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  • Dying, Death, /^Bereavement2nd Edition

    A Challenge for Living

    Inge Corless, RN,PIID,FAANBarbara B. Germino, RN,PIID,FAAN

    Mary A. Pittman,



  • Inge Baer Corless, RN, PhD, FAAN, a graduate of the Bellevue Schools of Nursing inNew York City, attended Hunter College and graduated from Boston University witha bachelor's degree in nursing, the University of Rhode Island with a master's degreein sociology, and from Brown University with a PhD in sociology. As a Robert WoodJohnson Clinical Scholar, Dr. Corless did postdoctoral study at the University of Califor-nia, San Francisco. She has held academic positions at Russell Sage College, the Univer-sity of Michigan, the University of North Carolina, Chapel Hill, as well as her currentposition at the MGH Institute of Health Professions at the Massachusetts GeneralHospital. Dr. Corless served as program director of St. Peter's Hospice in Albany, NY,and as a short-term consultant for the World Health Organization at the Western Pacificregional office. A Fellow of the American Academy of Nursing, Dr. Corless has writtenon hospice, end-of-life care, and HIV disease. Dr. Corless co-edited, with Dr. MaryPittman, AIDS: Principles, Practices, and Politics, and, with Dr. Barbara Germino andDr. Pittman, Dying, Death, and Bereavement: Theoretical Perspectives and Other Waysof Knowing, and the first edition of this book. Dr. Corless co-edited, with Zelda Foster,The Hospice Heritage. She coauthored, with James T. Corless, to produce their twodaughters, Theresa lola and Patricia Irene.

    Barbara B. Germino, PhD, RN, FAAN, has had an eclectic career in nursing that hasincluded patient care in three major medical centers, a community hospital, a 25-bedhospital on Kodiak Island, Alaska, and in home care; teaching in four university schoolsof nursing; and research on individual and family responses to life-threatening illness,including interventions to enhance their ability to manage problems and uncertainties,facilitating quality of life. Early work with chronically ill patients, and critical experi-ences, especially those with people who were dying with cancer, stimulated interestsin life-threatening illness and dying. The opportunity to do her doctoral work withJeanne Quint Benoliel, whose work had inspired her over many years, was a crucialexperience. With colleagues in nursing and social work, she developed and teaches aninterdisciplinary graduate course in death, dying, and bereavement across the life-span.She is currently Professor at the School of Nursing, University of North Carolina atChapel Hill, and holds the Carol Ann Beerstecher-Blackwell Chair of Thanatology. Sheis actively involved with the Carolinas Center for End of Life Care, working on a 3-year project to enhance end-of-life care awareness, knowledge, and delivery acrossthe Carolinas.

    Mary Pittman, DrPH, is President of HRET (Hospital Research and Education Trust)and a member of the executive staff of the American Hospital Association. Prior toassuming the leadership of HRET in 1993, she was President and CEO of the CaliforniaAssociation of Public Hospitals. Her areas of interest are community health and accessto vulnerable populations. She has provided education and training on a range of issues,e.g., program evaluation, substance abuse program development, and community healthprogram implementation. She has over 20 years experience in community-based pro-gram planning and design and has developed numerous public policy and legislativeproposals to expand access and quality of health care to underserved populations. Maryhas served as principal investigator on a number of research and demonstration grants.She is co-chair and founder of the Coalition for Healthier Cities and Communities.Mary has co-authored two books, AIDS: Principles, Practices and Politics, and Death,Dying, and Bereavement. She received master's degrees from the University of California-Berkeley in Public Health and City and Regional Planning, and her doctorate fromUC-Berkeley in Public Health Administration. Mary serves on the boards of a numberof organizations, as well as on many national advisory committees.

  • Copyright 2003 by Springer Publishing Company, Inc.

    All rights reserved

    No part of this publication may be reproduced, stored in a retrieval system, or transmittedin any form or by any means, electronic, mechanical, photocopying, recording, orotherwise, without the prior permission of Springer Publishing Company, Inc.

    Springer Publishing Company, Inc.11 West 42nd StreetNew York, NY 10036

    Acquisitions Editor: Ruth ChasekProduction Editor: Janice StangelCover design by Mimi Flow

    06 07 08 09 / 5 4 3 2 1

    New ISBN 0-8261-2656-1 2006 by Springer Publishing Company, Inc.

    Library of Congress Cataloging-in-Publication Data

    Dying, death, and bereavement: a challenge for living / edited by Inge Corless,Barbara B. Germino, Mary A. Pittman. 2nd ed.

    p. cm.Rev. ed. of: A challenge for living. c!995. Published by Jones & Bartlett

    Publishers"Companion volume to Dying, death, and bereavement : theoretical

    perspectives..."Introd.Includes bibliographical references and index.ISBN 0-8261-2655-31. Thanatology 2. Death. 3. Bereavement. 4. Terminal care. I. Corless, Inge B.

