Older adults conception of a ‘good death’

Abstract

Advances in medical care have led to an increasing number of older adults living with at least one chronic illness over a longer period of time. Correspondingly the disease trajectory and dying process may be prolonged, providing individuals with more time to plan for what they consider a ‘good death.’ A ‘good death’ is described through research primarily according to medical and biological aspects. While the psychosocial and spiritual elements are also part of a ‘good death,’ it is difficult to delineate the individual aspects important to individuals near the end of life. This study used descriptive qualitative research methods to describe older adults’ conceptions of a ‘good death,’ specifically the psychosocial and spiritual factors. Data were collected from 12 community-dwelling older adults in central Alabama, utilizing a semi-structured interview guide. Qualitative content analysis guided the data analysis procedures. Corr’s (1992) task-based approach to coping with dying framed the study and served to categorize participant statements. The findings suggested that a number of physical, psychological, social, and spiritual components contributed to the conception of a ‘good death,’ and that these were often interrelated. For example, the type of medical treatment desired at the end of life was influenced by the potential effect on members of the participants’ social network, such as necessity for the participants’ family members to care for them when they were no longer independent and had a poor quality of life. Participants’ motivations and values guided what these individuals believed could help them achieve a ‘good death.’ Conceptions were highly personal with the realization that preparation would allow them to control their situation, although unpredictable, near the end of life. Health social work practice may be strengthened by these findings as it confirms the holistic nature of helping older adults prepare in advance for the end of life. Efforts to maximize quality of life throughout serious illness and near the end of life are essential so that older adults may die a ‘good death.’