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Death and bereavement

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Death and bereavement


This essay examines death, bereavement, and the disposal of the dead through its social-psychological, historical, cross cultural, medical-ethical, and public policy aspects from the perspective of both the dying person and survivors. In its examination this course divided death and bereavement into the following five concepts and theories: 1) The stages of death and bereavement as outlined by Kubler-Ross. 2) Social implications, norms, and institutions that relate to death and dying in our society, i.e., Western attitudes toward death, historically and in contemporary times. 3) Cross-cultural, subcultural, ethnicity, and religious differences in dealing with death, bereavement, and disposal. 4) Medical-ethical issues such as the right to die, euthanasia, medical intervention, life support, organ donation, hospice, living wills, and disposal of the dead. 5) Financial and legal aspects of death and dying. My first close encounter with death was when I was seven years old. I traveled with my mother to visit with my maternal grandfather. He was my only living grandparent and it was the first time I had met him. I can remember that he looked old and pale and had a shock of white hair. While he knew who I was, he was somewhat confused as he kept referring to me by my mother's name. Although, he did not appear to be in pain, he had recently suffered a massive heart attack and was not expected to last much longer. My mother's childhood home was filled with relatives and family friends, but for me it was a strange atmosphere. I had not previously met many of my relatives and it had been several years since my mother had been home. People were constantly stopping by with food dishes and there was always a pot of tea brewing. The local priest was also a constant visitor and seemed to be pleased that so many of the family had made it back for my grandfather's last days. There wasn't an air of expectancy, but rather a quite acknowledgment that his time had come. My grandfather had been released from the hospital, because they could do nothing more for him. He knew he was going to die and it was his wish that he die at home, amongst family and friends. I often wonder if he would have had that choice today. My relatives took turns sitting with him and spent hours just holding his hand and talking to him softly. While I can see now that it must have been comforting for him to die surrounded by his family, it gave me the "creeps" to know that I was in the same house with someone who was going to die. I can remember praying that I would not be in the room when he passed on. I wasn't, he died in his sleep and I heard the news from my mother the next morning. It really didn't affect me too much as I hadn't really known him and I guess I didn't really appreciate what death was. I do remember wondering what they were going to do with my grandfather, I didn't much care for the idea that I was in the same house as a dead body.

As was the custom, my grandfather was laid out in the living room for viewing. It was a small town and it seemed that most everyone stopped by to pay their respects. The funeral was held at the local Catholic Church and my grandfather was buried in the family plot, purchased long before, next to his wife. I remember walking around the cemetery and feeling very uneasy that so many gravestones had the names of my relatives on them. After the funeral everyone returned to the house for the wake. I was surprised how festive the occasion was and remember thinking it morbid somehow to throw a big party after burying someone you loved, but now I can see it was a good way for people to deal with their grief. Food and drink flowed and everyone related their favorite tale, good and bad, about the deceased. I learned a lot about my grandfather and my family history and it made me feel part of the things. I felt somehow connected and part of this large and previously unknown crowd. The general consensus was that my grandfather had lived to be a good age, had lived a good life and would now be joining his wife in heaven. He was, they all agreed, lucky to be able to able to die surrounded by family and friends and in familiar surroundings. It is obvious to me now that my grandfathers death was accepted as a normal part of family life. He had lived amongst family and friends all his life and those same people were there with him at the end. Although I did not appreciate it at the time, it was a good way to die.

