SYA7933: Aging and End-of-Life Issues
Fall
2006
Class: Tuesdays 3:00-6:00 p.m. in sociology conference room
Instructor:
Monika
Ardelt, Ph.D.
Office:
3350
Turlington
Phone:
392-0251
ext. 247
E-mail:
Ardelt@soc.ufl.edu
Office
Hours: Tuesdays
and Thursdays 1:45-2:45 p.m. and by appointment
WWW:
http://web.clas.ufl.edu/users/ardelt/
Course Content
What constitutes dying well for older
persons, and how can families and institutions make the dying
experience less
painful and more emotionally rewarding for the dying and those close to
them? I
define dying well as the maintenance of psychological well-being, even
under
adverse circumstances. Based on a theoretical orientation that assumes
life-long psychosocial development and potential for psychological
growth, the
dying experience can be considered the last developmental milestone of
a
person’s life course. However, dying well in old age is still a
relatively
neglected topic. Unfortunately, dying well also appears to be the
exception
rather than the norm. Too many older people spend their last days or
hours of
their lives in places, such as hospitals or nursing homes, that may not
spare
any expenses to keep them alive but lack the human contact and
compassion to
facilitate a “good” death.
In this course, we will
explore the issues
surrounding dying well from multiple perspectives, including sociology,
psychology, biology, medical sciences, ethics, history,
spirituality/religion,
and economics. In particular, we will start by studying dying well from
a
developmental or life course perspective. Then we will discuss the
medical,
psychological, social, spiritual/religious, economic, ethical, and
legal
aspects of death and dying. We will end the course by considering
cultural
variations in end-of-life issues, examining the grieving process for
survivors,
and discussing the question of life after death.
Required
Gaughen, Shasta. 2003. Coping with Death. Contemporary
Issues Companion.
Nakaya, Andrea C. 2005. Terminal
Illness.
Opposing Viewpoints.
Additional reading will be made available to students through the instructor’s “library”.
Recommended
Maimon,
Elaine P.,
Janice H. Peritz, and Kathleen Blake Yancey. 2007. A Writer’s Resource.
A
Handbook for Writing and Research. 2nd Edition.
Requirements
To prevent the instructor from doing all of
the talking during class, each student will serve as the
presentation/discussion leader for two class sessions, which will be
rewarded
with 10% of the final grade (5% for each class session). There might be
more
than one presentation/discussion leader for a given topic. The tasks of
the
presentation/discussion leader(s) are to introduce the topic, to ask
questions
to initiate a discussion, and to guide the discussion.
Attendance: Attendance of class is
required because non-attendance by several students at a time will
destroy the
dynamic of the class. Students who have to miss all or part of a class
session
must inform the instructor in advance about their absence.
Service Learning Project: To facilitate learning and to understand the
material
from an experiential perspective, students are asked to volunteer for
2-4 hours
each week (after receiving the appropriate training) either at Haven
Hospice of
North Central Florida http://www.havenhospice.org/htm/vol.htm
or at one of the following nursing homes: Gainesville Health Care
Center, The Manor
at Gainesville, North Florida Rehab & Specialty Care, and
University Place
Care & Rehab. As their volunteering experience, students should
assist
and/or be a companion to older residents who are near the end of their
lives. Information
about the above agencies can be found at the Florida Campus Compact
Service
Learning Pro website. Go to http://uf.floridacompact.org/,
click
on “community partners” and then click on the list of approved
agencies. Click
on the agency you would like to volunteer with and contact the contact
person
of the agency by phone and/or e-mail.
Reflection
Journal:
For each class, you will write at least three pages (i.e., a minimum
of 72
lines) for a reflection “journal”. Reflections should be typed
and
double-spaced and should contain a heading that identifies the
student and
the class topic. To receive credit for the reflection journal entries,
you
should submit them during the class for which the entries were
written.
Each set of reflection journal entries is worth 3 points for a total of
36% of
your final grade.
Before you start volunteering, the reflection journal
entries will consist of one or more questions based on the assigned
readings
and possible answers to those questions or issues that should be
considered
when attempting to answer those questions. Reflect how the readings
might be
relevant for your personal or professional life.
After you started
volunteering,
the reflection journal entries will begin with a detailed description
of the
service learning experience during the past week. This will be followed
by an
analysis of the experience, particularly with regard to the current
class topic
and the assigned readings. End by reflecting on the relevance of the
service
learning experience and/or the course content for your personal or
professional
life. For each set of reflection journal entry, use the following
subheadings:
(a) service learning experience from <date(s)>, (b) analysis of
the
service learning experience, (c) application to personal or
professional life.
