1.ON DEATH AND DYINGSergio Flores | December 3, 2011

2. On Death and Dying ELISABETH KBLER-ROSS, M.D.ABOUT THE AUTHOR Born one of triplets in Zurich, Switzerland, Elisabeth was apsychiatrist, humanitarian, physician, and hospice pioneer who wrote On Death andDying in 1969 She authored 24 books published in 34 languages. Considered to have changed the face ofmedicine and one of the most influential people and important minds of the last century In 2005 the Elisabeth Kbler-Ross Foundation is formed to further the work and maintain her legacy Provides educational programs that deepen the understanding of those dying andgrieving for the dead Develop curricula for those involved in the care of the dyingButterflies became her symbol, symbolizing the beautifultransformation that she believed occurred at the time of death.The logo for her Foundation is the butterfly symbol.(http://www.ekrfoundation.org/) 3. On Death and Dying INTERVIEWING THE DYING At the Hospital where she worked in New York, Kbler-Ross was appalled by the standardtreatment of dying patients. Unlike her colleagues, she made it a point to sit withterminally ill patients, listening as they poured out their hearts to her. She began givinglectures featuring dying patients who talked about what they were going through. Impetus for book was conceived by four theological seminary students researching crisisin human life. They considered death as the biggest crisis people had to face In attempting to understand the needs of the dying, she addresses death in terms ofchange, by studying the terminally ill patients attittudes, those of their caregivers, andour cultural attitudes toward death death as an analogy to changeBOOK QUOTEIf this book serves no other purpose but to sensitize family members of terminally ill patients and hospital personnelto the implicit communications of dying patients, then it has fulfilled its task...help the patient and his family to get intune to each others needs and come to an acceptance of an unavoidable reality... Kbler-Ross (2011). (p. 151) 4. On Death and DyingRECURRING CHANGE THEMESDEATH AS CRISIS RESPECT AND DIGNITYDeath is the ultimate change In control of your destinyCrisis as a catalyst to change Manager - Subordinate relationshipDehumanizing Doctor - patient relationshipEnvy of the living EquanimityJob Loss/Retirement Catastrophic change EMPATHY REAWAKINING AND HOPE Needs to be understood Catalyst for renewal Perceptions of death (change) will Collective change color our ability to deal with it Listenting and understanding Reassurance Trust Impact of the messenger 5. On Death and DyingDEATH AS CRISISENVY OF THE LIVING Society has taught us to view death as a taboo Feelings or emotions that death invoke in us Perception toward death, dehumanizes the patient As a society we rather prolong life than diminish human ANACLITIC DEPRESSIONsuffering Patiens who are informed of their imminent death respond with anger, detachment, denial and fear Losing control of their own destiny But death, like change, is inevitable Patients express envy of the living Avoid death (change) at all costs Marasmus of the soul LOE Catastrophic change Job Loss Retirement 6. On Death and DyingCATASTROPHIC CHANGERETIREMENT Charles Schulz dies weeks after announcing his retirement Andy Rooney dies a month after his retirement A study of Shell Oil employees shows that those that retire earlier, die sooner than those who decide to work past their retiring age(http://www.webmd.com/healthy-aging/news/20051020/early-retirement-early-death)"I never dreamed that this would happen to me. I always had the feeling that Iwould stay with the strip until I was in my early eighties, or something likethat. But all of sudden its gone. I did not take it away. This has been takenaway from me. Charles Schulz on The Today Show 7. On Death and DyingEMPATHY AND UNDERSTANDINGLISTENING AND TRUST Patiens who are informed of their imminent death respond withanger, detachment, denial and fear Losing control of their own destiny The act of being merciful, provides relief Sit, listen, and share Change is intensely personal (Jeanie Daniel Duck) The sick person has feelings, the right to be heard Change is emotional, and evokes real feelings, wounds, our past(Attachment Theory) Patients suffer more not physically, but emotionally Communication as a catalyst for reassurance and trust More than 75% of those interviewed by Kbler-Ross make afull recoveryPeople have contexts just as organizations do Gass, Pascale, and Athos 8. On Death and Dying RESPECT AND DIGNITYEQUANIMITY Controlling your own destiny Doctors learn to judge whether or not a person is ready for the news, and the manner in which they will be told of death diagnosis - Hope Subjective management of individuals Achieved only by listening and understanding Address those that need to be heard and understood I am alive, dont forget that. You can hear my voice, I am not dead yetDo not apply the mushroom principal to change management: How to grow mushrooms?Keepem in the dark, and feed them bulls**t 9. On Death and DyingDABDA MODEL DENIALANGER BARGAININGDEPRESSION ACCEPTANCE 10. On