E.1 Death and Hope

A multicultural life-span perspective reveals that reactions to death are filtered through many cultural prisms, affected by historical changes and regional variations, and by the age of both the dying and the bereaved.

One emotion is constant, however: hope. It appears in many ways: hope for life after death, hope that the world is better because someone lived, hope that death occurred for a reason, hope that survivors rededicate themselves to whatever they deem meaningful in life.

Cultures, Epochs, and Death

Few people in developed nations have witnessed someone die. This was not always the case (see Table EP.1). If someone reached age 50 in 1900 in the United States and had had 20 high school classmates, at least six of those fellow students would have already died. The survivors would have visited and reassured friends who were dying at home, promising to see them in heaven. Almost everyone believed in life after death.

Now few die before old age, and if a young person dies, most often it occurs too quickly to say goodbye. Ironically, death has become more feared as dying has become less familiar (Carr, 2012). Accordingly, we begin by describing traditional responses when familiarity with death was common.

Paleontologists believe that 100,000 years ago, the Neanderthals buried their dead with tools, bowls, or jewelry, signifying belief in an afterlife (Hayden, 2012). The date is controversial: Burial could have begun over 200,000 years ago or more recently—but it is certain that long ago death was an occasion for hope, mourning, and remembrance. Two Western civilizations with written records—Egypt and Greece—had elaborate death rituals.

The ancient Egyptians built magnificent pyramids, refined mummification, and scripted instructions (called the Book of the Dead) to aid the soul (ka), personality (ba), and shadow (akh) in reuniting after death so that the dead could bless and protect the living (Taylor, 2010).

The fate of dead Egyptians depended partly on their actions while alive, partly on the circumstances of death, and partly on proper burial. Death was a reason to live morally and to honor the past. If the dead were not appropriately cared for, the living would suffer.

Another set of beliefs comes from the Greeks. Again, continuity between life and death was evident, with hope for this world and the next. The fate of a dead person depended on past deeds. A few would have a blissful afterlife, a few were condemned to torture in Hades, and most would enter a shadow world until they were reincarnated.

Three themes are apparent in all the known ancient societies, not only in Greece and Egypt, but also in the Mayan, Chinese, Indian, and African cultures.

• Actions during life were thought to affect destiny after death.
• An afterlife was more than a hope; it was assumed.
• Mourners said particular prayers and made specific offerings, in part to prevent the spirit of the dead from haunting and hurting them.

Now consider contemporary religions. Each faith seems distinct in its practices surrounding death. One review states: “Rituals in the world’s religions, especially those for the major tragic and significant events of bereavement and death, have a bewildering diversity” (Idler, 2006, p. 285).

Some details illustrate this diversity. According to one expert, in Hinduism the casket is always open, in Islam, never (Gilbert, 2013). In many Muslim and Hindu cultures the dead person is bathed by the next of kin; among some Native Americans (e.g., the Navajo) no family member touches the dead person. Specific rituals vary as much by region as by religion. In North America, Christians of all sects often follow local traditions. Similarly, there are more than 500 Indian tribes, each with its own heritage: It is a mistake to assume that Native Americans all have the same customs (Cacciatore, 2009).

According to many branches of Hinduism a person should die on the floor, surrounded by family, who neither eat nor wash until the funeral pyre is extinguished. By contrast, among some (but not all) Christians today, the very sick should be taken to the hospital; if they die, then mourners gather to eat and drink, often with music and dancing.

Diversity is also evident in Buddhism. The First Noble Truth of Buddhism is that life is suffering. Some rituals help believers accept death and detach from grieving in order to decrease the suffering that living without the deceased person entails. Other rituals help people connect to the dead as part of the continuity between life and death (Cuevas & Stone, 2011). Thus some Buddhists let the dying alone; other Buddhists hover nearby.

Religious practices change as historical conditions do. One example comes from Korea. Koreans traditionally opposed autopsies because the body is a sacred gift. However, Koreans value science education. This created a dilemma because medical schools need bodies to autopsy in order to teach. The solution was to start a new custom: a special religious service honoring the dead who have given their body for medical education (J-T. Park et al., 2011). The result: a dramatic increase in the number of bodies donated for research.

