Deck 14: Death, dying, and Bereavement

Question 1

Which of the following describes a problem with the disengagement theory and its approach to death?

A) It is based on the idea that older people grow to accept death as they age.
B) It does not describe how a person will react to his/her approaching death.
C) It places emphasis on the ego transcendence stage of aging rather than the generativity stage.
D) It focuses on the social effects of dying, and says little about how older people feel about it.
)

Answer 1

D

Question 2

Which of the following diseases caused 3.4% of Canadian men to die in 2008?

A) influenza and pneumonia
B) chronic lower respiratory diseases
C) diabetes
D) strokes

Answer 2

C

Question 3

Death in Canada today most often takes place in which of the following locations?

A) at home
B) at a hospice
C) in a retirement community
D) in a hospital or nursing home

Answer 3

D

Question 4

In 1926,what percentage of deaths occurred in infants and children under the age of five?

A) 1/3
B) 1/2
C) 2/3
D) 3/4

Question 5

Erikson's (1963)theory of ego development says that,in the last stage of life,a person reviews his/her life,ties up loose ends,and prepares for death.What does Erikson call this process?

A) the pre-generative stage
B) ego integrity
C) euthanasia
D) mortality recognition

Question 6

According to a study by Menec and colleagues (2007),where did most people aged 85+ have the greatest likelihood of dying?

A) in a nursing home
B) at a hospital
C) in a hospice
D) at home

Question 7

According to Wilkins (2006),which type of stress has an especially strong effect on older women?

A) emotional stress
B) psychological stress
C) physical stress
D) social stress

Question 8

In the ancient past,how did people perceive death and dying?

A) as a tragic consequence of a difficult life
B) as a wonderful journey to peace and tranquility
C) as a mysterious transition
D) as a confusing and depressing event

Question 9

According to the text,how do most seniors view their deaths?

A) as an impending event
B) as a distant event
C) as a tragic event
D) as a welcome event

Question 10

Today,most people die of which of the following?

A) acute illness
B) chronic illness
C) poverty
D) accidents

Question 11

According to Motiwala and colleagues (2006),where did almost half of deaths in Ontario occur in 2001-2002?

A) at home
B) at a nursing home
C) in a hospice
D) in a hospital

Question 12

Your cousin has cancer,and although she is not in pain,she has only a few months to live.According to Motiwala and colleagues (2006),where will your cousin most likely die?

A) at hospital
B) in a nursing home
C) at home
D) in hospice

Question 13

Which of the following diseases caused 23% of all Canadian deaths in 2008?

A) heart disease
B) cancer
C) stroke
D) Alzheimer's disease

Question 14

In 2008,which of the following diseases caused a higher percentage of death for men than for women?

A) influenza and pneumonia
B) stroke
C) Alzheimer's disease
D) malignant neoplasms (cancer)

Question 15

Life expectancy at birth in 2006-2008 stood at 78.5 years for males and at what age for females?

A) 76.4
B) 79.5
C) 83.1
D) 87.8

Question 16

Which of the following is true according to the disengagement theory?

A) Retirement and withdrawal from society lead to low life satisfaction.
B) A smooth transition of power from one generation to the next occurs when the two generations work together.
C) An awareness of death causes people to ease their way out of social life.
D) Fear of death causes many older people to lose their perspective and feel that their lives have no meaning.

Question 17

According to the National Population Health Survey (NPHS),which of the following items increases the risk of death?

A) increased alcohol consumption
B) increased level of education
C) being overweight
D) functional limitation

Question 18

In 2008,what percentage of deaths were senior deaths?

A) 57%
B) 68%
C) 72%
D) 78%

Question 19

Which of the following individuals exemplifies the concept of social death?

A) Mary, who is 69 and has dementia
B) George, who is frail but is still mobile
C) Phillip, who lives in a nursing home
D) Gertrude, who is 106 years old and living at home

Question 20

Which of the following is considered as a "disease of old age?"

A) arthritis
B) osteoporosis
C) macular degeneration
D) pneumonia

Question 21

Your aunt Grace has just learned that she has breast cancer,and she is in a state of denial.Which stage number is denial within Kubler-Ross's death and dying model?

A) first
B) second
C) third
D) fourth

Question 22

Which of the following buffers people from the fear of death,according to Wink (2006)?

A) pain medication and competent medical staff
B) friends and family
C) a strong religious belief
D) understanding one's disease and its progression

Question 23

According to Kahana (2006),what comes to an end in a woman's life when she is widowed?

