‘The calendar is just about up’: older adults with multiple chronic conditions reflect on death and dying

Abstract

Drawing on data from in-depth interviews with 35 men and women aged 73-91, this article examines the ways in which older adults with multiple chronic conditions talk about and prepare for death and dying. While the focus of the original study did not include questions concerning the end-of-life, the majority of our participants made unprompted remarks regarding their own and others' mortality. The participants discussed the prevalence of death in their lives as it related to the passing of significant others, as well as their own eventual demise. Additionally, the men and women expressed hopes and fears about their impending death, in particular with respect to prolonged pain and suffering, institutionalisation, and a loss of mental acuity and independence. Many of our participants also described their end-of-life plans, which included making funeral arrangements, obtaining living wills, and planning their suicides. They further reported a number of barriers to their planning for death, including a lack of willingness on the part of family members to discuss their wishes as well as a scarcity of institutional resources and support. We discuss our findings in relation to the extant research concerning older adults' experiences of death and dying, as well as Glaser and Strauss' (1971) theory of status passage and Marshall's (1986) conceptualisation of authorship and the legitimation of death.

A systematic review of physical illness, functional disability, and suicidal behaviour among older adults

“…In studies from Taiwan (Ku, Tsai, Lin, & Lin, 2009 ; Lee, Tsai, Chen, & Huang, 2014 ), the Netherlands (Rurup et al., 2011 ) and Sweden (Van Orden et al., 2014 ), older adults with a history of suicidal ideation or behaviour were interviewed about the reasons for their suicidality, while in a Canadian study (Clarke, Korotchenko, & Bundon, 2012 ), older adults were interviewed about preparing for death. Finally, a study from Norway (Kjølseth, Ekeberg, & Steihaug, 2010 ) used a psychological autopsy method to understand the suicide motives of a sample of older adults, from the point of view of their surviving significant others.…”

“…The Canadian study (Clarke et al., 2012 ) focused on the end of life plans of 19 women and 16 men who had at least three chronic health problems. These respondents, who were between the ages of 73 and 91 and mostly of European descent, were not interviewed about suicide, but the topic of suicide came up.…”

Psychosocial aspects of periodontal disease diagnosis and treatment

“…Some examples include the transitions from adolescence to adulthood, unmarried to married, or employed to retired, as well as promotion within one's career (Kellehear 1990). Status passage has been widely used in the literature in the context of understanding chronic illnesses (Clarke et al 2012;Gibson et al 2017; Kristiansen and Antoft 2016). Glaser and Strauss (1971) identified that status passages were most often scheduled, regularised, and prescribed.…”

What Enhancement Techniques Suggest about the Good Death

“…Journal of Current Cultural Research techniques of modern medicine provide a sense that death is controllable and subject to timing, when, for example, people in their nineties estimate healthy life years left to them in relation to the possibility of complex treatments and surgeries (Kaufman 2010;Clarke 2012). But when timing and control become important characteristics of the good death, the idea of the natural death becomes even more paradoxical.…”

“…As Clarke et al argue, research on the experience of living in a dying body has received only scant attention in gerontological studies (Clarke et al 2012). In general, the focus in these studies is on successful ageing, which overshadows living experiences that are somewhat incompatible with the notion of successful ageing (Bülow 2014).…”