The stages of death and bereavement as outlined by Kubler-Ross

My Aunt Caroline, my mother's older sister, was not so lucky when she died last year. In the months preceding her death my Aunt had suffered a series of debilitating strokes that had left her paralyzed on one side. A widow and unable to look after herself, she had for the last few months been resident in a local nursing home. Looking back it is easy now to see that upon hearing the news of my Aunt's initial stroke, my mother had struggled with the first stage of Kubler-Ross' death and bereavement process: Denial and isolation. I can remember when she told me that my Aunt had a stroke, she focused on the fact that it was not serious. The first stroke had been minor and the paralysis only temporary. My mother did not want to think the seriousness of her sister's condition, she wanted to believe that her sister would recover fully. However, over the next several months my Aunt's condition worsened and she suffered a series of strokes and was eventually bed-ridden, paralyzed on one side and unable to speak. The doctors' prognosis was there was no chance of recovery and the best they could do was to make her comfortable. On talking with my mother, it was obvious that she had moved on from denial to Kubler-Ross' second stage: Anger. My mother is a Roman Catholic and has always believed that God had a purpose for everything. While her faith never really wavered, I could see that she was finding it difficult to resolve her anger at God for making her sister suffer needlessly and her guilt at hoping that her sisters suffering would soon end (Kubler-Ross, 1991). My mother briefly entertained the third stage of Kubler-Ross' process: Bargaining. We went to mass and lit candles for my Aunt and prayed. My mother prayed not only for her sisters recovery, but was also willing to accept that maybe the best she could bargain or trade for would be an end to my Aunt's suffering. Just after Christmas my mother and I visited my Aunt and it was devastating to see the effect of the strokes. My aunt was able to recognize us and seemed to glad to know that someone was there. My mother spend hours with her sister just holding her hand and although it was obviously difficult for them to communicate, both seemed comforted. However, we were only able to stay for ten days and then had to return home. The one comforting thing was knowing that my cousins worked at the nursing home and were able to look in on my Aunt daily. After we got home, my mother was depressed, Kubler-Ross' fourth stage. She knew that it was unlikely that she would be able to see her sister again before she died and my mother wavered back and forth between depression and Kubler-Ross' fifth stage: Acceptance. She knew that my Aunt was going to die soon, she didn't want her to suffer anymore and there was absolutely nothing else that she personally could do. I got the news of my Aunt's passing in a telephone call from my mother. While she was sad at the loss of her sister, she was also relieved that her suffering had ended. My Aunt had long ago purchased a funeral plan that paid for all the services and her will designated exactly the type of service she wanted. According to her wishes my mother and my cousin made all the arrangements and there were only a few miscellaneous items that had to be purchased. My mother stated that it was a relief that there was no family squabbling about the cost or choice of services. My mother took care of the funeral arrangements and my Aunt was buried next to her husband in a double plot they had purchased soon after they got married. It was in the same cemetery where my grandfather had been buried. Looking back at my grandfather's death I can see now that both my grandfather and the family had somehow worked their way through to Kubler-Ross' fifth stage: Acceptance.

Attitudes toward death in the United States compared to other cultures

One explanation for the difference between how Western (especially American) and non-Western cultures cope with death can be traced to the value that the elderly command in society. In Japan and other nations the elderly are revered for accumulating experience and perfecting spiritual development. This is not generally so in America (Hoefler & Kamoie, 1995). In cultures where the elderly are held in high regard, death is most often confronted head on as an important rite of passage. By staying in contact with death in this way its members become more comfortable with death and see it as a normal and natural part of the progression of life. Americans on the other hand, have in many respects removed the specter of death from their everyday lives. The demise of the extended family often means that the elderly are no longer cared for in the home, but are condemned to live out their last days in nursing homes far removed for family and friends. When death does come, the funeral arrangement can be handled from start to finish by professionals. All that is required it that the bill be paid.

Denial of aging and inevitably death in America is an outgrowth of the liberal "pursuit of happiness" axiom that is central to the American political cultural and economic creed ( Hoefler, Kamoie, 1995). American culture tends to value youth and would rather deny their mortality. Basic to our failure to confront death is the fact that "American society in its preoccupation with perpetual youth, beauty and strength, has typically disguised, avoided denied and embellished death. Acknowledgment of death implies a sense of limits that flies in the face of American consciousness." (Hoefler & Kamoie, 1995: p. 172). Americans treat death as a great surprise when it overcomes a friend or family member, even if the departed was relatively old and ill, as if such a thing were not entirely natural. They go to great lengths to disguise their own aging and infirmity by utilizing the services of plastic surgeons and bottomless jars of anti wrinkle cream.

In contrast to the avoidance of death in American culture, Mexican culture sees life and death as different phases of an underlying process of regeneration.. The national fiesta El Dia de los Muertos, the Day of the Dead is a two day celebration of the communion between the living and the dead (Despelder & Strickland, 1992). During the Day of the Dead celebration families clean and decorate the graves of deceased family members, ...

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