This Document Contains Chapters 7 to 9 Chapter 7: Traumatic Death Test Questions Part I. Multiple Choice Questions Select the response that best answers the following questions. 1) Death as a result of terrorism, suicide, homicide, and death from AIDS can be characterized as __________. A) immoral death B) bereavement C) traumatic death D) traditional death Answer: C 2) The events of September 11, 2001 are an example of __________. A) terrorism B) suicide C) natural disaster D) complicated grief Answer: A 3) __________ death is sudden, violent, inflicted, and/or intentional. A) Traditional B) Traumatic C) Intervention D) Psychological Answer: B 4) __________ is the unlawful use of force or violence against persons or property to intimidate a government or civilian population, in furtherance of political or social objectives. A) Seppuku B) Postvention C) Traumatic death D) Terrorism Answer: D 5) The experience of being cut off from society refers to __________. A) alienation B) humiliation C) eros D) Thanatos Answer: A 6) Large scale response to traumatic events is called __________. A) traumatic death B) collective trauma C) alienation D) terrorism Answer: B 7) __________ is the eleventh leading cause of death. A) HIV/AIDS B) Heart Disease C) Terrorism D) Suicide Answer: D 8) __________ are more likely than __________ to attempt suicide. A) Women, men B) Men, women C) Teenagers, adults D) Adults, teenagers Answer: A 9) Men are most likely to use __________ in suicide attempts. A) poison B) a gun C) hanging D) jumping Answer: B 10) Feeling numb and bewildered are normal feelings for __________. A) soldiers B) parents C) suicide survivors D) terrorists Answer: C 11) __________ developed a theory on human motivation. A) Freud B) Beck C) Leenaars D) Durkheim Answer: A 12) __________ is the Greek word for death. A) Humiliation B) Suicide C) Eros D) Thanatos Answer: D 13) Freud’s hypothesis of anger turned inward is more commonly referred to as ___________. A) alienation B) humiliation C) depression D) eros Answer: C 14) Common risk factors for __________ include family history, psychotic features, and substance abuse. A) suicide B) terrorism C) HIV/AIDS D) collective trauma Answer: A 15) Durkheim developed __________ explanations of suicide. A) two B) four C) seven D) nine Answer: B 16) According to Durkheim, what type of suicide is it when an individual commits suicide as an escape from feeling oppressed? A) egoistic B) anomic C) altruistic D) fatalistic Answer: D 17) __________ is a sense of normlessness. A) Anomie B) Altruism C) Fatalism D) Egoism Answer: A 18) The type of suicide committed by the terrorists responsible for the 9/11 bombings is __________ suicide. A) egoistic B) altruistic C) fatalistic D) anomic Answer: B 19) Approximately __________ percent of people who attempt or commit suicide show advance warning signs. A) 20 B) 30 C) 50 D) 80 Answer: D 20) __________ helps distinguish was we do to help before and after suicide. A) Postvention B) Pre suicide C) Warning counsel D) Egoisitic suicide Answer: A 21) __________has been the fourth leading cause of death for persons ages 1-40 years in the United States for the last decade. A) Natural terrorism B) Suicide C) Homicide D) Altruism Answer: C 22) Amy recently died in a car crash where she was at fault for the accident because she was texting and driving. As part of the accident, Amy also hit and killed a small child crossing the street with her car. Out of respect for the small child’s parents, Amy’s parents attended the child’s funeral. Amy’s father said to the child’s parents at the event that he was very sorry and knew what the parents were going through. The child’s mother became very upset with Amy’s parents and blamed them and their daughter for the loss of her child. Amy’s parents are experiencing __________. A) seppuku B) disenfranchised grief C) collective trauma D) postvention Answer: B 23) HIV/AIDS is commonly transmitted through __________. A) genetics B) touch C) vaccination needles D) unprotected sex Answer: D 24) HIV-antibodies are produced in the body to try and fight invasion of CD4 helper cells that are central to the __________ system of the body. A) immune B) circulatory C) respiratory D) digestive Answer: A 25) HIV/AIDS was first discovered in __________ in the 1980s. A) bisexual women B) heterosexual men C) lesbian women D) gay men Answer: D Part II. Essay Questions Answer the following questions in your own words. 1) What are the basic differences between psychological and sociological explanations of suicide? Use the theories of at least one psychological and one sociological theorist to demonstrate the differences (e.g., Freud v. Durkheim). Answer: The basic differences between psychological and sociological explanations of suicide lie in their focus and underlying assumptions. Psychological explanations, as exemplified by Freud's psychoanalytic theory, emphasize internal, individual factors such as mental processes, personality traits, and unconscious conflicts. Freud might argue that suicide can result from unresolved psychological issues, such as feelings of guilt or aggression turned inward (i.e., introjection). In Freudian terms, suicide could be seen as an expression of an unresolved death wish or a desire to return to a state of non-existence, stemming from unresolved psychological conflicts. On the other hand, sociological explanations, as seen in Durkheim's theory of suicide, focus on external, social factors such as social integration, regulation, and cultural influences. Durkheim proposed that suicide rates are influenced by the degree of social integration and regulation in a society. He identified four types of suicide: egoistic (due to weak social integration), altruistic (due to excessive social integration), anomic (due to rapid changes in social regulation), and fatalistic (due to excessive social regulation). Durkheim argued that suicide rates could be understood by examining the level of social cohesion and regulation in a society. In summary, while psychological explanations emphasize internal, individual factors, sociological explanations focus on external, social factors. Freud's psychoanalytic theory highlights the role of internal conflicts and unconscious processes, whereas Durkheim's theory of suicide emphasizes the influence of social integration and regulation on suicidal behavior. 