Deck 13: Death and Dying

Question 1

The healthy lifespan refers to the length of time that an individual can:

A) maintain a positive attitude toward life's ending.
B) live without significant disease and disability.
C) be treated by others with respect and dignity.
D) live after passing the age that a relative died.

Answer 1

B

Question 2

According to findings from Whitehall II, individuals from lower social class compared to higher social class had higher risk of which mortality-related condition?

A) cancer
B) cardiovascular disease
C) chronic emphysema
D) osteoarthritis

Answer 2

B

Question 3

To measure the health of a population, epidemiologists use the age-standardized mortality rate, which provides what type of information?

A) weighted sum of deaths in the population on the basis of age.
B) the total number of deaths occurring within each age group.
C) weighted sum of deaths per year over the past ten years.
D) the average number of deaths occurring within each age group.

Answer 3

A

Question 4

The crude death rate provides information about which aspect of mortality?

A) Total number of deaths occurring in a given time period.
B) Percentage of deaths within each age group.
C) Number of deaths divided by the size of the population.
D) Average deaths occurring within each age group.

Question 5

An individual's rate of decline prior to death is referred to as the:

A) healthy lifespan.
B) social death.
C) acceptance stage.
D) dying trajectory.

Question 6

Which province has the lowest age-standardized mortality rate?

A) Nova Scotia
B) Ontario
C) Manitoba
D) British Columbia

Question 7

An individual showing a steady and continuously declining dying trajectory is likely to have which type of disease?

A) Renal failure.
B) Cancer.
C) Alzheimer's disease.
D) Cardiovascular disease.

Question 8

Policy makers evaluating the health of their country seek to achieve a low ___________________ mortality rate would indicate that fewer people are dying at young ages in a population.

A) crude
B) age-specific
C) total
D) age-standardized

Question 9

The death of an individual who is in the later stages of Alzheimer's disease typically occurs due to:

A) continuous loss of brain tissue.
B) desire for physician-assisted suicide.
C) development of an acute fatal illness.
D) general loss of the will to live.

Question 10

Which sociodemographic group for both sexes combined has the lowest life expectancy?

A) Married
B) Never-married / single
C) Managerial or professional
D) University educated

Question 11

The __________________ is the length of time an individual can live without significant disease and disability.

A) dying trajectory
B) age-adjusted death rate
C) healthy lifespan
D) good death

Question 12

An epidemiologist is conducting a study in which she is only interested in finding out how many people die each year for a given population. The measure she will use for this study is the:

A) age-standardized mortality rate.
B) crude death rate.
C) age-specific mortality rate.
D) gross death rate.

Question 13

The dying trajectory an individual experiences prior to death refers to which process?

A) Rate of biological decline.
B) Stages prior to death acceptance.
C) Loss of cognitive functioning.
D) Decline in appetite and muscle mass.

Question 14

Researchers believe that the main reason for the relationship between social class and mortality appears to be due to which factor in lower class occupations?

A) Higher exposure to environmental toxins
B) Lack of control over the pace and timing of work
C) Less time to spend with friends and family
D) Greater chance of injuries on the job

Question 15

The medical and legal definition of death considers it to occur when:

A) all vital organs have ceased functioning except the brain.
B) the individual is being kept alive only through life support
C) life support is removed but the vital organs continue to function.
D) all vital organs, including the brain have ceased functioning.

Question 16

Dying individuals experiencing the anorexia-cachexia syndrome, which is defined as which set of symptoms?

A) Accumulation of fluid in the extremities.
B) Hallucinations, delusions, and disorientation.
C) Loss of the desire to eat and decline in muscle mass.
D) Anxiety, depression, and memory loss.

Question 17

Loss of appetite and muscle mass in the period before a person dies is referred to as the:

A) dual-process model.
B) anorexia-cachexia syndrome.
C) rapid dying trajectory.
D) terminal decline.

Question 18

An age-standardized mortality rate in Canada in 2011 of 4.9 compared to the age-standardized mortality rate of 10.2 in 2000 means that:

A) the lifespan is showing a gradual increase per decade.
B) the population is getting healthier because people are dying at later ages.
C) fewer people overall were dying in 2011 than in 2000.
D) the population is getting unhealthier because people are dying at younger ages.

Question 19

Shortly prior to death, an individual is likely to experience which of the following symptoms?

