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Aging and The Life Course
Aging and The Life Course: An Introduction to Social Gerontology, 2/e
Jill Quadagno, Florida State University

Dying, Death, and Bereavement

Chapter Overview

1. How have cultural attitudes toward death changed over time?
There are enormous variations across societies and over time in attitudes toward death. Some societies engage in death avoidance while others celebrate the communion between the living and the dead. In the United States there has been an immense change in the process of dying from the nineteenth century to the present. This change is partly due to a shift in the average age of death and the association of dying with old age. It is also caused by a change in the causes of death. At one time most people died from acute illnesses that struck swiftly. Now people are more likely to die from a chronic illness that leads to a slow death. The setting for death has also changed. Most deaths once occurred in the home. Now death typically takes place in an institutional setting such as a hospital or nursing home.

2. How do people prepare for death?
Some people prepare for death by engaging in a life review. A life review is a process of reminiscing over one's experiences and finding meaning in past events. It helps the individual to view his or her life as having integrity.

3. What are the moral and legal issues involved in care of the dying?
Now that modern health technology has made it possible to extend life indefinitely, people face ethical and legal issues regarding the right to die. No issue has raised more controversy than euthanasia. There are two types of euthanasia. The less controversial form of euthanasia is passive euthanasia, which refers to the withholding or withdrawal of treatment. Active euthanasia, also known as assisted suicide, remains in legal limbo. Although it is illegal in most of the Western world, public opinion supports it under certain conditions.

4. What is a hospice, and how are hospice patients cared for?
Hospices are dedicated to providing death with dignity, free of pain. Hospices have expanded in the United States since payment for hospice care was allowed under Medicare. Although hospice care saves little in terms of public expenditures, it fulfills another objective, that of providing high-quality care at the end of life. Hospice care may be provided in several different settings including a hospital, a nursing home, or an individual's home.

5. How does an aged person's death affect family members?
Every married person who does not divorce or who does not die before his or her spouse will become widowed one day. The loss of a spouse is a stressful event that is associated with greater risk of illness and mortality. Although the death of a parent is a natural part of middle age and middle-aged people lead independent lives, parental death holds great symbolic meaning and represents a personal loss that also symbolizes one's own aging. Sons and daughters react to parental loss in gender-stereotypical ways. Sons are more likely to mimic their father's ways of dealing with stress. Daughters are more likely to consider the feelings of others and evaluate their own behavior in light of societal expectations for the proper expression of grief.