2) Explain Durkheim’s theory of suicide. In your essay explain how the concepts of social integration and social regulation relate to the types of suicide he outlines. Answer: Émile Durkheim, a founding figure in sociology, developed a groundbreaking theory of suicide in his seminal work, "Le Suicide" (1897). Durkheim's theory posits that suicide rates are not just individual acts but are influenced by social factors. He identified four types of suicide—egoistic, altruistic, anomic, and fatalistic—each linked to different levels of social integration and regulation. 1. Egoistic Suicide: This type of suicide occurs when individuals are not well integrated into society, leading to feelings of isolation and disconnection. Durkheim argued that individuals with weak social ties, such as unmarried people or those without strong community bonds, are more likely to commit egoistic suicide. The lack of social integration results in a sense of meaninglessness or purposelessness in life, increasing the risk of suicide. 2. Altruistic Suicide: In contrast to egoistic suicide, altruistic suicide occurs when individuals are overly integrated into society. This type of suicide is characterized by an excessive devotion to a group or cause, to the extent that individuals are willing to sacrifice their lives for the collective good. Examples include suicide bombers or members of cults who believe their death serves a higher purpose or benefits their community. 3. Anomic Suicide: Anomie refers to a state of normlessness or a breakdown of social norms, often caused by rapid social changes or disruptions. Anomic suicide occurs when individuals feel lost or disconnected due to a lack of clear societal expectations. For example, economic crises or sudden changes in social structure can lead to feelings of confusion and despair, increasing the risk of anomic suicide. 4. Fatalistic Suicide: This type of suicide occurs when individuals experience excessive social regulation, leading to feelings of oppression or hopelessness. Durkheim suggested that people in highly oppressive or controlling environments, such as prisoners or slaves, may resort to fatalistic suicide as a way to escape their circumstances. The concepts of social integration and social regulation are central to Durkheim's theory of suicide. Social integration refers to the extent to which individuals feel connected to society, while social regulation refers to the norms and rules that guide behavior within society. According to Durkheim, both high and low levels of social integration can contribute to different types of suicide, depending on the balance between integration and regulation. Overall, Durkheim's theory highlights the complex interplay between individual psychology and social forces in determining suicidal behavior. By emphasizing the importance of social factors, Durkheim's work laid the foundation for sociological approaches to understanding mental health and suicide. 3) Discuss why those left behind after a suicide are called survivors. Why is grieving suicide often a unique experience compared to loss from other types of death? Answer: The term "survivors" is used to describe those left behind after a suicide because they are survivors of the emotional and psychological impact of the suicide. Unlike other types of death, suicide often leaves survivors with complex feelings of guilt, shame, anger, and confusion. This is due to several factors that make grieving a suicide loss a unique experience: 1. Stigma and Shame: There is often a stigma surrounding suicide, which can lead survivors to feel shame or embarrassment about the circumstances of their loved one's death. This can make it challenging for survivors to openly discuss their grief and seek support. 2. Unanswered Questions: Suicide leaves survivors with many unanswered questions about why their loved one chose to end their life. This can create feelings of confusion and a sense of unfinished business, as survivors grapple with the search for understanding and closure. 3. Guilt and Self-Blame: Survivors of suicide loss often experience intense feelings of guilt and self-blame, wondering if they could have done something to prevent the suicide. This can lead to a prolonged and complicated grieving process as survivors struggle to come to terms with their perceived role in the death. 4. Social Isolation: Due to the stigma surrounding suicide, survivors may feel socially isolated and misunderstood. Friends and family members may be unsure of how to offer support, leading to feelings of alienation and loneliness. 5. Complicated Grief: Grieving a suicide loss can be more complicated and prolonged than grief from other types of death. Survivors may experience a range of emotions, including anger, betrayal, and relief, in addition to the more typical feelings of sadness and loss. 6. Trauma: Witnessing or discovering the aftermath of a suicide can be traumatic for survivors, leading to symptoms of post-traumatic stress disorder (PTSD) such as flashbacks, nightmares, and intrusive thoughts. Overall, grieving a suicide loss is a complex and challenging process that requires understanding and support from others. It is important for survivors to seek help from mental health professionals and support groups to navigate the unique challenges of grieving a suicide loss. 4) Discuss the nuances of HIV/AIDS. What is it? How is it transmitted? How is it treated? Answer: HIV/AIDS is a complex medical condition caused by the human immunodeficiency virus (HIV). HIV