A) Elevated mood.
B) Extreme wakefulness.
C) Clearer vision and hearing.
D) Visual hallucinations.

Question 20

The segment of the Canadian population with the lowest age-adjusted mortality rate is:

A) Caucasian / White Canadians
B) Asian Canadians
C) Black Canadians
D) First Nations

Question 21

An appointment of a durable power of attorney for health care specifies who will serve as a(n)_____________ for an individual should he or she become incapacitated.

A) legal guardian
B) health care proxy
C) illness advisor
D) care counselor

Question 22

By bringing dying patients home to have control over their care, health care professionals are attempting to help them achieve a ________ death.

A) beautiful
B) tamed
C) social
D) good

Question 23

The idea that Western culture is unwilling to accept the reality of mortality led Ernest Becker to write the critique of this attitude, called:

A) The Book of the Dead
B) On Death and Dying
C) The Denial of Death
D) Management of Terror

Question 24

Which country has the highest crude mortality rate in the world?

A) Bolivia
B) El Salvador
C) Rwanda
D) South Africa

Question 25

Making sense of the story of your life prior to death is a process known as:

A) legitimization of biography
B) death with dignity
C) terror management
D) awareness of finitude

Question 26

Moving dying patients from the home to hospitals in mid-20^th Century Western culture has led to the ethos of the _________ death.

A) invisible
B) social
C) tamed
D) noble

Question 27

The death ethos known as "tamed death" was prevalent during which time and place in history?

A) Western Europe until the early Middle Ages
B) China during the late 14^th century
C) Early revolutionary America
D) Western Europe and America in the 1800s

Question 28

Treating dying individuals as nonpersons when they approach the end of their lives is known as _________ death.

A) tamed
B) isolated
C) social
D) remote

Question 29

According to the perspective known as ________________ Theory, activating a person's thoughts about death may trigger a set of positive changes, including closer relationships, greater creativity, and more connection to others.

A) Terror Management
B) Life Review
C) Awareness of Finitude
D) Death with Dignity

Question 30

Media accounts of death due to natural disasters, school shootings, terrorist attacks and the like tend to promote a death ethos of:

A) Personal meaning .
B) Fear and mystery
C) Invisibility
D) Martyrdom

Question 31

In Canada the laws and terminology with respect to ________ ensures the rights of dying patients to be able to have an active role in their care and treatment.

A) Advance Directives
B) Terror management
C) Active life support
D) Palliative care

Question 32

According to research cited in the test, an increased risk of death due to cardiovascular disease is found in:

A) Assembly-line workers
B) Manual labourers
C) College professors
D) Farmers

Question 33

A woman's mother was diagnosed with terminal cancer but is convinced that, despite the odds, she will survive this disease. The woman realizes that her mother's chances are in fact close to zero. It appears that the mother is in which of the Kübler-Ross stages of dying?

A) bargaining
B) resistance
C) denial
D) depression

Question 34

Being able to die in a way that protects the individual from loss of control over the body is central to the idea of:

A) the beautiful death.
B) invisible death
C) death acceptance
D) death with dignity

Question 35

Regarding death as a transition to an eternal life is characteristic of which death ethos?

A) death acceptance
B) beautiful death
C) tamed death
D) invisible death

Question 36

During the early days and weeks after the loss of a spouse a widow who uses denial to adaptively avoid focusing or ruminating on the loss illustrates:

A) The restorative component of the dual process model of coping with bereavement
B) The attachment theory of bereavement.
C) Identity assimilation.
D)) Identity accommodation.

Question 37

The view of tamed death, prevalent until the early Middle Ages, regards death as:

A) a welcome end to life.
B) glorification of the self.
C) a noble path to life's end.
D) transition to eternal life.

Question 38

Which type of information would a cultural anthropologist use to classify a culture's death ethos?

A) class differences in mortality rates
B) rates of terminal illness by age group
C) the language people use to describe death
D) average cost of a long-term hospital stay

Question 39

The view that it is noble to die for a cause characterizes the ____________ death ethos.

A) tamed
B) beautiful
C) social
D) invisible

Question 40

According to your text, when a person begins to think about their own mortality they have reached:

A) 65 years of age
B) An awareness of finitetude
C) A legitimization of biography
D) A death ethos

Question 41

Summarize the timeline of changes in attitudes toward death and dying from the Middle Ages to the present.