The following are guidelines for writing the
description of your service learning experience:
1. Write down the date, time, and location of the service learning experience.
2. Describe the environment (does not need to be repeated if the environment does not change in subsequent visits).
3. Describe all persons in detail, i.e., age, gender, race, physical appearance, etc. (does not need to be repeated if the same persons are encountered in subsequent visits).
4. Make sure that all persons remain anonymous, i.e., use only pseudonyms as names.
5. Describe what people are doing when you arrive. Give a physical description of the people – clothes etc.
6. Give your impression of the resident(s) – (mental alertness, physical demeanor, etc.)
7. Describe your service learning experience in chronological order and in as much detail as possible.
8. Include any information that you think would be noteworthy.
Term Paper: There will be one term
paper that is due on December 5 during regular class time. The term
paper
should be based on your service learning project and your reflection
journal.
It should be between 15 and 25 pages long. Detailed instructions for
the term
paper will be distributed in class.
Cheating: I define copying parts or
all of an author’s or another student’s work, allowing another student
to copy
parts or all of your work, or simply duplicating parts or all of your
reflection journal entries as cheating.
WARNING: Students who are caught cheating in
this way will fail the class immediately!
Exams: There are no exams in this
course!
Accommodations
for Students with Disabilities:
Students requesting classroom accommodation must
first register with the Dean of Students Office. The Dean of Students
Office
will provide documentation to the student who must then provide this
documentation to the Instructor when requesting accommodation.
Grading
|
Requirement
Term paper Presentation of paper |
% of
Final Grade
10%
33%
47%
10% |
I will not grade on a curve, i.e. your grade
will depend on your absolute performance, not your performance compared
to
other students.
The points that you will earn can be
translated into letter-grades as follows:
|
90.0 - 100.0 = A |
70.0 - <77.5
= C |
Tentative Class Schedule
08/29 - Introduction: Preparing to Become a Compassionate Companion
09/05 - No class
No regular class: Meet at ET York Hospice Care Center (4200 NW 90th Blvd, GVL Fl 32606; phone: 352-378-2121) located in the Health Park off of NW 39th near the I-75 interchange for Hospice volunteer training on August 29, August 31, September 5, and September 7 from 6-9 p.m.
09/12 - Living with Death and Dying
Coping with death: pp. 15-20.
Tolstoï.
1899. The Death of Ivan Ilyitch.
Rolheiser, Ron. 2005. “Life’s Key Question.” Good News 12, Oct. 15-16.
Chinen,
Allen B. 1995. “The Mortal King.”
Pp. 335-36 in The Path Ahead. Readings in
Death and Dying, edited by L. A. DeSpelder and A. L. Strickland.
Attig,
Thomas. 1995. “Coping With
Mortality: An Essay on Self-Mourning.” Pp. 337-41 in The
Path Ahead. Readings in Death and Dying, edited by L. A.
DeSpelder and A. L. Strickland.
Killilea,
Alfred G. 1995. “The Politics
of Being Mortal.” Pp. 342-47 in The Path
Ahead. Readings in Death and Dying, edited by L. A. DeSpelder and
A. L.
Strickland.
Bertman,
Sandra L. 1995. “Bearing the
Unbearable: From Loss, the Gain.” Pp. 348-54 in The Path
Ahead. Readings in Death and Dying, edited by L. A.
DeSpelder and A. L. Strickland.
Enck, Graves. 2003. “The Dying Process.” Pp. 457-67 in Handbook of Death and Dying. Vol. I: The presence of death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
09/19- Biological, Psychosocial, and Spiritual
Perspectives
of the Dying Process
Biological Perspective
Nuland,
Sherwin B. 1994. How We Die. Reflections on Life’s Final
Chapter.
Coping with death: pp. 11-14.
Psychosocial Perspective
Kübler-Ross,
Elisabeth. 1969. On Death and Dying.
Edgley, Charles. 2003. “Dying as Deviance. An Update on the Relationship between Terminal Patients and Medical Settings.” Pp. 448-56 in Handbook of Death and Dying. Vol. I: The presence of death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
Spiritual Perspective
Kübler-Ross,
Elisabeth. 1999. “The Cocoon
and the Butterfly.” Pp. 41-76 in The
Tunnel and the Light. Essential Insights on Living and Dying,
edited by G.