A) her freedom
B) her former identity
C) her financial security
D) her social life

Question 24

What does Kubler-Ross (1969)state about different illnesses and their death trajectories?

A) They can create new stages of dying.
B) They create different trajectories of death.
C) They have no significant effect on the pattern of response by patients.
D) They can cause a patient to deviate from the normal pattern of dying.

Question 25

According to a study by Mancini et al.(2006),what percentage of widows/widowers demonstrated chronic grief?

A) 6.9%
B) 15.6%
C) 24.7%
D) 32.8%

Question 26

When do people deal with death the best?

A) when they have strong religious beliefs or no belief at all
B) when they have mild religious belief
C) when they have a severe acute or chronic illness
D) when they have seen friends or close family die

Question 27

What proportion of bereaved people go through morbid grieving?

A) a small percentage
B) 25%
C) 50%
D) a large percentage

Question 28

What are the two aspects of the depression phase of death and dying (Kubler-Ross,1969)?

A) mourning present losses and mourning future losses
B) fear of death and fear of dying
C) denial and acceptance
D) despair and anger

Question 29

According to Kubler-Ross,which of the following statements can be made about her stages-of-dying model?

A) All patients follow a similar series of stages in the death and dying process.
B) Most dying patients adopt one of five attitudes: anger, bargaining, denial, acceptance, or depression.
C) Dame Cicely Saunders' stages-of-death-and-dying model should be rejected, due to its impressionistic methods and unscientific presentation.
D) Patients can skip stages, stages can overlap, or people can go back over the same stage many times.

Question 30

According to Duffy and colleagues (2006),which of the following do dying individuals want?

A) to feel their life was worth living
B) to have their responsibilities taken care of
C) to have a pain-free death
D) to die with dignity

Question 31

Why do researchers such as Leming and Dickinson (2011)criticize Kubler-Ross's stage theory of death and dying?

A) They feel that the theory does not take into account the effects of dying on family or friends of the patient.
B) They feel that it cannot accurately predict how an individual will respond to the dying process.
C) They feel that it accurately describes the dying process for most patients, but it does not provide enough information on how others should respond to the patient during each stage.
D) They feel that not all patients experience the same emotions, needs, and coping methods.

Question 32

What is the final stage of death and dying,according to Kubler-Ross?

A) bargaining stage
B) acceptance stage
C) optimistic stage
D) depression stage

Question 33

Which of the following terms defines the typical public social conventions that occur after an individual passes away?

A) grieving
B) sorrow
C) bereavement
D) mourning

Question 34

In the last part of the last stage of Erikson's theory of ego development,the person experiences which of the following?

A) a deep concern for others and for the culture he/she will be leaving, thereby achieving ego transcendence
B) a need to overcome the Fear of Death vs. Life Transcendence conflict, thereby coming to terms with both life and death
C) a full withdrawal from his/her social roles and acceptance of death as inevitable, passively waiting for it
D) a full acceptance of his/her death, but the desire to keep on living to achieve some final goal he/she has set

Question 35

Which stage of Kubler-Ross's death and dying model involves anger directed at the doctor,a spouse,or even God?

A) first
B) second
C) third
D) fourth

Question 36

Studies that compare older and younger people find that older people express more concern about which of the following aspects of death?

A) the pain of dying
B) the fear of dying
C) the process of dying
D) the emotional trauma of dying

Question 37

Your great Aunt Beverly's husband lives in a nursing home after he had a stroke.He has dementia and needs continuous care.She is saddened to be alone in her home and she grieves for her husband as he used to be.She is also sorrowful,in expectation of his impending physical death.What type of grief is your great Aunt Beverly experiencing?

A) anticipatory grief
B) disenfranchised grief
C) delayed grief
D) exaggerated grief

Question 38

Onrust and Cuijpers (2006)found a high rate of which of the following among widows in the first year of widowhood?

A) smoking
B) alcoholism
C) major depressive disorder
D) illness

Question 39

Which trait is common to all five stages of Kubler-Ross's stage theory of death and dying?

A) fear
B) despair
C) hope
D) acceptance

Question 40

Northcott and Wilson (2008)say that the pattern of grieving depends on all EXCEPT which of the following?

A) the gender of the bereaved person
B) how the patient dies
C) how suddenly the death occurred
D) the age of the bereaved person

Question 41

In hospices,medical staff base pain control on which two techniques?

