Key Terms

1.0 Images of Life-Span Development: Edna, Age 75, and Her Life Review

2.0 The Social Worlds of Older Adults

disengagement theory

activity theory

social breakdown-reconstruction theory

ageism

eldercare

gerontologists

generational inequity

3.0 Ethnicity, Culture, and Gender

racism

sexism

4.0 Families and Social Relationships

grandparenting

5. Personality Development, Life Satisfaction, and Successful Aging

integrity versus despair

differentiation versus role preoccupation

body transcendence versus body preoccupation

ego transcendence versus ego preoccupation

life review

life satisfaction

selective optimization with compensation model

successful aging

6. Contemporary Concerns

age-condensed

age-gapped

truncated

matrilineal

step-family

social support

Essay and Critical Thinking Questions

Comprehension and Application Essay Questions

We recommend that you follow either our guidelines for "Answering Essay and Critical Thinking Questions,” or those provided by your instructor, when preparing your response to these questions. Your answers to these kinds of questions demonstrate an ability to comprehend and apply ideas discussed in this chapter.

1. Compare and contrast three social theories of aging.

2. Define ageism, and provide two original examples of ageism.

3. Imagine that you are an elderly adult. Indicate and explain the policy issues of concern to you.

4. Indicate where elderly adults live.

5. Explain what an elderly, ethnic female can expect to experience during late adulthood.

6. Evaluate your own culture's regard for the elderly in terms of the seven factors most likely to predict high status for the elderly.

7. If you were an elderly adult, what can you expect to happen to aspects of your social relations such as life-style, dating, and friendship?

8. Discuss the diversity of grandparenting functions and roles.

9. Describe the tasks and themes of personality development during late adulthood.

10. What is life satisfaction, and what factors influence one's life satisfaction?

11. Explain how the selective optimization with compensation model could help you age successfully.

Chapter 21 Death and Dying Summary

1.0 Images of Life-Span Development: Jack Kevorkian, The "Suicide Doctor"

Dr. Jack Kevorkian is an advocate of physician-assisted suicide for the desperately ill. Although "mercy killing" is illegal, biomedical ethicists regard this view as incompatible with notions of individual autonomy and privacy. The immediate future will entail continued ethical and legal debate over this practice.

2.0 Defining Death

Issues in Determining Death. Medical advances have made it difficult to determine when a person is dead. Those who stop breathing can be kept alive artificially for extended periods of time. Those who have no cognitive abilities may continue to breathe. Most medical practitioners agree that a person must be brain dead to be declared dead. All electrical activity in the brain, as measured by an EEG, must have stopped in both the cortical areas of the brain and in the brain stem.

Euthanasia. Euthanasia is the practice of assisting a terminally ill patient with his or her death. Active euthanasia involves intervention, passive euthanasia involves the removal of life support. Advances in technology have also made it difficult to know when to intervene and when not to intervene in the deaths of those who are or can be kept alive artificially.

3.0 Death and Sociohistorical, Cultural Contexts

Changing Historical Circumstances. In addition to the increasingly difficult question of determining when someone is dead, one historical trend is that there are fewer deaths during childhood and early adulthood and a second trend is that there is an increase in the number of people who die in hospitals rather than at home.

Death in Different Cultures. Unlike the Greeks, most Americans do not plan a glorious death. Perceptions about death vary and reflect the diverse values of different cultures. For the most part, individuals in the United States are death avoiders and death deniers as indicated by such things as the use of euphemistic language for death and an emphasis on prolongation of biological life rather than emphasizing diminished human suffering.

4.0 A Developmental Perspective on Death

Causes of Death and Expectations about Death. Individuals of different ages die for different reasons. Infants may die of birth defects, sudden infant death syndrome (SIDS), or from a failure to develop properly during the prenatal period. Children die from accidents and illnesses. Adolescents are more likely to die from suicides, homicides, and automobile accidents than children. Accidents and disease take young and middle-aged adults, and chronic illnesses are responsible for most of the deaths of older adults.

Attitudes toward Death at Different Points in the Life Span. The ability to cope with death is dependent on developmental level. Infants may show signs of ill health at the death of a parent but have no concept of permanence, consequently they have no concept of loss. Preschoolers do not understand about death. Five- to 8-year-olds have a vague understanding but know it can't happen to them, though they sometimes blame themselves for the death of others. The Finality and inevitability of death can be understood by 9-year-olds. Most psychologists believe honesty is the best strategy for helping children cope with death. Adolescents grasp the abstractness of death while working hard to avoid the topic. There is no evidence that a special orientation toward death emerges in early adulthood. Not until middle age does death become a life issue. At this time fear of death is at its peak. An acceptance of death marks the later adulthood period. Attitudes about death may vary considerably among adults of any age.

