A GLOSSARY OF TERMS

Relating to death and dying

by Linda Watson

This glossary of terms related to death and dying attempts to capture the meaning of sometimes complicated concepts in reasonably simple language. It is my hope that you will find this presentation of practical use as you navigate medical and other fields while talking about death.

Please feel free to copy and share this resource.

Linda Watson http://talkaboutdeath.blogspot.com

AN INVITATION

If you are facing the approach of your own death or that of someone you love, I invite you to look into my book

Facing Death: A Companion in Words and Images.

It is a completely unique book with stunning nature images and brief messages providing guidance, comfort and a touch of beauty. Learn more about the book at www.authorlindawatson.com or order it today from your local or online bookseller.

WHAT REVIEWERS HAVE SAID:

this book will touch your heart and soul with hope a soft, gentle, hope-filled companion for all of us who are dealing with death the book can be used by professionals as a springboard to open dialogue exquisite images and words will lighten any heart facing death this is a book to experience

Facing Death: A Companion in Words and Images

by Linda Watson Photography by Maggie Sale Health Professions Press, 2009 ISBN: 978-1-932529-48-7

Table of Contents CARE ........................................................................................................................4

Active Treatment.......................................................................................................4 Chronic Condition .....................................................................................................4 Terminal Condition ...................................................................................................4 Chronic Terminal Condition ......................................................................................4 Comfort Care ............................................................................................................4 Hospice/Palliative Care .............................................................................................2

MEDICAL INTERVENTIONS ...........................................................................3

Life Sustaining Treatment .........................................................................................3 Coma ........................................................................................................................3 Brain Death ...............................................................................................................3 Heroic or Extraordinary Measures .............................................................................4 Do Not Resuscitate....................................................................................................5 Do Not Intubate ........................................................................................................5

LEGAL ......................................................................................................................6
Power of Attorney .....................................................................................................6 Health Care Directive ................................................................................................6 Proxy ........................................................................................................................6 Refusal of Medication and/or Treatment ...................................................................6 Refusal of Nutrition and/or Fluids .............................................................................7

Withdrawing Treatment .............................................................................................7

FUNERAL ................................................................................................................8
Funeral Rites .............................................................................................................8 Obituary ...................................................................................................................8 Chief Mourners .........................................................................................................9 Visitation ..................................................................................................................9 Eulogy.......................................................................................................................9 Pallbearers ................................................................................................................9 Prayers for the Dead .................................................................................................9

DISPOSAL OF THE BODY.............................................................................10

Collection of the Body .............................................................................................10 Autopsy ..................................................................................................................10 Funeral Home .........................................................................................................10 Burial ......................................................................................................................11 Cremation ...............................................................................................................11 Mausoleum .............................................................................................................12 Columbarium ..........................................................................................................12 Grave Marker ..........................................................................................................12

INDEX ....................................................................................................................13

CARE
Active Treatmenttreatment medicines, chemotherapies or surgeries used to cure ailments, to slow the progress of disease and/or to repair injuries. Active treatment differs from comfort care at the end of life in that it is aimed at a cure rather than just symptom relief. Chronic Conditiona medical condition which is not curable but which has continuous or recurring symptoms that can be treated effectively. Examples of chronic conditions would include diseases like diabetes, conditions like asthma and the long term effects of certain injuries. Terminal Conditiona progressive condition caused by injury or disease that has no cure and that can be reasonably expected to cause the death of a person, usually within six months. Chronic Terminal Conditiona progressive condition caused by injury or disease which is expected to result in death eventually but which is, for the time being, responsive to life-sustaining treatments. Increasingly, many cancers fall into this category. Comfort Carea model of care in which the focus shifts from cure to comfort in order to maximize the quality of life for people with a terminal condition. The emphasis is upon relieving discomfort from symptoms, including: shortness of

breath, constipation, nausea, loss of appetite and/or difficulty swallowing or sleeping.

An illustration of the contrast between comfort care and active treatment is that in a comfort care setting, doctors might give high doses of painkillers to keep symptoms under control, even if painkillers at those doses might hasten death somewhat.