Question 42

Contrast the traditional views of bereavement with more contemporary views based on attachment theory.

Question 43

Describe the three dying trajectories shown. Indicate what types of deaths are most highly associated with each trajectory.

Question 44

Research following parents after the death of a child shows that:

A) the effects can last for as long as 20 years.
B) father are more affected than mothers.
C) the risk of mortality is highest when the children are older than 18.
D) parents are more likely to divorce after the death of a child.

Question 45

Summarize the five stages of dying in the theory of Kübler-Ross. Describe four criticisms of the theory.

Question 46

The Netherlands and Belgium are the only two countries that permit:

A) euthanasia.
B) physician-assisted suicide.
C) euthanasia and physician-assisted suicide
D) hospice care.

Question 47

The dual-process model of coping with bereavement proposes that the most adaptive way to adapt to loss is to:

A) completely repress the fact that the loss occurred.
B) alternate between restoration and loss as coping methods.
C) focus only on dealing with the practical consequences of the loss.
D) become entirely immersed in one's feelings about the loss.

Question 48

An 80-year-old woman is planning her living will through use of the Canadian Hospice Palliative Care Association's "Speak Up the Campaign " website. This will allow her to honor her desire for:

A) choosing who will inherit her savings.
B) life-support or resuscitation.
C) gaining access to medical records.
D) having no family present at her funeral.

Question 49

What were the main findings to emerge from the SUPPORT study? What are the implications of these findings for end-of-life care?

Question 50

Summarize four trends occurring in mortality rates throughout the world.

Question 51

Patients who choose not to have medical intervention when their heart or lungs shut down are issuing a(n):

A) euthanasia request.
B) physician-assisted suicide directive.
C) do-not-resuscitate order.
D) palliative care commitment.

Question 52

Briefly analyze the processes of awareness of finitude, legitimization of biography, and life review. How are these three processes related to each other?

Question 53

What are four cultural factors contributing to contemporary attitudes toward death and dying?

Question 54

A physician working with a terminally ill patient and his family suggest that they consider palliative care. This means that the patient would receive:

A) resuscitation if the patient goes into cardiac arrest.
B) life support for a maximum period of two weeks.
C) a minimum of pain medication unless absolutely necessary.
D) medications to provide pain relief and some physical therapy, as desired.

Question 55

The SUPPORT findings on managing patient care based on their dying trajectory suggested that the best model of care for patients experiencing a chronic illness with intermittent periods of worsening includes:

A) providing support and assistance for caregivers.
B) intervening only with hospice or palliative care .
C) educating patients about self-care and symptom management.
D) moving them into the hospital whenever their symptoms get worse.

Question 56

Unlike hospitals or nursing homes, hospices provide only______________ for their patients.

A) spiritual counseling
B) advance directives
C) palliative care
D) overtreatment

Question 57

What can be done to make death personally meaningful? Consider some examples.

Question 58

What are the medical symptoms that are often present when death is imminent?

Question 59

The DSM-5 considers extreme grief past a 2-week period following the loss of a close relative or friend to fit the criteria for which disorder?

A) Psychotic grief reaction
B) Attachment anxiety syndrome
C) Major depressive disorder
D) Bereavement adjustment disorder

Question 60

According to the ________________ view of bereavement the bereaved can continue to benefit from maintaining emotional bonds to the deceased individual.

A) conventional
B) social death
C) behavioral
D) attachment

Question 61

A recently widowed woman sees you in therapy for help in adapting to bereavement. Which theory of bereavement would you use as the basis for your treatment? Why?

Question 62

If you were a counselor working with dying patients and their families, how would you handle end-of-life decisions?

Question 63

What are the five patterns of reactions to the death of a spouse? Which of these is the most common?

Question 64

What is your position on euthanasia and physician-assisted suicide?

Question 65

Summarize the bereavement process for death of an adult child, a grandchild, a parent, a sibling, and a friend.

Question 66

How do mortality rates enhance our understanding of the factors influencing adult development and aging in terms of the biopsychosocial perspective? Be sure to elaborate on the biological, psychological, and sociocultural meaning of mortality rates.

Question 67

Examine historical trends in attitudes toward death and dying and contrast previous views with contemporary portrayals of death. In your opinion, how do these changes in attitudes affect the experience of dying for individuals? How would you facilitate death acceptance and meaningfulness?