Grip.
Dass, Ram.
2001. Still
Here: Embracing Aging, Changing, and Dying.
Singh,
Kathleen Dowling. 2000. The Grace in Dying: How We Are
Transformed
Spiritually as We Die.
09/26
- Hospice and Palliative
Care
Terminal illness: pp. 19-35, 49-90, 102-112
Coping with death: pp. 51-54, 114-125
Singer, Peter A., Douglas K. Martin, and Merrijoy Kelner. 1999. “Quality End-of-Life Care: Patients’ Perspectives.” Journal of the American Medical Association 281:163-68.
Byock,
Ira R. 1996. “The Nature of Suffering
and the Nature of
Leming, Michael R. 2003. “The History of the Hospice Approach.” Pp. 485-94 in Handbook of Death and Dying. Vol. I: The presence of death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
Connor,
Stephen R. 2000. “Hospice Care
and the Older Person.” Pp. 227-38 in Death
Attitudes and the Older Adult. Theories, Concepts, and Applications,
edited
by A. Tomer.
Brabant, Sarah. 2003. “Death in Two Settings. The Acute Care Facility and Hospice.” Pp. 475-84 in Handbook of Death and Dying. Vol. I: The presence of death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
Zerzan, Judy, Sally Stearns, and Laura Hanson. 2000. “Access to Palliative Care and Hospice in Nursing Homes.” Journal of the American Medical Association 284:2489-94.
10/03 - Being with Dying
Terminal illness: pp.115-127, 134-141
Wray, Elizabeth. 2003. “Learning to Let Go.” Alternative Medicine 57, May 2003: 88-126.
Vig, Elizabeth K., Nathaniel A. Davenport, and Robert A. Pearlman. 2002. “Good Deaths, Bad Deaths, and Preferences for the End of Life: A Qualitative Study of Geriatric Outpatients.” Journal of the American Geriatrics Society 50:1542-48.
Kovacs, Pamela J. and David P. Fauri. 2003. “Formal and Informal Caregiving at the End of Life.” Pp. 502-10 in Handbook of Death and Dying. Vol. I: The presence of death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
Fahnestock, Deborah T. 1999. “A Piece of My Mind: Partnership for Good Dying.” Journal of the American Medical Association 282:615-16.
Orr, Robert D. 2001. “A Piece of My Mind: You Have the Power.” Journal of the American Medical Association 286:2067-68.
Sachs, Greg A. 2000. “A Piece of My Mind: Sometimes Dying Still Stings.” Journal of the American Medical Association 284:2423.
10/10 - The Role of Religion and Spirituality at
the End of
Life
Terminal illness: pp. 128-133
Coping with death: pp. 38-43, 108-113
Daaleman, Timothy P. and Larry VandeCreek. 2000. “Placing Religion and Spirituality in End-of-Life Care.” Journal of the American Medical Association 284:2514-17.
Thibault, Jane. 2003. “How Can Health Care Professionals Meet the Spiritual Needs of Dying Older Patients.” Geriatric Times I:6pp.
Doka,
Kenneth J. 1993. “The Spiritual
Need of the Dying.” Pp. 143-50 in Death
and Spirituality, edited by K. J. Doka and J. D. Morgan.
Morgan, John D. 2003. “Spirituality.” Pp. 110-16 in Handbook of Death and Dying. Vol. I: The presence of death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
Leming, Michael R. 2003. “Religion and the Mediation of Death Fear.” Pp. 117-25 in Handbook of Death and Dying. Vol. I: The presence of death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
Siegel, Karolynn and Eric W. Schrimshaw. 2002. “The Perceived Benefits of Religious and Spiritual Coping Among Older Adults Living With HIV/AIDS.” Journal for the Scientific Study of Religion 41:91-102.
Horrigan, Bonnie. 2001. “Therese Schroeder-Sheker: Music Thanatology and Spiritual Care for the Dying.” Alternative Therapies 7: 69-77.
10/17
- The Cost of Health Care
and End-of-Life Care for Older Adults
Coping with death: pp. 55-60
Brogden,
Mike. 2001. Geronticide. Killing the Elderly.
Callahan,
Daniel. 1990. “Why We Must Set
Limits.” Pp. 23-36 in A Good Old Age? The
Paradox of Setting Limits, edited by P. Homer and M. Holstein.
