SPICT seems to be valuable for identifying geriatric patients in need of palliative care as it demonstrates significant association with one-year mortality and with clinical survival predictions of experienced geriatricians, as reflected by TLDs given.

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BackgroundOlder adults face accumulated vulnerabilities that can make day-to-day life a constant struggle. This may lead to the feeling that the story of their life has come to an end and a persistent death wish. In this context tiredness of life has become a widely used term, but remains a poorly understood concept in healthcare. This study seeks to review the health-related literature on tiredness of life and to identify attributes, antecedents and consequences of the concept. MethodsA concept analysis of the scientific literature in the health disciplines was performed using Rodgers’ evolutionary method. Four databases (Pubmed, Web of Science, CINAHL and EMBASE) were searched (January 2000-September 2019). ResultsThirty-three publications were included. Four defining attributes (being weary of life, motivational depletion, loss of meaning in life and an inability to connect to ones’ life), four antecedents (the experience of unpredictable circumstances, experienced age-related life struggles, the fear of dependency and social redundancy), and three consequences (euthanasia requests, voluntary refusal to eat and drink and suicide) were identified. Concepts such as ‘finished with life’, ‘suffering from life’ and ‘completed life’ were used interchangeably both in public debate as among health care providers and patients.ConclusionsInternational consensus definition on “tiredness of life” is currently lacking. Analysis of its defining attributes and antecedents provides important information related to its impact and potential risk factors. Clearly, more work is needed to grasp the experience of tiredness of life.