5.0 Facing One's Own Death

Kilbler-Ross's Stages of Dying. Kilbler-Ross provided the first conceptual framework for understanding the process of dying. She identified five stages of death: denial, anger, bargaining, depression, and acceptance. Dying individuals start by asking for second opinions and end by finding peace in their death. Not all individuals experience all the stages, nor are they always experienced in order. Some people fight their death until the end. Denial may characterize more deaths than Kilbler-Ross would argue; however, progressing through the five stages may optimize the death process.

Perceived Control and Denial. Perceived control and denial may work together as an adaptive orientation for the dying person. Denial can be adaptive or maladaptive, depending on the circumstance.

The Contexts in which People Die. Most people, about 80 percent, die in a hospital or long-term care institution. Advantages of hospital deaths included the availability of professional care and life-prolonging equipment. Most people would prefer to die at home but are afraid of the burden they will place on others, the lack of space, and the lack of professional care. Hospices are designed to let a person die without pain and with the best attitude possible. Their main goal is pain control and they strive for psychologically healthy deaths.

6.0 Coping with the Death of Someone Else

Communicating with a Dying Person. Most psychologists recommend an open and interactive exchange between a dying individual and significant others. Conversations with a dying individual should not dwell on pathology. Instead the focus should be on the dying person's strengths.

Stages and Dimensions of Grief. The people left behind after the death of a loved one may be emotionally numb, despairing, anxious, and sad. They are experiencing grief—an emotional numbness. According to Averill the three stages of grief are shock, despair, and recovery. According to Parkes, the four dimensions of grief are numbness, pining, depression, and recovery. Both views agree that when an individual resumes ordinary activity and has pleasant memories of the deceased, they are well on their way to recovery.

Making Sense of the World. A benefit of grief is that it stimulates individuals to make sense of their world. Each grieving individual may contribute something to this process.

Widowhood. Usually the most difficult loss is the death of a spouse. Such deaths are associated with depression, health-compromising behavior, and increased mortality rates. Widowhood is experienced differently depending on sociohistorical circumstances.

Forms of Mourning and the Funeral. Assisting in the grief process are death rituals. The most important aspect of mourning in most cultures is the funeral. Unlike the Hindus who once burned a man's wife for the prestige of the family, the practice of suttee, death rituals in the United States are more subtle. Funeral industry personnel argue that funerals help friends and family reach some closure in their relationship to the dead person. Others argue that funerals are an unnecessary and costly expense.

7.0 Death Education

Thanatologists study death and dying. Death education, usually done by thanatologists, may help an individual and a society come to grips with the issues surrounding dying and living. In many ways ours is still a death-avoiding society.

8.0 Contemporary Concerns

Sociocultural Worlds of Development 21.1: The Family and the Community in Mourning—the Amish and Traditional Judaism. The Amish culture and the traditional culture of Judaism have extensive mourning systems. The Amish are a conservative group that handles virtually every aspect of the funeral from dressing the body to providing the grieving family support for at least a year. The family and community have specific roles in mourning in traditional Judaism that are designed to promote personal growth and reintegrate the mourning individuals into the community.

Perspectives on Parenting and Education 21.1: Exploring Death Education. Although efforts have been made to include death education in the curriculum at all age levels, only colleges have consistently attempted to offer courses in death and dying.

Life-Span Practical Knowledge 21.1: Helping Children Grieve. This book presents a developmental approach to helping children cope with their own death or the death of a loved one.

Life-Span Practical Knowledge 21.2: How to Go on Living when Someone You Love Dies. This book provides advice about how to effectively grieve over someone's death. Unlike other books, it does not provide pat, overgeneralized recommendations.

Life-Span Practical Knowledge 21.3: How to Survive the Loss of a Love. This book makes an unusual presentation about loss through death as well as loss through divorce, rape, unmet life goals, and aging.

Life-Span Health and Well-Being: Diversity in Healthy Grieving. The therapeutic assumption that individuals need to break bonds with the deceased and return to an autonomous lifestyle is under reexamination cross-culturally. Detailed inquiry into grieving around the world suggests that different peoples grieve in various ways. Healthy coping entails growth, flexibility, and appropriateness within a cultural context.