17.0: What Does Psychology Say?

Figure 17.1 We typically think of death as occurring in old age, but it can occur at any point in the lifespan. Preparing for death and the grief that can surround it is valuable regardless of when or how death occurs. (credit: modification of work “flame” by Dawn/Flickr, CC BY 2.0)

Ray was only forty-four when he was diagnosed with an aggressive, inoperable cancer. In less than six months, he went from being happy and full of vitality to being in constant pain and completely dependent on others for care. Ray had been known for his sense of humor and outgoing personality, but months of tests and unsuccessful hospital treatments sapped his spirit. Whenever he had visitors, he cried and talked about wanting to die. He ultimately decided not to pursue additional treatment and died shortly thereafter.

Ray’s husband Geoffrey agonized over his situation, wondering whether there was a “right” course of action. They had both prepared legal documents expressing their end-of-life wishes, but he worried it would be too painful to adhere to Ray’s desire to forgo life support equipment if he had to make that decision. Dora, their three-year-old daughter, was too young to understand what was happening. All she knew was that her dad was in the hospital and that he was sad and sick-looking. She worried that she had done something bad to make him go away. After Ray’s death, Dora continued to act as though she expected him to come home.

Ray’s friends had done what they could during his illness, bringing the family food, taking care of Dora, sitting with Ray so Geoffrey could go to work. They even snuck his pet cat in to see him when it was obvious the end was near. After his death, his friends paid tribute to him by creating a slideshow of photos from his life and gathering for a memorial service in the building where he had directed many plays for his community theater group.

Ray and the people in his life all struggled with various elements of the dying process. Although each faced different challenges, all had questions, such as:

• What does it mean to die?
• What options exist for health care at the end of life?
• What are the social and cultural dimensions of death?
• What does grief look like, and how do we support someone who’s grieving?
• What do children understand about death?
• What does it mean to have a good death?

This chapter will explore these and other questions to get a better understanding of the physical, psychological, and social aspects of death.