Quality end-of-life care is subjective and based on individual values and beliefs. An advance directive provides a legal means of communicating these values and beliefs, as well as preferences in regards to end-of-life care when an individual is no longer able to make his or her desires known. In many nations, advance directives are underused…

Purpose: Almost half of people age 85 and older who die annually in the United States die as nursing home residents, yet because it is not always clear who is close to death, not all residents who might benefit from end-of-life care receive it. The purpose of this study is to develop a framework for organizing social interactions related to…

The study aimed at making a theory-driven inventory of end-of-life preferences. Participants were asked about a variety of preferences representing all eight motivational states described in Apter's Metamotivational Theory (AMT; Apter, 2001). Data from a convenience sample of 965 community participants and a convenience sample of 81 persons…

Purpose: The purpose of this study was to describe good quality care at the end of life (EOL) for hospice-enrolled residents in assisted living facilities (ALFs). Design and Methods: A qualitative descriptive design was used to obtain detailed descriptions of EOL care provided by ALF medication aides, caregivers, nurses, and hospice nurses in…

Deciding for or against a life-prolonging treatment represents a choice between prolonged life and death. When the death alternative is not described, individuals must supply their own assumptions. How do people imagine the experience of dying? The authors asked 40 elderly people open-ended questions about dying without 4 common life-prolonging…

Purpose: We designed this study to examine the end-of-life (EOL) experience in long-term care (LTC) based on input from key stakeholders. Design and Methods: The study consisted of 10 homogeneous focus groups drawn from a purposive sample of LTC residents (2 groups; total n = 11), family caregivers (2 groups; total n = 19), paraprofessional staff…

The vast majority of the 220,000 Canadians who die each year, principally of old age and progressive ill health, do not have access to specialized hospice or palliative care. Hospice and palliative care programs are unevenly distributed across Canada, with existing programs limited in capacity and services varying considerably across programs.…

Art work produced by geriatric patient on psychiatric ward illustrated metaphors of loss. After three months, patient was diagnosed with liver cancer; she died three weeks later. All work was produced before cancer diagnosis, yet it showed similarities to work by cancer patients, suggesting that client unconsciously knew she was dying and worked…

The study surveyed 135 health care professionals (74 nurses, 32 physicians, and 29 social workers) to examine their personal death attitudes and experiences in relation to their reported advance directive communication practice behavior. Negative correlations were found between collaborating with other health care professionals regarding the…

Contends that old age, in and of itself, should never need to be a cause for self-destruction. Further argues that suicide and assisted suicide carried out in the face of terminal illness causing unbearable suffering should be ethically and legally acceptable. Outlines a perspective on rational suicide among the elderly. (Author/NB)

Developed Hospice Caregiver Assessment Inventory to identify problems of those caring for dying patients, and Caregiver Intervention Plan. Analysis of 24 inventories and assessment plans identified problems of caregivers of dying older people. Results suggest that caregivers often need counseling assistance prior to death of patient, as well as…

Examined circumstances in the last 3 days of life for a sample of 1,227 elderly decedents. Interviews were with a surviving next-of-kin or a nonrelative about three months after the event of death. Around 34% of the decedents knew that death was impending, while about 40% had difficulty recognizing family members. (RJM)

Notes that people over age 60 have highest suicide rates and comprise one-fourth of all suicides. Presents case study illustrating risk assessment and intervention with elderly woman. Examines clinical issues related to recognition of suicidal elderly patients and presents practical approach to early detection, evaluation, and management of…

This "gray paper" addresses the concerns of older women regarding their control over death and dying. It is based on the observation that older women are devalued by society on account of both their age and gender, and hence are likely to be impoverished and vulnerable as they approach death. The paper begins by examining the legal,…

Assessed effects of nursing home staff training in care for the dying on quality of life of 306 terminally ill patients in 5 pairs of matched nursing homes assigned randomly to trained and not trained staff groups. Patients in trained homes had less depression and greater satisfaction with care than patients in control homes at 1 and 3 months.…