Autopsies create problems in the United States as well. Autopsies may be legally required and yet be considered a religious sacrilege. For instance, for the Hmong in Cambodia, any mutilation of the dead body has “horrifying meanings” and “dire consequences for…the spiritual well-being of the surviving family and community” (Rosenblatt, 2013, p. 125). In Minnesota, however, where many Hmong now live, the family does not need to be told about, much less give permission for, an autopsy if the coroner has “any question about the cause of death.”

Ideas about death are expressed differently in various cultures. For example, many people believe that the spirits of ancestors visit the living. Spirits are particularly likely to appear during the Hungry Ghost Festival (in many East Asian nations), on the Day of the Dead (in many Latin American nations), or on All Souls Day (in many European nations).

Consequently, do not get distracted by death customs or beliefs that may seem odd to you, such as mummies, hungry ghosts, reincarnation, or hell. Instead, notice that death has always inspired strong emotions, often benevolent ones. It is the denial of death that leads to despair (Wong & Tomer, 2011). In all faiths and cultures, death is considered a passage, not an endpoint, a reason for families and strangers to come together.

Understanding Death Throughout the Life Span

Thoughts about death—as about everything else—are influenced by each person’s cognitive maturation and past experiences. Here are some of the specifics.

Some adults think children are oblivious to death; others believe children should participate in funerals and other rituals, just as adults do (Talwar et al., 2011). You know from your study of childhood cognition that neither view is completely correct. Very young children have some understanding of death, but their perspective differs from that of older people. They may believe that the dead can come alive again. For that reason, a child might not immediately be sad when someone dies. Later, moments of profound sorrow might occur when reality sinks in, or simply when the child realizes that a dead parent will never again tuck them into bed at night.

Sorrow All Around When a 5-day-old baby died in Santa Rosa, Guatemala, the entire neighborhood mourned. Symbols and a procession help with grief: The coffin is white to indicate that the infant was without sin and will therefore be in heaven.

JOHAN ORDOÑEZ/AFP/GETTY IMAGES

Children are affected by the attitudes of others. If a child encounters death, adults should listen with full attention, neither ignoring the child’s concerns nor expecting adult-like reactions (Doering, 2010). Because the limbic system matures more rapidly than the prefrontal cortex, children may seem happy one day and morbidly depressed the next.

Young children who themselves are fatally ill typically fear that death means being abandoned (Wolchik et al., 2008). Consequently, parents should stay with a dying child, holding, reading, singing, and sleeping. A frequent and caring presence is more important than logic. By school age, many children seek independence. Parents and professionals can be too solicitous; older children do not want to be babied. Often they want facts and a role in “management of illness and treatment decisions” (Varga & Paletti, 2013, p. 27).

Children who lose a friend, a relative, or a pet might, or might not, seem sad, lonely, or angry. For example, one 7-year-old boy seemed unfazed by the loss of three grandparents and an uncle within two years. However, he was extremely upset when his dog, Twick, died. That boy’s parents, each grieving for a dead mother, were taken aback by the depth of his emotions. The boy was angry that he was not taken to the animal hospital before the dog was euthanized. He refused to go back to school, saying, “I wanted to see him one more time…. You don’t understand” (quoted in K. R. Kaufman & Kaufman, 2006, pp. 65–66).

Because the loss of a particular companion is a young child’s concern, it is not helpful to say that a dog can be replaced. Even a 1-year-old knows that a new puppy is not the same dog. Nor should a child be told that Grandma is sleeping, that God wanted sister in heaven, or that Grandpa went on a trip. The child may take such explanations literally, wanting to wake up Grandma, complain to God, or phone Grandpa to say “Come home.”

If a child realizes that adults are afraid to say that death has occurred, the child might decide that death is so horrible that adults cannot talk about it—a terrifying conclusion (Doering, 2010). Even worse is the idea that adults are not trustworthy: They lie to children.

Remember how cognition changes with development. Egocentric preschoolers might fear that they, personally, caused death with their unkind words. [Lifespan Link: Egocentrism is discussed in Chapter 9.]

As children become concrete operational thinkers, they seek facts, such as exactly how a person died and where he or she is now. They want something to do: bring flowers, repeat a prayer, write a letter. The boy whose dog died went back to school after his parents framed and hung a poem he wrote to Twick. Children see no contradiction between biological death and spiritual afterlife, as long as adults neither lie nor disregard the child’s concerns (Talwar et al., 2011).

