Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-12-02T18:13:59.231Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  18 November 2011

LAURA HURD CLARKE*
Affiliation:
School of Kinesiology, The University of British Columbia, Vancouver, Canada.
ALEXANDRA KOROTCHENKO
Affiliation:
School of Kinesiology, The University of British Columbia, Vancouver, Canada.
ANDREA BUNDON
Affiliation:
School of Kinesiology, The University of British Columbia, Vancouver, Canada.
*
Address for correspondence: Laura Hurd Clarke, School of Kinesiology, The University of British Columbia, 156–1924 West Mall, Vancouver, B.C., Canada, V6 T 1Z2. E-mail: [email protected]

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.

Type
Articles
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ai, A. L., Hopp, F. and Shearer, M. 2006. Getting affairs in order: influences of social support and religious coping on end-of-life planning among open-heart surgery patients. Journal of Social Work in End-of-Life & Palliative Care, 2, 1, 7194.Google Scholar
Arber, S., Vandrevala, T., Daly, T. and Hampson, S. 2008. Understanding gender differences in older people's attitudes towards life-prolonging medical technologies. Journal of Aging Studies, 22, 4, 366–75.Google Scholar
Black, H. K. 2007. How the ‘not religious’ experience and witness suffering and death: case studies. Journal of Religion, Spirituality and Aging, 19, 2, 6785.CrossRefGoogle Scholar
Broom, A. and Cavenaugh, J. 2010. Masculinity, moralities and being cared for: an exploration of experiences of living and dying in hospice. Social Science and Medicine, 71, 5, 869–76.CrossRefGoogle Scholar
Cicirelli, V. G. 1998. Views of elderly people concerning end-of-life decisions. Journal of Applied Gerontology, 17, 2, 186203.CrossRefGoogle Scholar
Clarke, D. and Seymour, J. 1999. Reflections on Palliative Care. Open University Press, Buckingham, UK.Google Scholar
Clarke, D. and Seymour, J. 2010. ‘At the foot of a very long ladder’: discussing the end of life with older adults and informal caregivers. Journal of Pain and Symptom Management, 40, 6, 857–69.Google Scholar
Fried, T. R., van Doorn, C., O'Leary, J. R., Tinetti, M. E. and Drickamer, M. A. 1999. Older persons’ preferences for site of terminal care. Annals of Internal Medicine, 131, 2, 109–12.Google Scholar
Garrett, D. D., Tuokko, H., Stajduhar, K. I., Lindsay, J. and Buehler, S. 2008. Planning for end-of-life care: findings from the Canadian study of health and aging. Canadian Journal on Aging, 27, 1, 1121.Google Scholar
Glaser, B. G. and Strauss, A. 1971. Status Passage. Aldine Atherton, Chicago.Google Scholar
Gott, M., Small, N., Barnes, S., Payne, S. and Seamark, D. 2008. Older people's views of a good death in heart failure: implications for palliative care provision. Social Science and Medicine, 67, 7, 1113–21.CrossRefGoogle ScholarPubMed
High, D. M. 1993. Advance directives and the elderly: a study of intervention strategies to increase use. Gerontologist, 33, 3, 342–9.CrossRefGoogle ScholarPubMed
Howarth, G. 1998. ‘Just live for today’: living, caring, aging, and dying. Ageing & Society, 18, 6, 673–89.Google Scholar
Kahana, B., Dan, A., Kahana, E. and Kercher, K. 2004. The personal and social context of planning for end-of-life care. Journal of the American Geriatrics Society, 52, 7, 1163–7.Google Scholar
Kellehear, A. 1990. Dying of Cancer: The Final Year of Life. Harwood Academic Publishers, New York.Google Scholar
Kelner, M. 1995. Activists and delegators: elderly patients’ preferences about control at the end of life. Social Science and Medicine, 41, 4, 537–45.Google Scholar
Kjolseth, I., Ekeberg, O. and Steihaug, S. 2010. Why suicide? Elderly people who committed suicide and their experience of life in the period before their death. International Psychogeriatrics, 22, 2, 209–18.CrossRefGoogle ScholarPubMed
Kwak, J. and Haley, W. 2005. Current research findings on end-of-life decision making among racially or ethnically diverse groups. The Gerontologist, 45, 5, 634–14.Google Scholar
Lloyd-Williams, M., Kennedy, V., Sixsmith, A. and Sixsmith, J. 2007. The end of life: a qualitative study of the perceptions of people over the age of 80 on issues surrounding death and dying. Journal of Pain and Symptom Management, 34, 1, 60–6.Google Scholar
Marshall, V. 1986. A sociological perspective on aging and dying. In Marshall, V. (ed.), Later Life: The Social Psychology of Aging. Sage Publications, Beverly Hills, California, 125–46.Google Scholar
McKinley, E. D., Garrett, J. M., Evans, A. T. and Danis, M. 1996. Differences in end-of-life decision making among black and white ambulatory cancer patients. Journal of General Internal Medicine, 11, 11, 651–6.Google Scholar
Nakashima, M. and Canda, E. R. 2005. Positive dying and resiliency in later life: a qualitative study. Journal of Aging Studies, 19, 1, 109–25.CrossRefGoogle Scholar
Prentice, D. A. and Carranza, E. 2002. What women and men should be, shouldn't be, are allowed to be, and don't have to be: the contents of prescriptive gender stereotypes. Psychology of Women Quarterly, 26, 4, 269–81.CrossRefGoogle Scholar
Schrader, S. L., Nelson, M. L. and Eidsness, L. M. 2009. Dying to know: a community survey about dying and end-of-life care. Omega, 60, 1, 3350.CrossRefGoogle Scholar
Seymour, J., Gott, M., Bellamy, G., Ahmedzai, S. H. and Clark, D. 2004. Planning for end of life: the views of older people about advanced care statements. Social Science and Medicine, 59, 1, 7586.Google Scholar
Singer, P. A., Martin, D. K. and Kelner, M. 1999. Quality end-of-life care: patients’ perspectives. The Journal of the American Medical Association, 281, 2, 163–8.Google Scholar
Statistics Canada 2006. How Healthy are Canadians? Annual Report 2005. Available online at http://www.statcan.ca/english/freepub/82-003-SIE/82-003-SIE2005000.htm [Accessed 21 June 2006].Google Scholar
Steinhauser, K. E., Christakis, N. A., Clipp, E. C., McNeilly, M., McIntyre, L. and Tulsky, J. A. 2000. Factors considered important at the end of life by patients, family, physicians, and other care providers. The Journal of the American Medical Association, 284, 19, 2476–82.CrossRefGoogle ScholarPubMed
Strauss, A. and Corbin, J. 1998. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Sage, Thousand Oaks, California.Google Scholar
Ternestedt, B. R. and Franklin, L. L. 2006. Ways of relating to death: views of older people resident in nursing homes. International Journal of Palliative Nursing, 12, 7, 334–40.Google Scholar
Twigg, J. 2000. The Body in Health and Social Care. Palgrave Macmillan, New York.Google Scholar
Vig, E. K., Davenport, N. A. and Pearlman, R. A. 2002. Good deaths, bad deaths, and preferences for end of life: a qualitative study of geriatric outpatients. Journal of the American Geriatrics Society, 50, 9, 1541–8.Google Scholar
Whitaker, A. 2010. The body as existential midpoint: the aging and dying body of nursing home residents. Journal of Aging Studies, 24, 2, 96104.Google Scholar