hospice the center of daily life in a way death with dying individuals, page F6 never experienced by post- seeking to “spare” them knowl- Recognizing the Humanity of Dying World War II generations. edge of their grave condition. Inmates: Prison Hospice Programs These events have assaulted While physicians and nurses page F8 us with the issue of our no longer engage in this own mortality, a topic evasive behavior, the Medicare Hospice Policy we, as a culture, tend advancement of tech- in Nursing Home Settings Hinders End-of-Life Care to avoid. In order to nology and increasing page F9 more effectively help health-care families in dealing options encourage Dying Caregivers with death at families to page F11 every stage of the discuss ways of Ambiguous Loss: Frozen Grief life course, we as prolonging life rather than death itself. in the Wake of WTC Catastrophe family professionals must begin to see In the 1960s, the hospice move- page F12 death as an important and appropriate ment reintroduced the notion of death subject matter for family life education. in home settings, making it more Grief: Intimacy’s Reflection In this article we reflect on attitudes common for individuals with terminal page F15 toward death and suggest strategies disease and their families to choose Working with Grieving Families for dealing with death as a normative home as an appropriate location for from a Meaning-Making Perspective component of family life across the death. Within hospice, death is openly page F16 life course. discussed, family members of all ages are encouraged to participate in Traumatic Loss and the Family DISCUSSIONS OF DEATH providing comfort care prior to death, page F18 Historically, death was a common and bereavement services are provided Parent Grief experience within families. Death was for family members. page F19 linked to childbirth and acute disease, Death discussions related to Dealing with the Violent Loss and young children often experienced terminal disease or aging frequently of a Child parental death. Because death typically focus on end-of-life decision-making. page F20 occurred within the home, all family Current family health policy related to members interacted with dying individ- end-of-life decision-making includes Helping Adolescents uals, witnessed death, and participated support for the use of advanced Cope with Grief in the funeral process. directives, which are legal instruments page F22 As a result of shifts in mortality, outlining choices for medical and life- Elder Grief death is now expected in old age, but prolonging treatments. However, we page F23 not in youth. The advent of hospitals have observed that it is uncharacteristic at the beginning of the 20th century for families to face critical illness armed Death as Normative continued on page F2 Family Focus On… Death and Dying DEATH AS NORMATIVE continued from page F1 with a plan for suggestions for inclusion of death conflict related to disbursement of death. Few have within each of the ten content areas financial assets after death. discussed a will, with the goal of validating death as an 7) Parent Education and Guidance: planned a appropriate topic of discussion within a Parents feel unprepared to discuss funeral, or life-course perspective. death with their children. Providing completed developmentally appropriate mate- advanced 1) Families in Society: Recognition of rials and strategies will assist them in directives. cultural variations among families introducing and continuing the Patients who related to death beliefs and practices. dialogue across the life course. have completed The development of culturally 8) Family, Law, and Public Policy: advanced relevant curricula will help Families of all ages and at all stages Susan K. Hoppough, directives report professionals interact more of the life course must plan for MSN, RN feeling effectively with families who are death, but few policies or other comforted in dealing with death issues. supports are available to encourage knowing prepa- 2) The Internal Dynamics of Families: this planning. Family responsibilities rations for death Death is a stressful event within that need public-policy support are in place, families. Family openness about range from routine safeguards such reducing the death will ease disruption of the as creating wills to making end-of- burden on their internal dynamics of the family when life decisions. families. death does occur. 9) Ethics: Death as an appropriate topic Our position 3) Human Growth and Development: of discussion across the life cycle is is that discus- Death is part of the life cycle. essential in understanding the sions of death Using teachable moments across formation of social attitudes within families the life course (e.g. the loss of related to the distribution Barbara Ames, Ph.D., must occur at a pet) will help families incor- of limited health-care When CFLE times unrelated porate death as a normative dollars and the death is a to a death event. topic of discussion. implications of tech- normal topic of Such opportunities may occur as part of 4) Human Sexuality: Death nological change. discussion across the a ritual or in relation to violence is related to sexual Recent advances in life course, families are reported in the media. Ritualistic values and decision- stem cell research better prepared for this practices and beliefs related to death making. Incorporating and the killing of inevitable event. vary among cultures and religions, but discussions of death as embryos force us to all provide a framework for discussing part of the life course examine the ethical death. Children can participate in these related to sexual choices is dilemmas associated practices through the lighting of essential in achieving healthy with procreation as candles, prayers, and days honoring sexual adjustment. Family life well as death. the dead. education should include such topics 10) Family Life Education: Planning, Secular opportunities to discuss as sexual relationships in illness and implementing, and evaluating life death may occur only in relation to the sexually transmitted diseases that course death education, with report of violence in the media. Events result in death. sensitivity to cultural and familial such as the shootings at Columbine or 5) Interpersonal Relationships: diversity, is a critical role for the deaths related to natural disasters leave Death is part of all interpersonal family life educator. children feeling frightened and unsure relationships. Understanding and of their safety, and parents unprepared freely sharing thoughts, fears, and Talking about mortality is not easy, to respond to their questions. Confusing desires related to death is essential to and the natural response is to protect and sometimes frightening euphemisms interpersonal relationships. family members from this difficult such as “passing,” “losing,” “gone to 6) Family Resource Management: subject. However, by acknowledging heaven,” or simply “gone” result from Decisions related to death and end- death as a normal and appropriate topic this uncertainty. of-life issues frequently hinge on of discussion across the life course, resources and the distribution of families can better prepare themselves DEATH AND FAMILY LIFE those resources among family for this inevitable life event. Family life EDUCATION members after death. Helping family educators have an important role in Family life educators are uniquely members to discuss death prior to facilitating this discussion. positioned to provide families with the death event will enable families assistance in the discussion of death to make informed choices about life- For more information, contact from a normative perspective. We offer prolonging measures and to reduce [email protected] or [email protected] Family Focus ❘ December 2001 F2 Family Focus On… Death and Dying A Visible Death by Susan K. Giboney, M.A., CFLE, Professor of Education, Pepperdine University, Malibu, California ur culture treats dying as if it appointment that day, but I thought it go? The problem is within. were invisible. We try to solve was routine. When I heard his voice, I Night: Against the prospects of no Othe problem of death by hiding knew I had to get home immediately. earthly future, the computer of my or denying it. We discourage dying The diagnosis of his invasive cancer put mind can only flash, “Does not people from knowing of their condition, us in shock! Here is Terry’s first entry in compute!” because death seems unmentionable. the journal he decided to keep, “It is our Light: Just when the night was darkest, Patients, in turn, son’s 25th birthday, but somehow that a pinpoint of light became visible. try to convince got lost in the events of this day — a Fanned by hope and help, it became others that they day that begins a journey into the my beckoning beacon and compass. are getting unknown for me, a journey of pain, Fight: Gradually sight, insight, and better. faith, doubt, tears, prayer, and, delight came into the new and Physicians are hopefully, healing. As I got into the car beautiful world unfolding daily in expected to to drive home from the doctor, I felt front of one who has been given a prevent dying.