Adolescents may be self-absorbed, philosophical, analytic, or distraught—or all four at different moments. [Lifespan Link: Adolescent dual processing is discussed in Chapter 15.] Counselors emphasize that adults must listen to teenagers. Self-expression is part of the search for identity; death of a loved one does not put an end to that search. Some adolescents use the Internet to write to the dead person or to vent their grief—an effective way to express their personal identity concerns (DeGroot, 2012).

“Live fast, die young, and leave a good-looking corpse” is advice often attributed to actor James Dean, who died in a car crash at age 24. At what stage would a person be most likely to agree? Emerging adulthood, of course. Worldwide, older teenagers and emerging adults control their anxiety about death by taking risks (de Bruin et al., 2007; Luxmoore, 2012).

Terror management theory explains some illogical responses to death, including why young people take death-defying risks (Mosher & Danoff-Burg, 2007). By surviving, they manage their terror by proving that death cannot get them. Especially when people aged 15 to 24 have access to guns and cars, this developmental tendency can be deadly (see Figure EP.1). Cluster suicides, foolish dares, fatal gang fights, and drug-impaired driving are more common during those years than later. Three attitudes typical of older adolescents are correlated: ageism, terror management, risk-taking (Popham et al., 2011b).

Typhoid Versus Driving into a Tree In 1905, most young adults in the United States who died were victims of diseases, usually infectious ones like tuberculosis and typhoid. In 2012, 3 times more died violently (accidents, homicide, suicide) than of all diseases combined.

Many studies have found that messages about the deadly consequences of smoking may provoke smokers to increase their consumption (Arndt et al., 2013). One study found that college students who were told that binge drinking is sometimes fatal were more willing to binge, not less so (Jessop & Wade, 2008). Thus teenagers and young adults may protect their pride and self-esteem by defying death and resisting the advice of adults.

Other research in many nations finds that when adolescents and emerging adults think about death, they sometimes become more patriotic and religious but less tolerant of other worldviews and less generous to people of other nations (Ellis & Wahab, 2013; Jonas et al., 2013). Apparently, people want to convince themselves that loyal, conscientious members of their own group (including themselves) are especially worthy of living.

When adults become responsible for work and family, attitudes shift. Death is not romanticized. Many adults quit addictive drugs, start wearing seat belts, and adopt other death-avoiding behaviors when they become parents. One of my students eagerly anticipated the thrill of her first skydive, paying in advance. However, the day before the scheduled dive she learned she was pregnant. She forfeited the money and shopped for prenatal vitamins.

To defend against the fear of aging and untimely death, adults do not readily accept the death of others. When Dylan Thomas was about age 30, he wrote to his dying father: “Do not go gentle into that good night/Rage, rage against the dying of the light” (D. Thomas, 1957). Nor do adults readily accept their own death. A woman diagnosed at age 42 with a rare and almost always fatal cancer (a sarcoma) wrote:

“For My Kids” Randy Pausch was a brilliant, innovative scientist at Carnegie Mellon University. When he was diagnosed with terminal pancreatic cancer, he gave a talk titled “The Last Lecture: Really Achieving Your Childhood Dreams” that became famous worldwide. He devoted the final 10 months of his life to his family—his wife Jai and their children Chloë, Dylan, and Logan.

PHOTOGRAPH © JAI PAUSCH. FROM THE BOOK THE LAST LECTURE BY RANDY PAUSCH WITH JEFFREY ZASLOW. COPYRIGHT © 2008 RANDY PAUSCH. REPRINTED BY PERMISSION OF HYPERION. ALL RIGHTS RESERVED.

When adults hear about another’s death, their reaction depends on the dead person’s age. Death in the prime of life is particularly disturbing. Michael Jackson and Whitney Houston were mourned by millions, in part because they were not yet old. Older entertainers who die are less mourned.

Reactions to one’s own mortality differ depending on the developmental stage as well. In adulthood, from ages 25 to 65, terminally ill people worry about leaving something undone or abandoning family members, especially children.

One dying middle-aged adult was Randy Pausch, a 47-year-old professor and father of three. Ten months before he died of cancer in 2008, he delivered a famous last lecture, detailing his childhood dreams and saluting those who would continue his work. After advising his students to follow their own dreams, he concluded, “This talk is not for you, it’s for my kids” (Pausch, 2008). Not surprisingly, that message was embraced by his wife, also in mid-adulthood, who wrote her own book, titled Dream New Dreams, which deals with overcoming death by focusing on life (J. Pausch, 2012).