attacks the body's immune system, specifically the CD4 cells (T cells), which help the immune system fight off infections. If left untreated, HIV can lead to the disease known as acquired immunodeficiency syndrome (AIDS), which is the final stage of HIV infection and can be fatal. Transmission: HIV is transmitted through contact with certain body fluids from a person who has HIV. The most common ways HIV is transmitted include: • Unprotected sexual contact with an infected person • Sharing needles or syringes with someone who has HIV • From mother to child during childbirth or breastfeeding (known as vertical transmission) • Rarely, through blood transfusions or organ transplants (in countries where blood is not screened for HIV) HIV is not spread through casual contact such as hugging, kissing, or sharing utensils. Symptoms: The symptoms of HIV can vary widely and may resemble those of the flu or other viral illnesses. Some people may not experience any symptoms for many years, while others may develop severe symptoms shortly after infection. Common symptoms of HIV include fever, swollen lymph nodes, sore throat, rash, muscle and joint pain, and headache. Diagnosis: HIV is diagnosed through blood tests that detect the presence of HIV antibodies or the virus itself. Early diagnosis is important for starting treatment and preventing the progression to AIDS. Treatment: HIV is treated using antiretroviral therapy (ART), which involves taking a combination of HIV medicines every day. ART helps to lower the viral load (amount of HIV in the body) to undetectable levels, which allows the immune system to recover and prevents the progression to AIDS. It also reduces the risk of transmitting HIV to others. Prevention: The most effective way to prevent HIV is to practice safe sex by using condoms consistently and correctly, and to avoid sharing needles or syringes. HIV testing and early diagnosis are also important for preventing the spread of the virus. Overall, HIV/AIDS is a complex condition that requires ongoing medical care and management. With proper treatment, people with HIV can live long, healthy lives and prevent the transmission of HIV to others. 5) What concepts help us best explain why terrorists commit terrorist acts? In other words, write an essay that explains why individuals become terrorists. In your essay use two specific examples of terrorist acts to help demonstrate your understanding of this form of traumatic death. Answer: Understanding why individuals become terrorists involves considering a range of complex psychological, social, and political factors. Several key concepts help explain the motivations behind terrorist acts, including grievances, radicalization, and group dynamics. 1. Grievances: Many terrorists are driven by perceived grievances, whether real or imagined, against a particular group, government, or ideology. These grievances can stem from political, social, economic, or religious factors. For example, the 9/11 terrorist attacks on the United States were motivated in part by grievances against U.S. foreign policy in the Middle East, particularly its support for Israel and military presence in Muslim-majority countries. 2. Radicalization: Radicalization is the process by which individuals adopt extreme beliefs and ideologies, often leading them to commit terrorist acts. This process can be influenced by a variety of factors, including personal experiences of discrimination or marginalization, exposure to extremist propaganda or ideology, and social or peer pressure. The radicalization of the Tsarnaev brothers, who carried out the Boston Marathon bombing in 2013, is an example of how individuals can become radicalized over time, often through exposure to online extremist content. 3. Group Dynamics: Terrorist groups often provide a sense of belonging and purpose to individuals who feel marginalized or alienated from mainstream society. Group dynamics, including peer pressure, groupthink, and charismatic leadership, can play a significant role in motivating individuals to commit acts of terrorism. The 2008 Mumbai attacks, carried out by the Pakistan-based militant group Lashkar-e-Taiba, illustrate how group dynamics can influence individuals to participate in coordinated terrorist acts. 4. Psychological Factors: Psychological factors, such as a desire for revenge, a need for power or status, or a sense of nihilism or hopelessness, can also contribute to individuals becoming terrorists. These factors are often intertwined with the broader social and political context in which terrorism occurs. 5. Political and Ideological Motivations: For some terrorists, their actions are driven by political or ideological goals, such as overthrowing a government, establishing an independent state, or promoting a particular religious or ideological agenda. These motivations can be deeply rooted in historical grievances or perceived injustices. In conclusion, individuals become terrorists for a variety of reasons, including grievances against perceived oppressors, exposure to radical ideologies, and a desire for belonging or significance. Understanding these motivations is crucial for developing effective strategies to prevent and counter terrorism. Chapter 8: In the Valley of the Shadow: Facing Death Test Questions Part I. Multiple Choice Questions Select the response that best answers the following questions. 