Table of Contents
Abstract
Death is a part of life, which has continued to evolve along with society. In the past, death was a sudden process that occurred before young adulthood. However, the modern healthcare system has overcome early mortality from infections, and life expectancy has increased. Therefore, the time between diagnosis with a terminal illness and death has increased, which gives the family and patient time process and consider the nature of death. The paper illustrates that there is a vast difference in how people process and accept the final days of their lives.
Studies show that attitude towards death is influenced by religion, culture, ethnicity, social status, and several other factors. For example, beliefs can act as a buffer towards end of life anxiety. People that believe in life after death are more accepting of the reality. However, there are still moments of grief and fear that are experiences, and the paper will present different theories that have been used to explain these phenomena.
Keywords: Death; Dying; Fear; End of Life; Grief
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Death is inevitable for human being, which makes it an important topic in developmental psychology. The leading causes of mortality have continued to change over the past three decades, and in the same period life expectancy has increased by more than 20 years. At the beginning of the 20th century, acute infectious illnesses such as influenza and tuberculosis were the most prominent killers. However, in the modern era, chronic pathologies such as heart disease, cerebrovascular incident, and cancer are now the leading causes of death.
The concept of dying is complex as it can be classified into different types that include biological, when the body begins to disintegrate and there is a sharp decline in physiological capacity, and clinical all neurological function ceases. There is also social death, which occurs when people stop visiting or contacting an individual with a terminal illness. The paper will focus on psychological death, when an individual starts coming to terms with his or her death and begins to isolate and avoid others.
Description
In the United States, death has changed dramatically over the last two centuries in terms of the age, where, or how people die. According to Carr (2012), before the 20th century, the majority of deaths occurred before young adulthood. The deaths were sudden and un expected; however, in the modern society a significantly higher proportion occurs in late adulthood. For example, in 2010 over 2.3 million deaths occurred among people above 65 years (Carr, 2012). As society develops and the healthcare sector establish better ways for disease management, more cases of mortality occur following a long battle with chronic illness.
Several factors impact the period between diagnosis and terminal state, and these include a social support structure, access to medical care, and cultural perceptions towards death. The majority of Americans in late adulthood anticipate their death and illnesses are related to exercise, diet, or lifestyle problems. Therefore, the prolongation of this phase along with other external factors race interpersonal and psychological factors. Instead of living in fear of death, people have the opportunity to accept this phenomenon and prepare for the emotional, practical, and spiritual of dying (Carr, 2012). Therefore, it is important to understand the demographic and cultural factors that influence perception of death.
Regardless of birthplace or worldviews, one thing that unites people from different cultures and background is that everyone experiences biological and clinical death. However, the conceptualization of this process differs between groups as there are contrasting options on life after death. Healthcare providers should be aware of the different viewpoints, and the appropriate ways to assist patients during this period. For example, Gire (2014) points out that depending on the culture, death is conceived as involving different conditions that include illness, sleep, or reaching a certain age.
A common example in this regard is that of Christianity, which considers life after death as the way to reach God in heaven. Hence, such religious viewpoints tend to lessen grief and the burden of loss for the family as they feel their loved one is in “a better place.” On the other hand, the patient is more accepting of his or her fate due to the perception that God determines when it is time to die. At times religious views can lead to a dilemma between the healthcare providers and the patient. For example, Jehovah’s Witness patients are against blood transfusion (Kitihara, Ota, and Jeevanadam, 2019).
Therefore, when this is the only lifesaving intervention available, the physicians are stuck between the moral obligation to save lives and respecting autonomy of the patient. In many cases, the patients would rather die than break their code, which illustrates the impact religion has on the concept of death.
The preparation for death is also a fascinating concept, as several scholars suggest that individuals from western society “deny or fear” death more than other cultures (Carr, 2012). This stance on death often leads to a tentative life style that is marred with inactivity and alienation.
This concept has long been discussed in the form of parables and scientific literature. In regards to the latter, there is limited evidence to support the hypothesis that accepting death results in a more positive outlook on life. Another study found that many adults in the United States take the certain steps in preparation for their death such as financial planning for their children, insurance, and funeral policies. In fact, elderly people and their family are aware that death is a possibility in the near future, and come to terms with this by writing wills or spending time with loved ones.
Recent Research
Despite the awareness and anticipation of death, there are still anxiety, which is variable between different groups and when comes face to face with death. Gire (2014) conducted an evaluation that found the most common response to death or the passing of a loved one is fear. For the past three decades, researchers have used the social psychological perspective, particularly terror management to shed more light on fear associated with death. The theory suggests that humans and animals have instincts that drive self-preservation (Martens, Burke, and Faucher, 2010).
However, through evolution, humans have been able to overcome this instinct through higher cognitive abilities that enhance self-awareness and the ability to anticipate outcomes in the future. Thus, there is the subconscious dilemma between self-preservation and anticipation. Martens et al (2010) states that individuals that are afraid of death do whatever is necessary for them to stay alive.
Another concept that has also been extensively studies is that of bereavement and grief, as death does not culminate with the loss of life. In fact, even the person that is dying experiences some form of grief upon the awareness that he or she is going to die.
Findings show that among some cultures it is not the death itself that causes grief but concerns about how loved ones will react to the situation. In a study among a Nigerian population, the concept of disenfranchised grief, whereby individuals experience a loss that they cannot openly morn, is one of major concern (Eyetsemitan, 2002). Such cases also make acceptance of death challenging for the individual that is chronically ill. The country also has a high number of religious individuals, which has been found to be a buffer against the fear of death. Wink and Scott (2005) came to a different conclusion, which was that consistency and firmness of beliefs, and not religion had a more significant impact on anxiety about death.
Conclusion
In summation, death and dying is a complex issue that has transitioned in the past two centuries from a sudden and unexpected to an anticipated occurrence following a chronic illness. Hence, today the interval between the beginning of a terminal illness and death has increased, which makes understanding the different perceptions towards the nature of death paramount for healthcare providers. Studies illustrate the variation that exists in attitude and perception between different communities and cultural groups. Care providers should improve their cultural competence to facilitate the needs of the patients more efficiently. Living organisms are naturally driven towards self-preservation, and the dilemma that occurs due to higher cortical abilities and conditioned views due to culture or religion enhances the complexity of this topic.
References
- Carr, D. (2012). Death and dying in the contemporary United States: What are the psychological implications of anticipated death? Social and Personality Psychology Compass, 6(2), 184-195.
- Eyetsemitan, F. (2002). Cultural interpretation of dying and death in a non-Western Society: The case of Nigeria. Online Readings in Psychology and Culture, 3(2), 1.
- Gire, J. (2014). How death imitates life: Cultural influences on conceptions of death and dying. Online Readings in Psychology and Culture, 6(2), 3.
- Martens, A., Burke, B. L. & Faucher, E. H. (2010). Two decades of terror management theory: A meta-analysis of mortality salience research. Personality and Social Psychology Review, 14(2), 155-195.
- Wink, P., & Scott, J. (2005). Does religiousness buffer against the fear of death and dying in late adulthood? Findings from a longitudinal study. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 60(4), P207-P214.