A) adjusting the dosages until the patient is pain-free, and giving the next dose before the previous dose has worn off
B) giving the patient only enough drugs to reduce the pain, and waiting until the patient shows signs of pain before giving the next dose
C) teaching the patient to overcome chronic pain without the use of drugs, and using drugs only when acute pain becomes severe
D) giving the patient a low dosage to overcome chronic pain, and providing the patient with drugs so that he/she can adjust dosages for his/her comfort

Question 42

According to the Quality End-of-Life Coalition of Canada (2008),what percentage of dying Canadians have access to high-quality hospice palliative care at home?

A) 3/4
B) 2/3
C) 1/2
D) 1/3

Question 43

Pain control in hospices such as St.Christopher's is based on which of the following?

A) meditation and mental techniques that allow the patient to control his/her pain yet remain alert
B) hypnotism
C) adjustment of drug dosage
D) teaching the patient to understand his/her situation and deal with it realistically

Question 44

According to Garrett and colleagues (2008),what percentage of Canadians aged 75+ have an advance directive?

A) 17%
B) 28%
C) 32%
D) 39%

Question 45

What is one of the main problems with advance directives?

A) They are not enforceable by law in Canada, and therefore doctors and family frequently disregard them.
B) Many people cannot or will not write a living will because their religion condemns it as a form of suicide.
C) In some cases people will change their minds as they near death, but they will not get a chance to change their advance directive.
D) It does not fulfill its main function of relieving doctors of responsibility for stopping treatment.

Question 46

Jerry was in a car accident and is now in a coma.He has a written order on his medical chart that indicates that he is not to be revived should his heart stop.What is the name for this medical order?

A) fail-to- revive order
B) do-not-resuscitate order
C) advance-directive order
D) living-will order

Question 47

Which of the following is an example of an ethical conflict that doctors face when they treat dying patients?

A) defining the exact criteria for death
B) convincing the family to remove a person from life support
C) deciding what to do when treatment that extends a patient's life also prolongs his/her suffering
D) ongoing court battles over the legal status of euthanasia and the culpability of doctors

Question 48

In a hospice,what do staff members mainly focus on?

A) helping the patient to deal with both the emotional and the spiritual aspects of dying
B) prolonging life
C) helping the family and friends of dying patients
D) the comfort and well-being of the patient

Question 49

The modern hospice was the creation of which of the following individuals?

A) Saunders
B) Kubler-Ross
C) Gray
D) Genseric

Question 50

By eliminating a patient's pain,hospices seek to accomplish which of the following?

A) building up the patient's hope of recovery and creating a positive attitude
B) giving patients the opportunity to remain active and at work
C) relieving a patient's fear and anxiety and ensuring that the person dies in comfort
D) decreasing the anxiety of friends and family over the patient's condition

Question 51

Which type of document authorizes relatives or doctors to withdraw or withhold artificial methods of life support in the case of a terminal illness?

A) a writ of cessation
B) a living will
C) a medical directive
D) an order in absentee

Question 52

Marital ties persist after the loss of a spouse,exemplifying which of the following?

A) a primary indicator of abnormal grief adjustment.
B) the reason that some widows and widowers decide against remarriage after the death of a spouse
C) behaviour that is acceptable for older people but dysfunctional for younger people
D) a form of morbid grieving that should be treated if it becomes prolonged

Question 53

What is the term for programs that do the same work as hospices,but that exist within an acute care hospital?

A) general care programs
B) ICUs (Intensive Care Units)
C) palliative care units
D) no-code-blue wards

Question 54

Your mother has asked you and your sibling to sign a document stating that she has chosen the two of you to make decisions on her behalf,should she lose her mental capacity to do so as she ages.What is the name of this type of document?

A) a living will
B) an incapacitated wish
C) a power of attorney
D) an advanced instruction

Question 55

Directives most often take the form of which of the following?

A) the flexible power of attorney
B) the estate will
C) passive euthanasia
D) the durable power of attorney and the living will

Question 56

Which of the following statements can be made regarding doctors and directives?

A) Doctors increasingly welcome having directions on the type of care a patient wants.
B) Doctors resent being forced to make decisions based on laws.
C) Doctors often make no effort to determine if the patient has a living will, and even ignore it if one does exist.
D) Doctors fear prosecution for stopping treatment or not treating secondary illnesses.

Question 57

According to Wolff and Wortman (2005),what behaviour did men tend to exhibit more frequently after the loss of a wife?