1) The likelihood of death decreases __________ and increases __________. A) as people age, after infancy B) after infancy, as people age C) before infancy, as people age D) as people age, in the teen years Answer: B 2) Advances in __________ contribute to longer life expectancy. A) medicine B) religion C) community D) the economy Answer: A 3) The mortality rate __________ as life expectancy __________. A) increases, stays the same B) stays the same, decreases C) increases, decreases D) decreases, increases Answer: D 4) Increased __________ also increases the likelihood of morbidity. A) life expectancy B) homicide C) suicide D) death rates Answer: A 5) Strauss’ theory of death outlines __________ basic death trajectories. A) two B) four C) six D) nine Answer: B 6) Various trajectories of death impact __________. A) societal life expectancy B) mortality rates C) technological advancement D) relationships with the dying Answer: D 7) ALS is commonly known as __________ disease. A) Hartnup B) Lou Gehrig’s C) Lyme D) Addison Answer: B 8) __________ is often a less invasive surgical method. A) Cryosurgery B) Radiation C) Chemotherapy D) Ultrasound Answer: A 9) After a workplace accident doctors were able to save Jerry’s life. However, Jerry cannot live without the assistance of life support. Jerry’s condition is best described by what term? A) gemeinschaft B) morbidity C) mortality D) dying trajectory Answer: B 10) Chemotherapy is a common treatment for __________. A) sickle cell anemia B) HIV/AIDS C) cancer D) diabetes Answer: C 11) After receiving her cancer diagnosis, Sandra was told by her doctor that she most likely has a year to live. What is this lifespan estimate called? A) death sentence B) prognosis C) treatment plan D) prescriptive Answer: B 12) One of the ways Kübler-Ross’ stages of dealing with dying have been misunderstood is that the coping process is not __________. A) explained with theory B) in need of attention C) fluid D) prescriptive Answer: D 13) In Corr’s task-based model of coping with dying dealing with self-worth, acceptance, and hope are most likely tasks in the __________ dimension. A) spiritual B) social C) psychological D) physical Answer: B 14) To help process her husband’s leukemia diagnosis Chloe and her husband started attending a couple’s support group. In Corr’s task-based model of coping with dying this support group most likely falls under the tasks in the __________ dimension. A) social B) psychological C) physical D) spiritual Answer: A 15) What scholar’s explanation for coping with the process of death and dying are commonly used in Likert scales (i.e., a quantitative research measurement item) to study death and dying? A) Kübler-Ross B) Durkheim C) Groves D) Corr Answer: C 16) Scholars have described __________ attributes of hope, a term that is sometimes thought of as elusive, mysterious, or “soft” as a social science concept. A) three B) four C) five D) seven Answer: B 17) A __________ is a legal document where you declare what will happen to your assets and who will manage your estate when you die. A) whole life policy B) prognosis C) will D) insurance policy Answer: C 18) The person who manages your assets and estate after you’ve died is called the __________. A) executor B) manager C) funeral director D) kin appointee Answer: A 19) There are __________ basic types of life insurance policies. A) two B) four C) six D) ten Answer: A 20) Ken is 50 years old and has never had a life insurance policy. He is looking for something affordable that will pay out upon his death within the next 30 years. What is most likely the best type of life insurance policy for Ken? A) health insurance B) term insurance C) whole life insurance D) suicide insurance Answer: B 21) Michele is a young professional in her mid-twenties looking to take out a life insurance policy on herself. She is looking for something that she can also use as a kind of savings account to possibly cash in much later in life. What is most likely the best type of life insurance policy for Michele? A) living trust insurance B) health insurance C) term insurance D) whole life insurance Answer: D 22) Using life-support measures to sustain life when a person has already begun the process of dying demonstrates what Bartholome refers to when he says America has a need for __________. A) rituals of withdrawal B) spiritual hounding C) existential dying D) limitations of hospice Answer: A 23) A __________ is a written document that designates a person to manage your property; it can be changed at any time while you are living. A) term will B) whole trust C) will D) living trust Answer: D 24) Radiation therapy is a common treatment for __________. A) chronic migraines B) TB C) cancer D) chemotherapy Answer: C 25) It is significantly more likely that a(n) __________ person will die from SIDS than cancer, heart disease, or stroke. A) newborn B) younger C) older D) teenage Answer: A Part II. Essay Questions Answer the following questions in your own words. 1) Explain how personal relationships are potentially impacted by each of Strauss’ dying trajectories. In your essay be sure to explain each trajectory and its relationship to time and death. Answer: Strauss' dying trajectories suggest that the experience of dying varies based on factors like the nature of the illness. Each trajectory can impact personal relationships differently: 1. Sudden Death: Little time for preparation, leading to shock and trauma in relationships. 2. Terminal Illness: Prolonged period of illness allows for emotional preparation but can strain relationships due to caregiving. 3. Organ Failure: Uncertain timing of death causes anxiety, impacting relationships. 4. Frailty: Gradual decline in health provides opportunities for meaningful interactions but can strain relationships due to caregiving and emotional strain. 2) What are the Kübler-Ross stages of dealing with dying? Explain whom the model characterizes, specifically what an individual might experience in each stage, and how the model has been critiqued in recent years. Answer: The Kübler-Ross stages, also known as the five stages of grief, are a model proposed by psychiatrist Elisabeth Kübler-Ross in her 1969 book "On Death and Dying." The model describes the emotional stages that terminally ill patients often go through when faced with their own impending death. These stages are not necessarily experienced in a linear fashion and can vary in intensity and duration from person to person. The stages are: 1. Denial: The first stage involves a refusal to believe or accept that one is dying. This can manifest as shock, numbness, or a sense of disbelief. Individuals in this stage may ignore medical diagnoses or dismiss the severity of their condition. 