Holstein,
Martha. 1990. “Voices of the
Old.” Pp. 37-43 in A Good Old Age? The
Paradox of Setting Limits, edited by P. Homer and M. Holstein.
Wetle,
Terrie and Richard W. Besdine.
1990. “Letting Individuals Decide.” Pp. 53-57 in A Good
Old Age? The Paradox of Setting Limits, edited by P. Homer
and M. Holstein.
Perry,
Daniel and Robert N. Butler. 1990.
“Aim Not Just for Longer Life, but Expanded ‘Health Span’.” Pp. 91-94
in A Good Old Age? The Paradox of Setting
Limits, edited by P. Homer and M. Holstein.
Somers,
Anne R. 1990. “Setting Limits or
Promoting Health?” Pp. 101-5 in A Good
Old Age? The Paradox of Setting Limits, edited by P. Homer and M.
Holstein.
Reagan,
Michael D. 1993. “Is Global
Budgeting the Way to Set Limits on Health Care for the Elderly?” Pp.
125-35 in Facing Limits. Ethics and Health Care for
the Elderly, edited by G. R. Winslow and J. W. Walters.
Menzel,
Paul T. 1993. “Counting the Costs
of Lifesaving Interventions for the Elderly.” Pp. 137-49 in Facing
Limits. Ethics and Health Care for
the Elderly, edited by G. R. Winslow and J. W. Walters.
Begley,
Charles E. 1993. “Cost
Containment and Conflicts of Interest in the Care of the Elderly.” Pp.
151-60
in Facing Limits. Ethics and Health Care
for the Elderly, edited by G. R. Winslow and J. W. Walters.
Schneider,
Edward L. 1993. “Changing the
Debate about Health Care for the Elderly.” Pp. 161-74 in Facing
Limits. Ethics and Health Care for the Elderly, edited by G.
R. Winslow and J. W. Walters.
Spielman,
Bethany. 1993. “Achieving
Equity and Setting Limits: The Importance of Gender.” Pp. 177-89 in Facing Limits. Ethics and Health Care for
the Elderly, edited by G. R. Winslow and J. W. Walters.
Culpepper,
Emily Erwin. 1993. “Ageism,
Sexism, and Health Care: Why We Need Old Women in Power.” Pp. 191-209
in Facing Limits. Ethics and Health Care for
the Elderly, edited by G. R. Winslow and J. W. Walters.
Veatch,
Robert M. 1993. “How Age Should
Matter: Justice as the Basis for Limiting Care to the Elderly.” Pp.
211-29 in Facing Limits. Ethics and Health Care for the
Elderly, edited by G. R. Winslow and J. W. Walters.
Winslow,
Gerald R. 1993. “Exceptions and
the Elderly.” Pp. 231-43 in Facing
Limits. Ethics and Health Care for the Elderly, edited by G. R.
Winslow and
J. W. Walters.
10/24
- Euthanasia and
Physician-Assisted Suicide
Terminal illness: pp. 91-101, 144-188
Coping with death: pp. 126-136
Quill, Timothy E. 1993. “Doctor, I Want to Die. Will You Help Me?” Journal of the American Medical Association 270:870-73.
Angell,
Marcia. 1997. “The Supreme Court
and Physician-Assisted Suicide - The Ultimate Right.” The
Foley,
Kathleen M. 1997. “Competent Care
for the Dying Instead of Physician-Assisted Suicide.” The
Eddy, David M. 1994. “A Piece of My Mind: A Conversation with My Mother.” Journal of the American Medical Association 272:179-81.
Muskin, Philip R. 1998. “The Request to Die: Role for a Psychodynamic Perspective on Physician-Assisted Suicide.” Journal of the American Medical Association 279:323-28.
Hardwig,
John. 1997. “Is There a Duty to
Die?”
Osgood,
Nancy J. 2000. “Ageism and
Elderly Suicide: The Intimate Connection.” Pp. 157-73 in Death
Attitudes and the Older Adult. Theories, Concepts, and
Applications, edited by A. Tomer.
Moody, Janis. 2003. “Euthanasia: A Need for Reform.” Nursing Standard 17:40-44.
Yeoman, Barry. 2003. “Colleen’s Choice.” AARP The Magazine:66-68,71.
Meier, Diane E. 1998. A Change of Heart on Assisted Suicide. The New York Times, April 24, 1998.
McNeil, Donald G. Jr. 2003. “First Study on Patients Who Fast to End Lives.” The New York Times, July 31, 2003.
