![]() ![]() ![]() Patients should be made aware that they can participate in their end-of-life care in two distinct ways: by actively making decisions at the end of their life and by making decisions about how they believe they would wish to be cared for based on a hypothetical scenario of impairment. 3,4 Health care providers should have a heightened awareness about the variations in perception, acceptance, participation, and family relations regarding the dying patient. 3 People's responses to death fall into three general categories: acceptance of death (viewing death as inevitable and as a natural part of the life cycle) defiance of death or denial of death-refusing to confront death and attempting to protect themselves from it while viewing death as an abnormal part of the human experience. 2Īccording to Munoz and Luckmann, while death is universal, responses to death and dying ( TABLE 2) are developed by cultures of people with their own set of beliefs, mores, norms, standards, and restrictions. Nuland described in his book How We Die the following characteristics of certain universal processes all individuals experience as they die: "the stoppage of circulation the inadequate transport of oxygen to tissues the flickering out of brain function the failure of organs the destruction of vital centers." 2 Nuland states that while the above processes are universal, each death is a story as distinctive as the face shown during our lives, and choices can be made allowing each of us to have our own death. 2 Author, surgeon, and professor of medicine Sherwin B. Although the universal factor in all death is ultimately loss of oxygen, the cause of death may be due to a variety of diseases and disorders with or without disease, however, the body continues to age and death is inevitable. ![]()
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