Hospice/Palliative Carea model of care involving a coordinated team of professionals from many specialties, plus volunteers, that focuses upon comfort care. Such care may be used alongside forms of active treatment in some cases, and extends to offering support for loved ones and caregivers as well.

Hospice/Palliative Care Teammay include doctors, nurses, social workers, spiritual counsellors, volunteer visitors, physiotherapists and/or occupational therapists, depending upon need. SettingsHospice/Palliative Care may be implemented in the home, in a long-term care facility, in a specialized unit in a hospital, or in a hospice as such, and could involve being transported from one such setting to another if needs change.

Glossary of Terms by Linda Watson

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MEDICAL INTERVENTIONS
Life Sustaining Treatmentany treatment upon which a person relies for life and without which they die. Such treatment may include surgical interventions, blood transfusions, dialysis, chemotherapies, artificial feeding, intravenous fluids and/or breathing support. Comaa state of deep unconsciousness in which a person has signs of brain activity, but in which they are unable to respond to their environment. A person in a coma will require some form of life-sustaining treatment for survival. Some people do recover from a coma. Brain Deatha condition in which all brain impulses stop, including those that control heartbeat and breathing, most often after the brain has been deprived of oxygen for six minutes or more. Brain death is not reversible and people who suffer brain death never recover.

Organ Donationif brain death has been declared, individuals and/or

families have an option to authorize surgical removal of organs (e.g. heart or liver) and/or tissues (e.g. bone marrow) in order to allow transplant to people whose lives could be thus prolonged. This is entirely

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at the discretion of the family unless the person themselves has given permission in a health care directive or elsewhere. The removal of such organs does not affect funeral arrangements in any way. Withdrawing Life Supportswhen brain death has been declared, family members and medical professionals may determine the time has come to legally withdraw artificial feeding, heart stimulation and/or breathing equipment since no recovery can be expected. Family can choose to be present when this is undertaken.

Heroic or Extraordinary Measuresgenerally understood as emergency actions

intended to save life including: CPR (cardiopulmonary resuscitation), breathing support, artificial nutrition and certain surgeries. In the context of the end of life, such measures can be seen as undesirable because many of them cause a degree of pain or distress and because, at best, they just prolong the dying process.

Technologies

intravenous linea tube which carries fluids through a

needle into a vein, typically in the hand or arm

gastric tubea tube that is inserted through the abdominal

wall into the stomach to deliver nutrition and/or medications by this route instead of by mouth

nasogastric tubea tube run through the nose into the

stomach to deliver nutrition and/or medications by tube instead of by mouth

total parental nutritionan intravenous line into a vein to

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provide nutrition elements and/or medications instead of by mouth ALSO: TPN

breathing tubea flexible tube placed in the throat to open

an airway and thus aid breathing

ventilator or respiratoran electric machine attached to a

breathing tube that passes breathable air into the lungs to assist or replace normal breathing

defibrillatorin general usage, two pads placed on the chest

to give an electric shock to the heart muscle to cause it to beat regularly again. This therapy is only useable under certain conditions

Do Not Resuscitatean order made by an individual and/or their physician instructing medical personnel (contrary to usual practice) not to provide CPR or other intervention in the case of a heart attack or stroke. ALSO: DNR Do Not Intubatean order made by an individual and/or their physician instructing medical personnel (contrary to usual practice) not to insert a breathing tube in the case of trouble with breathing. ALSO: DNI

Glossary of Terms by Linda Watson

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LEGAL
Power of Attorneya legal document in which an individual is authorized to act on behalf of another in business or financial matters. If it includes the right to make decisions in the event of physical or mental incapacity, it may be called a durable or enduring power of attorney. Health Care Directivea legal document in which a person declares ahead of time their preferences, should they become incapacitated, about the amount and type of medical interventions desired. ALSO: an Advance Directive or Living Will Proxysomeone named in a health care directive (may or may not be the person who has power of attorney) to make decisions about consenting to, withholding or withdrawing treatment supports in keeping with the terms of a health care directive or with wishes expressed to them by some other means. Refusal of Medication and/or Treatmenta decision made by a competent individual with a terminal condition, on their own behalf, to refuse continuing treatment. Consultation about comfort care options in such a situation is generally recommended.

