Patients' diverse beliefs about what happens at the time of death

Abstract

BACKGROUND:Beliefs about what happens at the time of death surely affect a patient's whole dying experience and could help guide end‐of‐life care. Yet virtually no research describes those beliefs. This exploratory study begins the descriptive process.METHODS:Assuming culture is key, we interviewed 26 Mexican‐American (MA), 18 Euro‐American (EA), and 14 African‐American (AA) inpatients about their beliefs concerning what happens at the time of death.RESULTS:One belief, that death separates the dead from the living, was widespread. Majorities of all 3 ethnic group samples and of 5 of the 6 gender subsamples expressed this belief, saying the dead “go” or “leave” from this life. Other beliefs differed by ethnic group or gender. For example, more EAs (50%) than others said death is a momentary event, and more MAs (35%) than others said death involves “being taken” by an external force (always God or Jesus). Furthermore, considerably more EA women (45%) than others said some senses persist after death. In contrast, the physiologic signs that participants cited as defining the exact time of death varied from individual to individual with no ethnic or gender pattern, and no one sign predominated.CONCLUSIONS:A few beliefs about what happens at the time of death may characterize Americans in general; many other beliefs may characterize only certain ethnic groups, genders, or individuals. To identify such beliefs and to use them to guide end‐of‐life care, hospitalists and other health professionals may have to elicit them directly from patients or survivors. Journal of Hospital Medicine 2012. © 2011 Society of Hospital Medicine

Knowledge Gaps About End-of-Life Decision Making Among Mexican American Older Adults and Their Family Caregivers: An Integrative Review

“…It is important to note that the samples in Blackhall et al (1995), Blackhall et al (1999), Blackhall et al (2001), and Murphy et al (1996) were similarly described by the authors and may have been the same participants. Likewise, Perkins et al (2002), Perkins et al (2004), Perkins et al (2009), Perkins et al (2012a), and Perkins et al (2012b) appeared to have involved the same sample as well as Finley et al (2012) and Finley et al (2013). Consequently, of the 22 articles, it appeared there might only have been 15 unique samples.…”

“…Spiritual/religious dimension. Authors noted the importance of religious beliefs among MAs and the ways religious beliefs related to agreement with LST (Blackhall et al, 1999;Finley et al, 2013), coping with LLI (Nedjat-Haiem et al, 2012), and concepts of how and when death should occur (Ko et al, 2013;Perkins et al, 2009Perkins et al, , 2012aPerkins et al, , 2012b. Gelfand et al (2001) and Taxis et al (2008) noted the important role of prayers and religious observances, although the findings of these authors conflicted about the role of priests around the time of death.…”

“…In addition, nursing perspectives, that is, considering health issues within contexts, were poorly represented in the literature. Only three research teams included nurses with doctorates (Adams et al, 2007;Ko et al, 2013;Taxis et al, 2008), a masters' degree (Gelfand et al, 2001), and a registered nurse (Perkins et al, 2012a(Perkins et al, , 2012b.…”

Gender Differences in End-of-Life Care in Older Mexican American Adults

“…Likewise, Finley et al 39,40 also appeared to have described the same sample in their reports. Perkins et al [48][49][50][51][52] also seemed to have reported on the same participants. Finally, Ko et al 45(p10) described their sample as a ''part of a larger, quantitative study on EOL care among 122 older adults (64 KAs and 58 MAs).''…”

“…Synonyms for death provide clues to one's beliefs about what happens at death. 51 Older MA males were more likely to believe that a dying person ''goes or leaves'' or ''is taken'' at the time of death, when compared to older MA females who believed that the dying person ''passes on or away'' at the time of death. 51(p112) Suffering.…”