2. Anger: As the reality of the situation sets in, individuals may experience anger and resentment. They may question "Why me?" or express anger towards loved ones, healthcare providers, or a higher power. This stage can be characterized by feelings of injustice and frustration. 3. Bargaining: In this stage, individuals may try to negotiate a way out of death. This can involve making deals with a higher power, seeking alternative treatments, or trying to delay the inevitable. This stage is often marked by feelings of guilt and a desire to regain control. 4. Depression: As the certainty of death becomes more apparent, individuals may experience profound sadness, despair, and feelings of hopelessness. This stage can involve withdrawing from others, loss of interest in activities, and a sense of mourning for the life that will soon be lost. 5. Acceptance: The final stage involves coming to terms with one's own mortality. Individuals in this stage may feel a sense of peace, calm, and readiness for death. This stage is not necessarily marked by happiness but rather by a sense of closure and acceptance of the inevitable. Critiques of the Kübler-Ross model in recent years have focused on its oversimplification of the grieving process and its applicability to all individuals. Critics argue that not everyone experiences these stages or experiences them in the same way. Additionally, the model has been criticized for implying a linear progression through the stages, whereas in reality, grief is often more complex and cyclical. Some also argue that the model may not adequately address cultural or individual differences in coping with death and dying. Despite these critiques, the Kübler-Ross stages remain a widely recognized framework for understanding the emotional experiences of individuals facing death. 3) How does Corr’s Task-Based model of coping with dying elaborate and/or revise the Kübler-Ross stages of dealing with dying? How might thinking about both models help us to best explain and help individuals coping with death? Answer: Corr's Task-Based model of coping with dying builds upon and revises the Kübler-Ross stages by emphasizing the dynamic nature of coping with death and dying. Developed by psychologist Kenneth J. Doka and based on the work of William Worden, this model suggests that individuals facing death engage in a series of tasks rather than stages. These tasks are not necessarily sequential and can be revisited as needed. The tasks include: 1. Acknowledging the reality of death: Similar to Kübler-Ross's denial stage, this task involves recognizing and accepting the inevitability of one's own death or the death of a loved one. 2. Coping with the emotional aspects of dying: This task involves experiencing and processing a wide range of emotions related to dying, including sadness, fear, anger, and anxiety. 3. Clarifying life goals and values: This task involves reflecting on one's life and identifying what is most important and meaningful. It can help individuals find a sense of purpose and meaning in the face of death. 4. Enhancing interpersonal relationships: This task involves strengthening relationships with loved ones and resolving any conflicts or unfinished business. It can help individuals find comfort and support during the dying process. 5. Maintaining hope and a sense of control: This task involves finding sources of hope and maintaining a sense of control over one's life, even in the face of death. It can help individuals cope with the uncertainty and fear associated with dying. Thinking about both models can help us better understand and support individuals coping with death. The Kübler-Ross stages provide a framework for understanding the emotional experiences that individuals may go through, while Corr's Task-Based model emphasizes the ongoing and dynamic nature of coping. By considering both models, we can tailor our support to meet the specific needs of individuals facing death, helping them navigate the emotional, psychological, and spiritual challenges of the dying process. 4) Given the many models presented in this chapter that scholars have developed to better understand and help those experiencing death and dying, what research methods do you think are best suited to studying the processes and coping strategies associated with facing the end of life? In your essay explain how specific quantitative and/or qualitative methods are, or are not, well suited to empirically testing at least two of the models presented in this chapter (i.e., Kübler-Ross stages of dealing with dying, Corr’s Task-Based model of coping with dying, Grove’s Spiritual Pain framework, Farran’s Process of Hope). Answer: Studying the processes and coping strategies related to death and dying benefits from a combination of quantitative and qualitative methods: • Quantitative methods like surveys and content analysis can quantify aspects of grief and coping strategies, useful for assessing the prevalence and sequence of models like Kübler-Ross' stages or Corr's Task-Based model. However, they may oversimplify complex experiences. • Qualitative methods like interviews and narrative analysis offer in-depth insights into individuals' experiences and coping strategies. They are suitable for exploring models like Grove's Spiritual Pain framework or Farran's Process of Hope, providing rich data to validate and refine these models. Combining these methods provides a more comprehensive understanding, enhancing our ability to support individuals facing the end of life. 5) Discuss the importance of planning for one’s death. What are some of the ways an individual can do this? What, specifically, does each of the options entail? Answer: Planning for one's death is a crucial aspect of preparing for the inevitable. It not only helps individuals ensure that their wishes are respected but also provides peace of mind to both themselves and their loved ones. There are several ways an individual can plan for their death: 1. Creating a Will: A will is a legal document that outlines how a person's assets and estate should be distributed after their death. It allows individuals to specify their wishes regarding property, finances, and guardianship of minor children. Creating a will ensures that one's assets are distributed according to their wishes, minimizing disputes among family members. 