Adult attitudes about death are often irrational. Logically, adults should work to change social factors that increase the risk of mortality—such as air pollution, junk foods, and unsafe transportation. Instead, many people react more strongly to events that rarely cause death, such as anthrax and avalanches. They particularly fear deaths that seem random.

For example, people fear travel by plane more than by car. In fact, flying is safer: In 2008 only 11 commercial airplanes crashed in the entire world, killing 587, but 84,000 people were killed by motor vehicles in the United States alone (U.S. Bureau of the Census, 2011b). Ironically, when four airplanes crashed on 9/11, 2001, many North Americans drove long distances instead of flying. In the next few months, 2,300 more U.S. residents died in car crashes than usual (Blalock et al., 2009). Not logical, but very human.

A Toothache Worse Than Death? A cohort of young adults (average age 21) and old adults (average age 74) were divided into three groups. One group wrote about their musings of their own death (giving them overt thoughts about dying), another did a puzzle with some words about death (giving them unconscious thoughts about death), and the third wrote about dental pain (they were the control group). Then they all judged how harshly people should be punished for various moral transgressions. Those who wrote about dental pain are represented by the zero point on this graph. Compared with them, those older adults who thought about death were less punitive, but younger adults were more so. The difference in the ratings of the young and old was more pronounced if their thoughts were unconscious than if they were overt.

In late adulthood, attitudes shift again. Anxiety decreases; hope rises (De Raedt et al., 2013). Life-threatening illnesses reduce life satisfaction more among the middle-aged than the elderly (Wurm et al., 2008). Terror-management irrationality diminishes (Maxfield et al., 2007) (see Figure EP.2).

Some older people are quite happy even when they are fatally ill, which is beneficial. Indeed, many developmentalists believe that one sign of mental health among older adults is acceptance of mortality, which increases concern for others. Some elders engage in legacy work, trying to leave something meaningful for later generations (Lattanzi-Licht, 2013).

As evidence of this attitude change, older people seek to reconcile with estranged family members and tie up loose ends that most young adults leave hanging (Kastenbaum, 2012). Some people are troubled when their parents or grandparents allocate heirlooms, discuss end-of-life treatments, or buy a burial plot, but all those actions are developmentally appropriate.

Acceptance of death does not mean that the elderly give up on living; rather, their priorities shift. In an intriguing series of studies (Carstensen, 2011), people were presented with the following scenario:

• A member of your immediate family
• The author of a book you have just read
• An acquaintance with whom you seem to have much in common

Older adults, more than younger ones, choose the family member. The researchers explain that family becomes more important when death seems near. This is supported by a study of 329 people of various ages who had recently been diagnosed with cancer and a matched group of 170 people (of the same ages) who had no serious illness (Pinquart & Silbereisen, 2006). The most marked difference was between those with and without cancer, regardless of age (see Figure EP.3). Attitudes change when death becomes more salient.

Turning to Family as Death Approaches Both young and old people diagnosed with cancer (one-fourth of whom died within five years) more often preferred to spend a free half-hour with a family member rather than with an interesting person whom they did not know well. For healthy people, age mattered most in deciding their preference.

Near-Death Experiences

Even coming close to death may be an occasion for hope. This is most obvious in what is called a near-death experience, in which a person almost dies. Survivors sometimes report having left the body and moving toward a bright light while feeling peace and joy. The following classic report is typical:

Near-death experiences often include religious elements (angels seen, celestial music heard). Survivors often become more spiritual, less materialistic. To some, near-death experiences prove that “Heaven is for real” (Burpo & Vincent, 2010).

Most scientists are skeptical, claiming that

Nevertheless, a reviewer of near-death experiences is struck by their similarity to religious beliefs about death. In every culture, “all varieties of the dying experience” move people toward the same realizations: (1) the limitations of social status, (2) the insignificance of material possessions, and (3) the narrowness of self-centeredness (Greyson, 2009).

Praise Famous Men The funerals of two men, Chris Kelly (left) half of the Kriss Kross rap duo, and Paul Celluci (right), former governer of Massachusetts, show cultural contrasts and underlying universals.

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JOHN TLUMACKI/THE BOSTON GLOBE VIA GETTY IMAGES