Death and Dying: Attitudes, Causes, Process, & Measures
Presented by Karen Mueller
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Each day of our lives, 250,000 people die in the world. Although the circumstances are unique for each individual, certain commonalities exist with respect to the ways in which our lives come to an end. Despite the inevitability of our eventual death, prevailing attitudes and societal customs shelter us from the realities of this natural process, possibly preventing us from engaging authentically with our patients as they face the end of life. This course will explore the attitudes, causes, and trajectories of the dying process, emphasizing the clinical manifestations associated with the shutting down of body systems and physiologic processes. Finally, this course will explore objective measures which can be used for prognosis of mortality, measurement of symptoms, and assessment of function. It is hoped that this course will promote awareness, understanding and empowerment as we support our patients and their families through this ultimate journey.
Meet your instructor
Karen Mueller
Karen Mueller, PhD, DPT, PT, NBC-HWC, is a clinical professor and professor emerita in the Department of Physical Therapy and Athletic Training at Northern Arizona University in Flagstaff, AZ. She also holds certifications as a Professional Health and Well-Being Coach (Wellcoaches) and a National Board-Certified Health and…
Chapters & learning objectives
1. Societal Attitudes Towards Suffering and Death
Death and suffering are universal and pervasive human experiences, yet most of us avoid these topics. How can we effectively and compassionately interact with patients facing the end of life if we are not aware of our own attitudes? This chapter will invite learners to explore their own experiences and attitudes towards death and pain. Suggestions for preparing ourselves to meet the needs of dying patients from both personally and professional perspectives will also be discussed.
2. How We Die: Causes and Trajectories
250,000 persons die each day in the world, and these deaths have commonalities in terms of the causes and trajectories. This chapter will explore the leading causes of expected and unexpected death. The concept of death trajectories--the length of time over which the process of physiologic decline occurs--will be explored, categorized and linked to the resulting implications for patient education and support.
3. The Physiologic Process of Dying
For many persons the process of death evolves over months, weeks and days. This chapter will describe the physiologic, behavioral and psychological processes associated with the gradual shutting down of physiologic processes associated with imminent death. Finally the unquantifiable but prevalent concept of deathbed phenomena will be discussed along with suggestions for supporting patients and their families when these occur.
4. Assessments for Prognosis, Symptoms and Function
While none of us can predict the exact moment of death, the presence of several observable indicators allows for general prognostication, which can help patients and families to experience optimal quality of life in the face of decline. The measurement of symptom type and severity can be used to guide optimal interventions for comfort and the assessment of function can help us support patient quality of life.