2. Advance Directive: An advance directive, also known as a living will, is a legal document that specifies a person's wishes regarding medical treatment in the event that they are unable to communicate their wishes themselves. It can include instructions regarding life-sustaining treatments such as ventilators or feeding tubes. Creating an advance directive ensures that one's healthcare preferences are known and respected. 3. Durable Power of Attorney for Health Care: This legal document allows an individual to appoint a trusted person to make healthcare decisions on their behalf if they become unable to do so. It ensures that someone who knows their wishes and values is making decisions about their care. 4. Funeral and Burial Planning: Pre-planning funeral and burial arrangements can relieve loved ones of the burden of making these decisions during a difficult time. It allows individuals to specify their preferences for burial or cremation, funeral services, and other arrangements. 5. Organ Donation: Individuals can also choose to become organ donors by registering with their state's organ donor registry. This decision can potentially save lives and improve the quality of life for others after their death. Each of these options entails careful consideration and documentation. It is important for individuals to discuss their wishes with their loved ones and ensure that their plans are legally binding and up to date. Planning for one's death can provide peace of mind and ensure that one's wishes are respected, making the process easier for loved ones during a difficult time. Chapter 9: Intensive Caring: Hospice and Palliative Care Test Questions Part I. Multiple Choice Questions Select the response that best answers the following questions. 1) End-of-life care for people who are not expected to live longer than six months is the role of __________. A) palliative care B) living wills C) intensive care D) hospice Answer: D 2) In __________, patients have to abandon curative care. A) palliative care B) hospice C) cancer treatment D) intensive care Answer: B 3) The __________ model of care is not generally person-centered or holistic. A) biomedical B) intensive caring C) hospice D) wellness paradigm Answer: A 4) In the wellness paradigm of medical care, efforts are aimed at __________. A) eliminating disease B) prolonging life C) defeating death D) caring for the whole person Answer: D 5) In the biomedical model of medical care, care is aimed at __________. A) accepting disease and death B) spiritual care C) prolonging life D) alleviating suffering Answer: C 6) All societies have idealized concepts about proper and improper ways to die, the preferred manner being __________. A) the good death B) biomedical treatment C) ceremonial D) prolonging life Answer: A 7) In contemporary America there is often a disconnect between __________ and __________. A) care, pain management B) funerals, cremation C) the good death, end of life care D) science, technology Answer: C 8) The work of __________ paved the way for the modern hospice movement. A) Saint Christopher B) Dame Cicely Saunders C) David Tasma D) Bishop Basil Answer: B 9) The first hospice in the U.S. was located in __________. A) Rhode Island B) Tennessee C) California D) Connecticut Answer: D 10) The first hospice organization in the U.S. was formed in __________. A) 1945 B) 1960 C) 1975 D) 1990 Answer: C 11) The term __________ care has roots in the Latin language denoting that it is aimed at alleviating suffering. A) palliative B) preventative C) intensive D) biomedical Answer: A 12) Which organization has formally defined palliative care? A) World Health Organization B) U.S. Government C) American Pediatrics Association D) Canadian Nurse’s Union Answer: A 13) HBPCP stands for __________. A) holistic-based preventative care policies B) hospital-based palliative care programs C) hospital-based patient care policies D) holistic-based person-centered programs Answer: B 14) Most patients that die __________ are under hospice care. A) suddenly B) in a hospital C) at home D) in a nursing home Answer: C 15) Estimates suggest that up to __________ percent of American hospitals now offer palliative care services. A) 10 B) 20 C) 45 D) 60 Answer: B 16) In a palliative care team a __________ is frequently the team coordinator. A) chaplain B) social worker C) doctor D) nurse Answer: D 17) For about a decade, Carl has suffered from back pain without relief. What type of pain best describes Carl’s condition? A) acute B) chronic C) incident D) breakthrough Answer: B 18) Sandra is currently bedridden in a nursing home. She frequently experiences hip pain until the nurse’s aid repositions her. What type of pain best describes Sandra’s condition? A) acute B) chronic C) incident D) breakthrough Answer: C 19) According to the WHO guide for using medications to control cancer pain there are __________ levels to pain management for cancer patients. A) two B) three C) four D) six Answer: B 20) The medical term for severe shortness of breath is __________. A) anemia B) dyspnoea C) congestion D) obstruction Answer: B 21) The “death rattle” falls under which of the following symptoms associated with the last stages of illness? A) reduced consciousness B) gastrointestinal problems C) breathing difficulties D) weight loss Answer: C 22) The term __________ pain describes pain as a physical, psychological, social, and spiritual experience. A) episodic B) chronic C) acute D) total Answer: D 23) What legal document do health-care providers follow when an individual is at the end of life or is unable to communicate? A) living will B) DNR C) power of attorney D) trust Answer: A 24) Approximately 70 percent of hospice is funded by __________. A) out of pocket savings B) private insurance C) Medicare D) Medicaid Answer: D 25) The limited resources of small communities is a problem for what healthcare program? A) Medicare B) Medicaid C) Social Security D) Disability Answer: A Part II. Essay Questions Answer the following questions in your own words. 