Deck 15: Dying, Death, and Grief

Question 1

Which of the following is not a type of advance directive?

A) choosing a proxy
B) becoming an organ donor
C) DNR
D) living will
E) all of the above are advance directives

Answer 1

all of the above are advance directives

Question 2

DNR relates specifically to:

A) CPR
B) artificial feeding
C) respirators
D) medication usage
E) active euthanasia

Answer 2

CPR

Question 3

Which state allows assisted suicide?

A) California
B) Rhode Island
C) Oregon
D) Idaho
E) no state allows assisted suicide

Answer 3

Oregon

Question 4

Although assisted suicide is illegal in most states, what must health professionals honor according to the Supreme Court?

A) advance directive
B) the need for palliative care
C) the wishes of the patient and family
D) religious beliefs regarding death
E) all of the above

Question 5

What was one of the most important findings of the SUPPORT survey?

A) health professionals need more education in administering medication to dying patients
B) advanced directives are often overlooked
C) staff need a break from working with dying individuals
D) terminally ill patients need additional emotional support
E) health professionals do an excellent job at supporting terminally ill patients.

Question 6

The most commonly accepted definition of when death occurs is:

A) when the heart stops beating
B) when breathing ceases
C) when higher brain waves cease
D) when body functions stop
E) none of the above

Question 7

Which of the following is the most common place of death for elders?

A) at home
B) in a nursing home
C) in a hospital
D) in a board and care home
E) in a hospice facility

Question 8

Survivors of the death of a loved one commonly experience:

A) increased physician and hospital visits
B) increased consumption of alcohol
C) insomnia
D) all of the above
E) b and c only

Question 9

The federal Uniform Determination of Death Act of 1981 mandates that:

A) states define death as the absence of breathing and heart rate
B) states define death as the absence of brain function
C) states may define death differently, but must report deaths that are suspicious to a federal panel
D) states define death as the absence of breathing, heartbeat and brain function
E) none of the above

Question 10

Which of the following characterizes the individuals who chose to ingest legally prescribed lethal medications in Oregon between 1998 and 2005:

A) almost 4,000 terminally individuals took their lives
B) less than one tenth of one percent of the deaths chose assisted suicide
C) The most common terminal diagnosis was AIDS
D) a and c are true
E) none are true

Question 11

Fasting as a way to hasten death is very painful.

Question 12

Death anxiety is higher among young adults than old adults.

Question 13

Formal institutions provide the vast majority of care for the terminally ill.

Question 14

In 1900, those 65 and older comprised less than 20 percent of all deaths. Currently it is more than 70 percent.

Question 15

Machines can allow the heart to beat, the lungs to inflate, nutrients to enter and wastes to leave the body in a brain-dead individual.

Question 16

Voluntary motor function is lost when the body is without oxygen for six minutes.

Question 17

Surveys reveal that about half the physicians in the U.S. support assisted suicide.

Question 18

Because of the Patient Self-Determination Act of 1990, all residents of nursing homes have living wills or durable power of attorney documents.

Question 19

In most states, paramedics called to a residence are required to provide CPR if the heart has stopped beating, even if the victim has signed an advance directive.

Question 20

Elders generally think and talk about death more than younger persons.

Question 21

In general, women adapt better to the loss of spouse than do men.

Question 22

Because health professionals commonly confront death in their careers, they are skilled in working with dying persons and their families.

Question 23

Tranquilizers and sedatives are effective and are recommended to reduce grief among the bereaved.

Question 24

In most states, conscious, mentally stable adults have the right to refuse any type of medical treatment, even if it may result in their death.

Question 25

Several states have enacted a "death with dignity" law which permits physicians to administer a fatal dose of a drug to hasten death in a terminally ill patient.

Question 26

In our country, most people abandon their sick older relatives. Because of this, most are cared for in the hospital instead of in the home.

Question 27

The federal Patient Self-Determination Act of 1991 requires that all nursing home patients complete advance directives upon admission.

Question 28

Because of the federal Uniform Determination of Death Act, all states now have the same requirements regarding advance directives.

Question 29

Fewer that half the hospice users are over 65.

Question 30

The most common diagnosis of those under hospice care is AIDS.

Question 31

The Supreme Court ruled that individuals have the right to medications to alleviate pain and other physical symptoms when terminally ill, even if it hastens death.

Question 32

At least 90 percent of the residents of nursing homes have completed at least one form of an advance directive.

Question 33

Older people think of death more and fear death less than younger people.

Question 34

A federal law mandates that hospitals discuss advance directives with all incoming patients.

Question 35

A federal law mandates that physicians be trained in pain management and end of life care before they can be licensed to practice.

Question 36

What variables affect the grieving process?

Question 37

Define passive vs. active euthanasia and give an example of each.
What are the qualifications and reimbursement rules regarding the use of hospice services under Medicare?

Question 38

How does a living will differ from a durable power of medical care? What are some problems with these legal documents?

Question 39

Who is Dr. Kevorkian and why is he well known?

Question 40

List the major tasks of the dying person.

Question 41

Describe the services offered by a hospice program.

Question 42

Discuss five rights of the dying person.

Question 43

List five factors that determine where a terminally ill individual dies.

Question 44

One way to die is with "the dwindles." What does that term mean and what are the characteristics of those who die with "the dwindles?"

Question 45

Describe stages of dying as defined by Kü bler-Ross. What are the advantages and disadvantages of using this model as a professional?

Question 46

Discuss the problems faced by both family members and professionals who care for individuals who are dying.

Question 47

Discuss the pros and cons of advance directives and list the reasons why they are not more commonly used. Also, list the reasons why, even when an advance directive is completed, they are not often followed.

Question 48

Discuss the legal outcome of Oregon's Death with Dignity Act and summarize the number and type of individuals who took their lives through this means.

Question 49

List and describe eight behaviors that characterize the dying person.

Question 50

Discuss the case of Terri Schiavo. What did the Supreme Court decide? What is the take-home lesson from this case?

Question 51

Discuss the case of Dr. Jack Kevorkian. How did his actions differ from physicians in Oregon who assisted suicides under the Death with Dignity Act?

Question 52

What do studies of terminally ill show us regarding assisted suicide?

Question 53

Present an argument for or against assisted suicide.

Question 54

Give the background on hospice. What services are offered? How does hospice care differ from a conventional medical treatment?

Question 55

How is the dying trajectory different today than it was 100 years ago? What impact does it have on the individual, the family, society as a whole?

Question 56

Describe the SUPPORT study and discuss its major findings.

Question 57

List ways in which medical schools are attempting to improve end-of-life care.

Question 58

Discuss ways in which the administrator of a hospital or nursing home might support their staff who work with the dying.