Death and DyingDENIAL Resistance is to be expected/accepted Who moved my cheese - Hem and Haw DENIAL This cannot be happening to me How long will this last? Why me?Ultimately, can lead to actual death 11. On Death and DyingANGERStrong emotions about change stemsfrom desperationMisderected alienation of a resistor willANGERoften hinder rather than helpCathartic Grief includes angerShould be respected, and understoodChange is fundemantally about feelings; companies that want their workers tocontribute with their heads and hearts have to accept that emotions are essential tothe new management style Jeanie Daniel Duck 12. On Death and DyingBARGAINING Ive been good, I can be better What if I dont participate?BARGAINING Can I be the exception? Ive learned my lesson 13. On Death and DyingDEPRESSION Loss of hope Emotional attachmentDEPRESSION Reactive and Preparatory Sadness , regret, fear, and uncertainty 14. On Death and DyingACCEPTANCEUnderstanding no more fearResignationACCEPTANCEDetachmentEnlightmentLook not mournfully into the past. It comes not back again. Wisely improvethe present. It is thine. Go forth to meet the shadowy future, without fear.- Henry Wadsworth Longfellow (1807 - 1882) 15. On Death and Dying 3-PHASE MODELDABDA MODEL OVERLAYED ON KURT LEWINS MODELUnfreeze Mobilise Refreeze Create the case for Identify and mobilise Embed new ways ofchange the resources working in the fabric of Dissatisfaction with required to effectthe organizationthe status quo changeDENIAL AND ANGERBARGAINING ACCEPTANCE (DEPRESSION)Choosing a model is not an arbitrary choice--it is an ideological one. The assumptions we makeabout change are also assumptions about the nature of reality and people. Van de Ven & Poole (Theories and Models of Organizational Change) 16. On Death and DyingDIALETIC CORE PHILOSOPHYCONSTRADICTION IS A NATURAL STATE Change occurs when opposing powers (contradictory values competing with eachother), gain sufficient power to confront and engage the status quo.(http://gre.academia.edu/MJReid/Papers/252681/A_brief_review_of_Van_de_Ven_and_Pooles_1995_article_Explaining_development_and_change_in_organizations_Academy_of_Management_Review_20_3_) The DABDA model follows a directly linear representation of this philosophy, but at themicro, rather than macro, level(http://changingminds.org/disciplines/change_management/kubler_ross/kubler_ross.htm)It is inconceivable for our unconscious to imagine an actual ending of our own life here on earth, and if this life of ours has toend, the ending is always attributed to a malicious intervention from the outside by someone else. In simple terms, in ourunconscious mind we can only be killed; it is inconceivable to die of a natural cause or of old age. Therefore death in itself isassociated with a bad act, a frightening happening, something that in itself calls for retribution and punishment. 17. On Death and DyingDABDA & ADKAR KNOWLEDGE REINFORCEMENT BARGAININGACCEPTANCEGROWTHAWARENESS/DESIRE ABILITYDENIAL /ANGERDEPRESSION ENLIGHTMENT 18. On Death and DyingREAWAKENING AND HOPE THE ROLE OF HOPE IN ACCOMPLISHING CHANGE Even when the situation is most dire, the possibility of hope canfacilitate change`Positive FocusedFlexibleOrganizedProactive- Characteristics of Resilient Individuals (Conner Partners)Not thinking of dying, but thinking of living Dont focus on the negative, focus on the positive 19. On Death and DyingREAWAKENING AND HOPEOLD FRAME OF MIND NEW FRAME OF MIND IMPERSONALPERSONAL RIGIDITY SENSITIVITY QUANTITY OF LIFE QUALITY OF LIFEABSOLUTES FLEXIBILITY LAWETHICS POWERIMPACTCONTENTEDNESS HAPPINESS VICTORY IN CONFLICTS CONFLICT RESOLUTION(Hey & Moore, 1998) 20. On Death and DyingREAWAKENING AND HOPEHow has death changed us asa society? Peresonally? Collectively?The impact on our everydaylives and decisions The collective reality that has changed our lives so drastically 21. On Death and DyingREFERENCES Change Management Learning Center - Prosci (1996 2011). "ADKAR- a model for change management : ChangeManagement Tutorial Series. Retrieved November 5, 2011, from http://www.change-management.com/ Conner, Daniel (2004). Developing Resilient Teams for Managing Change. Conner Partners website, fromhttp://www.connerpartners.com Duck, Jeanie Daniel (1998). Managing Change: The Art of Balancing. Harvard Business Review on Change Goss, Tracy, Pascals, Richard and Athos, Anthony (1998). The Reinvention Roller Coaster: Risking the Present for aPowerful Future. Harvard Business Review on Change Hey, Kenneth R. and Moore, Peter D. (1998). The Caterpillar Doesnt Know: How Personal Change is Creating Organizational Change. New York, NY: The Free Press. Kubler-Ross, Elisabeth (2011). On Death and Dying. Simon & Schuster, Inc.. Kindle Edition. 22. On Death and DyingIMAGE REFERENCES http://www.indiesolo.com/files/images/10178_371241.jpg http://all-silhouettes.com/silhouetteclipart/ http://www.serebiiforums.com/showthread.php?t=551694 http://www.myspace.com/ekrfoundation/photos http://peanuts.wikia.com/wiki/Charlie_Brown 23. On Death and DyingVIDEO AND AUDIO REFERENCES http://www.youtube.com/v/aO4xpkH_YMw http://youtu.be/CYZJXoyrHnw