Glossary of Terms by Linda Watson

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Refusal of Nutrition and/or Fluids a decision made by a competent individual with a terminal condition, on their own behalf, to refuse food and/or liquids. Consultation about comfort care options in such a situation is generally recommended. Withdrawing Treatmentthe legal discontinuation of life-sustaining treatment from an individual with a terminal condition at their own request, on the basis of a health care directive or as the result of a medical determination of brain death. Such a decision is usually made in the context of consultation with the family.

Glossary of Terms by Linda Watson

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FUNERAL

Obituarya brief notice of the death of a person, usually published in an online or print newspaper, indicating the persons name, age, surviving family, history and, if applicable, the place and time of a service. The obituary may be composed by family members. Funeral Ritesa service in a home, place of worship or funeral home to mark the passing of someone who has died. Such rites vary widely across various religious and cultural traditions but generally include prayers, readings and music.

Funeral Servicea service of remembrance and celebration in which the remains of the person who has died are present in a casket, coffin or urn. Memorial Serviceas above but without the presence of the persons remains. Committal ServiceA brief service at the site where the deceased is to be buried, entombed or otherwise lodged. ALSO: Graveside Service

Glossary of Terms by Linda Watson

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Chief Mournersthis term is used to identify those closest to the person who

has died including: their romantic partner or spouse, immediate family and/or particular friends. Priority seating is generally reserved at a funeral for the chief mourners. Visitationa time or times scheduled for friends and family to visit with the chief mourners in a house, funeral home or place of worship. Attendance is regarded as a way to pay respect to the bereaved and for the deceased. In some settings, the body is present in an open casket, in which case it is often called a Viewing. ALSO: Calling Hours or Wake Eulogya speech given at a funeral or memorial service which is intended to describe the character and accomplishments of the person who has died. A eulogy may be delivered by a religious leader, a friend and/or a family member, and generally includes personal anecdotes. Pallbearersfamily members and/or friends or colleagues asked to help carry a casket out of the place where a funeral is held to the hearse and from the hearse to the burial plot. In some regions, pallbearers may be hired. Prayers for the Deadin some traditions, ritual and other prayers may be said for the protection of the dead and the comfort of the living at special gatherings in addition to the formal services. These prayers may be offered on the eve of the funeral, during the first year after the death, on the anniversary of the death and/or on the occasion of a religious holiday or other sacred observance.

Glossary of Terms by Linda Watson

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DISPOSAL OF THE BODY

Collection of the Bodywhen a person dies in hospital, their body is transferred by stretcher to the hospital morgue until funeral home or crematorium representatives arrive to collect it. If an anticipated death occurs in the home, the same professionals may collect the body from the home. In all cases, the body is transported inside a properly sized zippered bag on a wheeled stretcher. Autopsya procedure conducted in some cases in a hospital morgue after death, to determine the exact cause of death, if unknown. The procedure involves opening the body to examine internal organs and other tissues. In the case of a suspicious death, an autopsy may be performed in a government morgue where there is access to specialized equipment. Funeral Home a service business that caters to the bereaved and a facility to which dead bodies are delivered for processing. A full-service funeral home is generally staffed by funeral directors, professional embalmers and support staff, and has space to process bodies, display caskets and urns, park hearses and limousines, host funeral or memorial services, and interview the bereaved or those doing pre-planning of their own funeral and burial. ALSO: Mortuary or

Funeral Parlour

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Embalmingan optional process of sanitizing, disinfecting and temporarily preserving a dead body by means of replacing blood in veins and arteries with certain chemicals. Embalming is usually accompanied by dressing and grooming the body for viewing and/or a funeral service. Hearsea customized vehicle used to the transport the body in a casket from a funeral home to the location of a funeral service and/or cemetery.