1) Explain the basic differences between the biomedical model of care and palliative medicine. Answer: The biomedical model of care focuses primarily on the biological aspects of disease and illness. It emphasizes the diagnosis and treatment of specific symptoms or conditions using medical interventions such as medications, surgery, and other procedures. This model tends to view health as the absence of disease and aims to cure or manage illness through these interventions. On the other hand, palliative medicine is a specialized area of healthcare that focuses on improving the quality of life for patients facing serious illness. Palliative care addresses the physical, emotional, social, and spiritual needs of patients and their families, aiming to provide relief from the symptoms and stress of illness. Unlike the biomedical model, palliative care is not limited to end-of-life situations and can be provided alongside curative treatments. In summary, the biomedical model of care is centered on treating the biological aspects of disease, while palliative medicine focuses on holistic care to improve the quality of life for patients with serious illness. 2) Describe the evolution of hospice palliative care in North America. Why does the author refer to it as “hospice palliative care”? Answer: Hospice palliative care in North America has evolved significantly over the past few decades. Initially, the concept of hospice care emerged in the United Kingdom in the 1960s, emphasizing holistic care for terminally ill patients, focusing on pain and symptom management, emotional and spiritual support, and enhancing quality of life. In North America, hospice care began to gain traction in the 1970s, with the first hospice program established in the United States in 1974. These early programs were largely independent, community-based initiatives focused on providing end-of-life care outside of traditional healthcare settings. Over time, the concept of hospice care expanded to include a broader range of services and settings, leading to the development of the hospice palliative care approach. This approach recognizes that palliative care principles can benefit patients at various stages of illness, not just those at the end of life. As a result, the term "hospice palliative care" is used to encompass both hospice care for those nearing the end of life and palliative care for patients with serious illnesses who may still be receiving curative treatments. The evolution of hospice palliative care in North America has been driven by a growing recognition of the importance of providing comprehensive, compassionate care for individuals with serious illnesses. This approach emphasizes the importance of addressing not only physical symptoms but also psychological, social, and spiritual aspects of care, in order to improve quality of life for patients and their families. 3) Explain the various roles of a “hospice team.” What parties are involved and, specifically, what are their responsibilities to patient care? Answer: A hospice team is a multidisciplinary group of healthcare professionals and volunteers who work together to provide comprehensive care for patients receiving hospice services. The team is typically led by a hospice physician or medical director and includes the following members: 1. Hospice Physician/Medical Director: The physician oversees the patient's care plan, collaborates with other healthcare providers, and provides medical guidance and expertise. 2. Registered Nurse (RN): The RN coordinates and manages the patient's care, provides skilled nursing care, and serves as a liaison between the patient, family, and other members of the hospice team. 3. Hospice Aide: The hospice aide provides personal care and assistance with activities of daily living, such as bathing, grooming, and dressing. 4. Social Worker: The social worker provides emotional support, counseling, and assistance with practical matters such as advance care planning, financial concerns, and accessing community resources. 5. Chaplain or Spiritual Care Provider: The chaplain or spiritual care provider offers spiritual support and guidance according to the patient's beliefs and values, and assists with end-of-life spiritual care needs. 6. Volunteers: Volunteers provide companionship, respite care, and practical assistance to patients and their families. 7. Bereavement Coordinator: The bereavement coordinator provides support and counseling to the patient's loved ones before and after the patient's death. The responsibilities of the hospice team include: • Developing and implementing a comprehensive care plan tailored to the patient's needs and preferences. • Managing pain and other symptoms to ensure the patient's comfort and quality of life. • Providing emotional support and counseling to the patient and their family. • Educating the patient and family about the disease process, treatment options, and end-of-life care. • Coordinating care with other healthcare providers and community resources. • Providing bereavement support to the patient's loved ones after the patient's death. Overall, the hospice team works together to ensure that the patient receives compassionate, holistic care that addresses their physical, emotional, social, and spiritual needs during the end-of-life journey. 