    II. Germino, Barbara B. III. Pittman, Mary. IY Challenge for living. Y Dying,death, and bereavement.HQ1073.C464 2003306.9dc21 2003042537

    Printed in the United States of America by Bang Printing.

  • Contents

    Foreword by Dame Cicely Saunders viiIntroduction by Inge CorlessPain by Richard Sabo xviiAcknowledgments xviii

    Part One: The Challenge of Understanding Death

    Artists 3Deborah Holtorf

    1 Communicating About Death and Dying 7Albert Lee Strickland and Lynne Ann DeSpelder

    2 Death Education for Children 25Hannelore Wass

    3 Death Education for Adults 43Charles A. Cor.r

    4 Respecting the Spiritual Beliefs of the Dying and Bereaved 61Thomas Attig

    Part Two: The Challenge of Dying

    The Struggle to End My Father's LifeZelda Foster

    5 Dying in the Hospital 87Patrice O'Connor

    6 Dying at Home 105Barbara B. Germino

    7 Stories of the Living Dying: The Hermes Listener 117Paula G. Balber

    8 Symptom Management for the Terminally 111 145Fredrica Preston, Stephanie Tang, and Ruth McCorkle




  • vi Contents

    9 Hospice and Palliative Care: A Legacy in the Making 181Inge Corless and Patrice Nicholas

    10 Regulatory Issues in the Care of the Dying 201Judi Lund Person

    Part Three: The Challenges of Grief and Bereavement

    I Don't Know How to Grieve 221Colleen Corcoran

    11 The Bereavement Process: Loss, Grief, and Resolution 225Joseph T. Mullan, Leonard I. Pearlin, and Marilyn M. Shaft

    12 Social Support and Mutual Help for the Bereaved 247Phyllis R. Silverman

    13 Helping Children During Bereavement 267Elizabeth P. Lamers

    14 The Study of Sibling Bereavement Research: An Historical 287PerspectiveBetty Davies

    15 Loss of a Pet 303Morris A. Wessel

    Part Four: Related Issues

    Take Me Home 309Bin Yao

    16 The Role of the Social Worker 313Zelda Foster and Kay W. Davidson

    17 Physical Therapists: Palliative Care Competencies 329Theresa H. Michel

    18 Thanatology: Its End and Future (with Special Reference to 345Euthanasia)Larry R. Churchill

    19 The Future of Palliative Care 357Derek Doyle

    Part Five: In Conclusion

    20 Reprise 371Mary A. Pittman

    Index 375

  • Foreword

    Dame Cicely Sounders

    Trained as a nurse during World War II and be-ing invalided out, Dame Cicely Sounders obtained awar degree at Oxford and became a medical socialworker. Concern for the pain control of dying pa-tients, and the distress of their families, moved herto study medicine, and in 1958 she began workamong the patients of St. Joseph's Hospice. The expe-rience there was one of the roots of St. Christopher'sHospice, which she founded, together with a smallgroup, and which opened in 1967. From the start, itwas planned as a teaching center and a focus of re-search in the control of pain and other distress interminal illness. This work has been recognized worldwide and was the catalyst for thehospice movement.

    Dame Cicely has received a number of honorary degrees, including Honorary Doctor-ate of Science from Yale in 1969, Lambeth Doctorate of Medicine from the Archbishop ofCanterbury in 1977, Doctorate from the Open University in 1978, and Honorary Doctor-ate of Law, Columbia University, New York, in 1979. She has been a member of the At-tendance Allowance Board since it started; and from 1973 to 1978 was a member of theMedical Research Council. Dame Cicely was awarded the Templeton Prize for Progressin Religion in 1981. Other honorary degrees have followed, including honorary doctor-ates in law and civil law from Oxford and Cambridge Universities in 1986.

    Dame Cicely is an honorary fellow of the Royal College of Physicians, the Royal Col-lege of Surgeons, and the Royal College of Nurses. She was awarded the British MedicalAssociation's Gold Medal for Distinguished Merit in July 1987, and was made a Free-man of the London Borough of Bromley in October 1987, In 1988, she was made an hon-orary fellow of the Royal College of Psychiatrists. In 1989, Dame Cicely was awardedthe Order of Merit by Her Majesty the Queen.

    Over 40 years ago, I had the opportunity and privilege of accompanyan isolated man who talked through his thoughts and feelings with meduring the last 2 months of his life. A Jew from Warsaw, he had lost his



  • viii Foreword

    family and believed that he had made no impact on the world during hisshort life of 40 years. The first ideas of hospice developed during ourconversations, and for me they ar