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

Ageing Soc. 2012 Nov 1;32(8):1399-1417. doi: 10.1017/S0144686X11001061.

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.

Keywords: Chronic conditions; ageing; death; dying; end-of-life planning; later life.