4) What are the most common symptoms associated with the last stages of illness? Describe how each of the symptom categories manifest in patients at the end of life. Answer: In the last stages of illness, patients often experience a range of physical, psychological, and spiritual symptoms. Common symptoms include: 1. Pain: Pain is a prevalent symptom in patients at the end of life and can be caused by the underlying illness, treatments, or other factors. Pain may be experienced as dull, aching, sharp, or throbbing and can be localized or widespread. 2. Fatigue: Patients often experience extreme tiredness and lack of energy in the last stages of illness. This can be due to the illness itself, as well as side effects of treatments and the body's overall decline. 3. Shortness of Breath: Difficulty breathing can occur as the body weakens and the disease progresses. This symptom can be distressing and may require interventions such as oxygen therapy or medications. 4. Loss of Appetite: Many patients experience a decreased desire to eat as their illness advances. This can be due to a variety of factors, including changes in metabolism, side effects of treatments, and the body's natural decline. 5. Nausea and Vomiting: These symptoms can occur due to the illness itself, as well as side effects of medications and treatments. They can be distressing and impact a patient's quality of life. 6. Constipation: Patients may experience constipation due to factors such as decreased mobility, changes in diet, and medications. This can be uncomfortable and contribute to overall discomfort. 7. Delirium: Delirium is a state of confusion that can occur in patients at the end of life. It may be caused by factors such as the underlying illness, medications, or metabolic imbalances. 8. Anxiety and Depression: Patients may experience heightened anxiety or depression as they near the end of life. This can be due to a variety of factors, including the awareness of their prognosis, pain and other symptoms, and changes in their social and emotional support. 9. Spiritual Distress: Patients may experience spiritual distress as they reflect on their life and prepare for death. This can manifest as feelings of guilt, anger, or fear, as well as a desire for spiritual comfort and connection. 10. Weakness and Decline in Functional Status: Patients often experience a decline in physical strength and functional abilities as their illness progresses. This can impact their ability to perform daily activities and contribute to feelings of fatigue and dependence. Overall, the management of symptoms in patients at the end of life requires a holistic approach that addresses physical, psychological, and spiritual needs. Effective symptom management can improve quality of life and provide comfort and dignity to patients as they approach the end of life. 5) Describe the two government-funded programs that help cover medical expenses for Americans. What are their similarities and differences? How do the programs operate? Answer: The two main government-funded programs in the United States that help cover medical expenses for Americans are Medicare and Medicaid. Similarities: 1. Both programs are funded by the federal government, but they are administered by states in the case of Medicaid, and by the federal government for Medicare. 2. Both programs provide healthcare coverage to eligible individuals, but they serve different populations. 3. Both programs help cover a range of medical expenses, including hospital stays, doctor visits, and prescription drugs. Differences: 1. Eligibility: Medicare is primarily for individuals aged 65 and older, as well as certain younger individuals with disabilities. Medicaid, on the other hand, is available to low-income individuals and families, as well as certain other populations such as pregnant women and people with disabilities. 2. Coverage: While both programs cover a range of medical services, Medicare provides more comprehensive coverage for seniors and certain disabled individuals. Medicaid coverage varies by state and may include additional benefits beyond what Medicare offers. 3. Cost-sharing: Medicare recipients typically pay premiums, deductibles, and coinsurance for certain services. Medicaid, however, is a means-tested program, meaning that costs are based on income and assets, and may include minimal or no cost-sharing for eligible individuals. 4. Administration: Medicaid is administered by states according to federal guidelines, leading to variations in coverage and eligibility requirements across states. Medicare is administered directly by the federal government, providing more consistency in coverage and eligibility nationwide. Operation: Medicare operates as a federal program that provides health insurance to eligible individuals through several parts: • Part A covers hospital stays, skilled nursing facility care, hospice care, and some home health care. • Part B covers certain doctor services, outpatient care, medical supplies, and preventive services. • Part C, also known as Medicare Advantage, allows beneficiaries to receive their Medicare benefits through private health plans approved by Medicare. • Part D provides prescription drug coverage. Medicaid, on the other hand, is a joint federal and state program that provides health coverage to eligible low-income individuals and families. States administer their own Medicaid programs within federal guidelines, so benefits and eligibility can vary widely between states. States receive federal funding to help cover the costs of their Medicaid programs, and they have some flexibility in designing and implementing their programs, which can lead to differences in coverage and eligibility criteria between states. Test Bank for Death, Dying and Bereavement in a Changing World Alan R Kemp 9780205961009
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