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Responses to death and dying: primates and other mammals.

ABSTRACT: Although some definitions of thanatology-broadly definable as the study of death and dying-exclude nonhumans as subjects, recognition of the scientific value of studying how other species respond to sick, injured, dying and dead conspecifics appears to be growing. And whereas earlier literature was largely characterized by anecdotal descriptions and sometimes fanciful interpretations, we now see more rigorous and often quantitative analysis of various behaviors displayed towards conspecifics (and sometimes heterospecifics) at various stages of incapacitation, including death. Studies of social insects in particular have revealed chemical cues that trigger corpse management behaviors, as well as the adaptive value of these behaviors. More recent research on other taxonomic groups (including aquatic and avian species, and mammals) has sought to better document these animals' responses to the dying and dead, to identify influencing factors and underlying mechanisms, and to better understand the physiological, emotional, social and psychological significance of the phenomena observed. This special issue presents original short reports, reviews, and full research articles relating to these topics in New World monkeys, Old World monkeys and apes, as well as equids and proboscids. The range of events, data, hypotheses and proposals presented will hopefully enrich the field and stimulate further developments in comparative evolutionary thanatology.

SUBMITTER: Anderson JR

PROVIDER: S-EPMC7183548 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Responses to death and dying: primates and other mammals.

Anderson James R JR

Primates; journal of primatology 20200101 1

Although some definitions of thanatology-broadly definable as the study of death and dying-exclude nonhumans as subjects, recognition of the scientific value of studying how other species respond to sick, injured, dying and dead conspecifics appears to be growing. And whereas earlier literature was largely characterized by anecdotal descriptions and sometimes fanciful interpretations, we now see more rigorous and often quantitative analysis of various behaviors displayed towards conspecifics (an ...[more]

PMID: 31902088

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Project description:IntroductionMeasuring the quality of care at the end of life and/or the quality of dying and death can be challenging. Some measurement tools seek to assess the quality of care immediately prior to death; others retrospectively assess, following death, the quality of end-of-life care. The comparative evaluation of the properties and application of the various instruments has been limited.ObjectiveThis systematic review identified and critically appraised the psychometric properties and applicability of tools used after death.MethodWe conducted a systematic review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines by systematically searching MEDLINE, Embase, CINAHL, and PsycINFO for relevant studies. We then appraised the psychometric properties and the quality of reporting of the psychometric properties of the identified tools using the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) checklist. The protocol of this systematic review has been registered on PROSPERO (CRD42016047296).ResultsThe search identified 4751 studies. Of these, 33 met the inclusion criteria, reporting on the psychometric properties of 67 tools. These tools measured quality of care at the end of life (n = 35), quality of dying and death (n = 22), or both quality of care at the end of life and dying and death (n = 10). Most tools were completed by family carers (n = 57), with some also completed by healthcare professionals (HCPs) (n = 2) or just HCPs (n = 8). No single tool was found to be adequate across all the psychometric properties assessed. Two quality of care at the end of life tools-Care of the Dying Evaluation and Satisfaction with Care at the End of Life in Dementia-had strong psychometric properties in most respects. Two tools assessing quality of dying and death-the Quality of Dying and Death and the newly developed Staff Perception of End of Life Experience-had limited to moderate evidence of good psychometric properties. Two tools assessing both quality of care and quality of dying and death-the Quality Of Dying in Long-Term Care for cognitively intact populations and Good Death Inventory (Korean version)-had the best psychometric properties.ConclusionFour tools demonstrated some promise, but no single tool was consistent across all psychometric properties assessed. All tools identified would benefit from further psychometric testing.

Project description:ImportanceImproving end-of-life care in the intensive care unit (ICU) is a priority, but clinically modifiable factors of quality of dying and death (QODD) are seldom identified.ObjectivesTo comprehensively identify factors associated with QODD classes of dying ICU patients, emphasizing clinically modifiable factors based on the integrative framework of factors associated with for bereavement outcomes.Design, setting, and participantsThis observational cohort study was conducted at medical ICUs of 2 Taiwanese medical centers from January 2018 to March 2020 with follow-up through December 2022. Eligible participants included primary family surrogates responsible for decision making for critically ill ICU patients at high risk of death (Acute Physiology and Chronic Health Evaluation II score >20) but who survived more than 3 days after ICU admission. Data analysis was conducted from July to September 2023.Main outcomes and measuresQODD was measured by the 23-item ICU-QODD questionnaire. Factors associated with patient membership in 4 previously determined QODD classes (high, moderate, poor to uncertain, and worst) were examined using a 3-step approach for latent class modeling with the high QODD class as the reference category.ResultsA total of 309 family surrogates (mean [SD] age, 49.83 [12.55] years; 184 women [59.5%] and 125 men [40.5%]) were included in the study. Of all surrogates, 91 (29.4%) were the patients' spouse and 66 (53.7%) were the patients' adult child. Patient demographics were not associated with QODD class. Two family demographics (age and gender), relationship with the patient (spousal or adult-child), and length of ICU stay were associated with QODD classes. Patients of surrogates perceiving greater social support were less likely to be in the poor to uncertain (adjusted odds ratio [aOR], 0.89; 95% CI, 0.83-0.94) and worst (aOR, 0.92; 95% CI, 0.87-0.96) QODD classes. Family meetings were associated with the poor to uncertain QODD class (aOR, 8.61; 95% CI, 2.49-29.74) and worst QODD class (aOR, 7.28; 95% CI, 1.37-38.71). Death with cardiopulmonary resuscitation was associated with the worst QODD class (aOR, 7.51; 95% CI, 1.12-50.25). Family presence at patient death was uniformly negatively associated with the moderate QODD class (aOR, 0.16; 95% CI, 0.05-0.54), poor to uncertain QODD class (aOR, 0.21; 95% CI, 0.05-0.82), and worst QODD class (aOR, 0.08; 95% CI, 0.02-0.38). Higher family satisfaction with ICU care was negatively associated with the poor to uncertain QODD class (aOR, 0.93; 95% CI, 0.87-0.98) and worst QODD class (aOR, 0.86; 95% CI, 0.81-0.92).Conclusions and relevanceIn this cohort study of critically ill patients and their family surrogates, modifiable end-of-life ICU-care characteristics played a more significant role in associations with patient QODD class than did immutable family demographics, preexisting family health conditions, patient demographics, and patient clinical characteristics, thereby illuminating actionable opportunities to improve end-of-life ICU care.

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Responses to death and dying: primates and other mammals.

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Responses to death and dying: primates and other mammals.

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