A) socializing
B) remarrying within a year
C) smoking and drinking
D) travelling

Question 58

Which of the following is true in the informed consent context of dying?

A) The staff and the family know that the patient is dying but do not tell the patient.
B) The staff, the patient, and the family all know that the patient is dying, but no one speaks about it.
C) The staff and the patient know that the patient is dying but do not tell the patient's family.
D) The patient has a right to know about the physicians choice of treatment.

Question 59

When did the first palliative care units open in Canada?

A) the mid-1960s
B) the mid-1970s
C) the mid-1980s
D) the mid-1990s

Question 60

A living will sets out which of the following?

A) the attorney's right to make financial decisions on a person's behalf
B) the doctor's right to terminate treatment
C) the ill person's right to his/her wishes at the end of life
D) the nurse's right to choose intensive and aggressive treatments

Question 61

Uncle Ross is in a coma,and doctors inform you that he will not recover.Your aunt doesn't want him to suffer.Someone makes the decision to end Uncle Ross's life.What is the term used to describe this scenario?

A) active euthanasia
B) non-voluntary euthanasia
C) mercy killing
D) involuntary euthanasia

Question 62

What is the role of the doctor in physician-assisted suicide?

A) gives an ill patient the means to commit suicide
B) files a motion with the courts to gain permission to assist in ending patients lives
C) requests to be removed from caring for patients with terminal illness if they do not agree with the idea of doctor assisted suicide
D) takes the means of suicide upon him-/herself to actively end patients' lives

Question 63

Which of the following countries now permits physician-assisted suicides in cases of advanced terminal illness?

A) The United States
B) Canada
C) France
D) Sweden

Question 64

What is another name that is commonly used as a substitute for "euthanasia"?

A) manslaughter
B) murder
C) mercy killing
D) medicine-induced death

Question 65

Which of the following can eliminate the question of responding to requests for active euthanasia?

A) the cessation of treatment of dying patients
B) laws that make active euthanasia illegal
C) using the closed awareness context for dying
D) symptom control and good palliative care

Question 66

What is the term for the process of killing someone because he/she asks for death or to relieve his/her suffering?

A) active euthanasia
B) passive euthanasia
C) palliative care
D) third degree murder

Question 67

According to Dupere,what percentage of Canadians in 2006 had access to palliative care services?

A) 3%
B) 8%
C) 15%
D) 19%

Question 68

What is the function of funeral practices and rituals?

A) to help resolve family conflicts
B) to help the bereaved family cope with grief and to re-establish community bonds after the loss of a community member
C) to take the bereaved family's attention away from the death of the individual, and reaffirm life's deeper meaning
D) to give family and friends the opportunity to cut ties with the deceased and continue on with their lives

Question 69

Explain the differences between assisted suicide and euthanasia (active and passive).

Question 70

Explain the five stages of death,as developed by Dr.Elizabeth Kubler-Ross.

Question 71

Julia lives in Toronto,and her mother,who is 74 years old,lives in Winnipeg.Julia is worried about her mother,as she has terminal cancer,and she lives alone in an apartment.Julia refuses to believe that her mother is seriously ill,and so she decides to go to Winnipeg to demand medical treatment for her mother.According to Northcott and Wilson (2008),what is the term used to describe Julia's behaviour and actions regarding her mother's situation?

A) the prodigal daughter syndrome
B) the California daughter syndrome
C) the lost child phenomenon
D) the black sheep phenomenon

Question 72

Which country passed the Termination of Life on Request and Assisted Suicide (Review Procedures)Act?

A) Canada
B) The United States
C) France
D) The Netherlands

Question 73

In 2009,the Netherlands reported a number of cases of physician-assisted suicide.Where did 80% of those patients die?

A) in a hospice
B) at home
C) in a hospital
D) in a nursing home

Question 74

Interview someone who has a living will.What types of advanced directives are included? Who has the individual appointed as his/her surrogate or spokesperson? Has the individual discussed the directives with the surrogate/spokesperson? How did the individual decide what information to include in the living will?

Question 75

Interview someone about euthanasia.How does he/she feel about it? Should Canada legalize euthanasia? Why or why not?

Question 76

Compare and contrast what constitutes a "good" death and a "bad" death.

Question 77

What is the term for actively helping someone relieve his/her suffering and achieve a painless death?

A) euthanasia
B) healthcare consent
C) palliative care
D) prognosis

Question 78

List and explain the five responses to the loss of a spouse.