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- alternative to hospital
care at the end of life that emphasizes the physical, emotional, social, and spiritual needs of dying persons and their families
o Has become increasingly popular in developed countries
o The hospice approach only begins when medical interventions to extend life have ceased and the person is considered to have 6 months or less to live
o Is sometimes implemented at a separate institution devoted to hospice, but more often is applied in the home/nursing home
§ Makes it possible for
people to die among family members as they prefer
o It has been shown that dying persons and their families respond much more favorably to it than standard hospital care
§ Hospice care is also much less expensive than hospital care
o Only 40% of deaths in the US involve a hospice program
o Hospice tends to only be applied at the very end of a life, with a median length of 20 days
o Among people who have died using hospice, 46% are white, 37% Latino, 34% African American, 31%
Native American, and 28% Asian American
o Some people are against hospice because it means giving up the hope of a cure and acknowledging that death is imminent
o Has prolonged effects on the widowed, but these effects are complex and vary by gender
o Among the widowed spouse, psychological problems are 10x higher than among their married peers, including depression, anxiety, substance use, and cognitive difficulties with memory and concentration
o
80% of women outlive their husbands
§ This pattern is consistent across cultures, nations, and historical periods
§ Widows often struggle financially after their husbands die and are unlikely to remarry
· However, strengthen relationships with children and friends and try to build a new life
o Men are more likely to experience physical and mental health problems following the death of a spouse, and recover more slowly
§ 7x more likely to remarry than women
o Upon death the eyes are clothes, the body is covered and laid on the floor, and candles are lit
o The body is not to be left alone, and eating and drinking in the room is forbidden. Flowers can also not be present
o The body is buried in a grave but not cremated
§ After the burial, family members enter an intense 7 day period called shiva
· During this time they can only sit on the floor, do not work, bathe, cut their hair, wear makeup, or change their clothes
·
Following shiva, another period of restriction called schloshim lasts until 30 days after burial
o Mourners may not shave, cut their hair, attend parties, or listen to music
o Upon hearing of the death of a family member or close friend, the tradition is to express grief by tearing one's clothes