ALSO: Funeral Coach

Burialthe act of placing the dead body or cremated remains, in a casket or urn, into the ground and covering it with earth. ALSO: Interment

Direct Burialtransferring a body directly from a morgue or funeral home to a cemetery for burial without any processing, service or viewing. Casketa box of wood, metal, plastic or even cardboard into which the dead body is placed for burial and/or a funeral service. ALSO: Coffin Cemeterya piece of land specifically set aside by a municipality as a place where the remains of the dead are permanently buried in caskets or urns in the earth, or placed in above-ground mausoleums or columbaria. Gravean individual burial site in a cemetery. Such a site will be detailed in an official register in the cemetery office. Grave Lineran underground box made of wood, metal or concrete that holds a casket and lessens the possibility of collapse or slippage in the earth. ALSO: Vault

Cremationa process which reduces a dead body to its most basic elements

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through burning. Once the cremation process is complete, the ashes are collected and any bone fragments are crushed until the whole has the consistency of coarse grey sand.

Direct Cremationtransferring the body from a morgue or funeral home to the crematorium Crematoriuma licenced facility where the dead body, sometimes in a cardboard casket, is placed into a brick-lined chamber called a retort in a furnace made for the purpose of cremating human remains Urna small container made of wood, metal, plastic or even cardboard into which cremated remains are placed for burial or for storage
Scattering of Ashes distribution of cremated remains in a place with significance for the family or for the person who has died. Common methods include burying the ashes beneath a freshly planted tree, scattering them to the wind or pouring them into a body of water. Some jurisdictions limit where this can be done.

Mausoleuma free-standing building with one or more chambers where shrouded or casketed bodies may be entombed Columbariuma free-standing wall or part of a building with individual compartments in which urns containing ashes may be placed. Grave Markera permanent or semi-permanent marker or statue made of wood, metal or stone which displays, at a minimum, the name of the person who has died along with dates of birth and death. ALSO: Tombstone, Grave

Stone or Memorial Marker

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INDEX
Crematorium 12

A
Active Entry 4

D
defibrillator 4
Direct Burial 11 Direct Cremation 12 DISPOSAL OF THE BODY 10

Advance Directive 6
ashes 12 Autopsy 10

B
Brain Death 3

DNI 5 DNR 5
Do Not Intubate 5 Do Not Resuscitate 5 durable power of attorney 6

breathing tube 4
Burial 11

C
Calling Hours 9
Casket 11 Cemetery 11 Chief Mourners 9 Chronic Condition 4 Chronic Terminal Condition 4

E
Embalming 11 enduring power of attorney 6 Eulogy 9 Extraordinary Measures 4

Coffin 11
Collection of the Body 10 Columbarium 12 Coma 3 Comfort Care 4 Committal Service 8 Cremation 11

F
Funeral Coach 11
Funeral Home 10 Funeral Rites 8 Funeral Service 8 Funerals 8

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G
gastric tube 4
Grave 11 Grave Liner 11 Grave Marker 12

N
nasogastric tube 4

O
Obituary 8 Organ Donation 3

Grave Stone 12 Graveside Service 8

H
Health Care Directive 6 Hearse 11 Heroic Measures 4 Heroic or Extraordinary Measures 4 Hospice 2 Hospice/Palliative Care 2 Hospice/Palliative Care Team 2

P
Pallbearers 9 Palliative Care 2 Power of Attorney 6 Prayers for the Dead 9 Proxy 6

R
Refusal of Fluids 7 Refusal of Medication 6 Refusal of Nutrition 7 Refusal of Treatment 6

I
Interment 11 intravenous line 4

respirator 4

L
Life Supports 3 Life Sustaining Treatment 3

S
Scattering of Ashes 12

Living Will 6

M
Mausoleum 12

T
Terminal Condition 4

Memorial Marker 12
Memorial Service 8

Tombstone 12 total parental nutrition 4

Mortuary 10

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U
Urn 12

Viewing 9 Visitation 9

W V
Vault 11 ventilator 4 Wake 9
Withdrawing Life Supports 3 Withdrawing Treatment 7

May you find comfort and inspiration. May you find the support you need. May you move toward acceptance, and may you find peace at the last --Linda Watson

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