10/31
- Legal Preparations for
the End-of-Life
Terminal illness: pp. 36-48
Coping with death: pp. 44-50, 61-65, 141-147
Pevey, Carolyn. 2003. “Living Wills and Durable Power of Attorney for Health Care.” Pp. 891-98 in Handbook of Death and Dying. Vol. II: The response to death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
Fagerlin,
Angela and Carl E. Schneider. 2004.
“Enough. The Failure of the Living Will.”
Miller, Robert K. Jr, Jeffrey Rosenfeld, and Stephen J. McNamee. 2003. “The Disposition of Property. Transfers between the Dead and the Living.” Pp. 917-25 in Handbook of Death and Dying, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
Bryant, Clifton D. and William E. Snizek. 2003. “The Last Will and Testament. A Neglected Document in Sociological Research.” Pp. 926-33 in Handbook of Death and Dying, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
11/07
- No class
11/14 - Cultural Variations in End-of-Life Issues
Meagher,
David K. and Craig P. Bell.
1993. “Perspectives on Death in the Africa-American Community.” Pp.
113-30 in Death and Spirituality, edited by K. J.
Doka and J. D. Morgan.
Cicirelli,
Victor G. 2000. “Older Adult’s
Ethnicity, Fear of Death, and End-of-Life Decisions.” Pp. 175-91 in Death Attitudes and the Older Adult.
Theories, Concepts, and Applications, edited by A. Tomer.
Mouton,
Charles P. 2000. “Cultural and
Religious Issues for African Americans.” Pp. 71-82 in Cultural
Issues in End-of-Life Decision Making, edited by K. L.
Braun, J. H. Pietsch, and P. L. Blanchette.
Talamantes,
Melissa A., Celina Gomez, and
Kathryn L. Braun. 2000. “Advance Directives and End-of-Life Care: The
Hispanic
Perspective.” Pp. 83-100 in Cultural
Issues in End-of-Life Decision Making, edited by K. L. Braun, J. H.
Pietsch, and P. L. Blanchette.
Yeo,
Gwen and Nancy Hikoyeda. 2000.
“Cultural Issues in End-of-Life Decision Making Among Asians and
Pacific
Islanders in the
Van
Winkle, Nancy Westlake. 2000.
“End-of-Life Decision Making in American Indian and
Krakauer, Eric L., Christopher Crenner, and Ken Fox. 2002. “Barriers to Optimum End-of-Life Care for Minority Patients.” Journal of the American Geriatrics Society 50:182-90.
11/21
- Grieving
Coping with death: pp. 67-72, 80-83, 97-100
Doka,
Kenneth J. 1993. “The Spiritual
Crisis of Bereavement.” Pp. 185-93 in Death
and Spirituality, edited by K. J. Doka and J. D. Morgan.
Neimeyer, Robert A. and Louis A. Gamino. 2003. “The Experience of Grief and Bereavement.” Pp. 847-54 in Handbook of Death and Dying. Vol. II: The response to death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
Rosenblatt, Paul C. 2003. “Bereavement in Cross-Cultural Perspective.” Pp. 855-61 in Handbook of Death and Dying. Vol. II: The response to death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
11/28
- Is There Life after Death?
Coping with death: pp. 21-36
Dillon, Jane. 2003. “Reincarnation. The Technology of Death.” Pp. 65-76 in Handbook of Death and Dying. Vol. I: The presence of death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
Gowan, Donald E. 2003. “Christian Beliefs Concerning Death and Life After Death.” Pp. 126-36 in Handbook of Death and Dying. Vol. I: The presence of death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
Rodabough, Tillman and Kyle Cole. 2003. “Near-Death Experiences as Secular Eschatology.” Pp. 137-47 in Handbook of Death and Dying. Vol. I: The presence of death, edited by C. D. Bryant et al. Thousand Oaks, CA: Sage.
Kübler-Ross,
Elisabeth. 1999. “Life,
Death and Life after Death.” Pp. 79-106 in The
Tunnel and the Light. Essential Insights on Living and Dying,
edited by G.
Grip.
Rolheiser, Ron. 2004. “The Law of Karma.” February 8, 2004, http://www.ronrolheiser.com/arc020804.html.
12/05 - Class
Presentations of Papers
Maimon,
Elaine P.,
Janice H. Peritz, and Kathleen Blake Yancey. 2007. A Writer’s Resource.
A
Handbook for Writing and Research. 2nd Edition.