Death wishes among older people assessed for home support and long‐term aged residential care

Cheung, Gary; Edwards, Siobhan; Sundram, Frederick

doi:10.1002/gps.4624

Cited by 23 publications

(16 citation statements)

References 55 publications

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“…The piloting of these two instruments allowed us to estimate the prevalence of the wish to die in older people hospitalized in geriatric rehabilitation. The prevalence of the wish to die (12.9%‐14.9% according to the assessment tool) was higher than reported for primary care populations 65 years and older using other measurement tools, but strikingly similar to that reported by a large longitudinal study among Dutch citizens between 58 and 98 years old . It was slightly lower than the prevalence generally obtained with terminally ill patients in palliative care across all ages .…”

Section: Discussionsupporting

confidence: 79%

Wish to Die in Older Patients: Development and Validation of Two Assessment Instruments

Dürst

Spencer

Büla

et al. 2020

J American Geriatrics Society

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OBJECTIVES The wish to die may be different in geriatric patients than in younger terminally ill patients. This study aimed to develop and validate instruments for assessing the wish to die in geriatric patients. DESIGN Cross‐sectional study. SETTING Geriatric rehabilitation unit of a university hospital. PARTICIPANTS Patients (N = 101) aged 65 years or older with a Mini‐Mental State Examination score of 20 or higher, admitted consecutively over a 5‐month period. MEASUREMENTS The Schedule of Attitudes Toward Hastened Death (SAHD) was adapted to the older population (SAHD‐Senior). A second tool was developed based on qualitative literature, the Categories of Attitudes Toward Death Occurrence (CADO). After cognitive pretesting, these instruments were validated in a sample of patients admitted to a geriatric rehabilitation unit. RESULTS The SAHD‐Senior showed good psychometric properties and a unifactorial structure. In the studied sample, 12.9% had a SAHD‐Senior score of 10 or higher, suggesting a significant wish to die. Associations were observed between high levels of the SAHD‐Senior and advanced age, high levels of depressive symptoms, lower quality of life, and lower cognitive function. The CADO allowed for passive death wishes to be distinguished from wishes to actively hasten death. According to the CADO, 14.9% of the sample had a wish to die. The two instruments showed a concordance rate of 90.1%. CONCLUSION The wish to die in older patients admitted to rehabilitation can be validly assessed with two novel instruments. The considerable proportion with a wish to die warrants investigation into concept, determinants, and management of the wish to die. J Am Geriatr Soc 68:1202–1209, 2020.

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Section: Discussionsupporting

confidence: 79%

Wish to Die in Older Patients: Development and Validation of Two Assessment Instruments

Dürst

Spencer

Büla

et al. 2020

J American Geriatrics Society

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“…Older adults assessed for home support services and aged residential care typically have physical illness and/ or functional impairment [16]. Functional limitation is one of the main aetiological factors for loneliness in older adults [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 on the health and psychosocial status of vulnerable older adults: study protocol for an observational study

et al. 2020

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Background Many countries around the world have adopted social distancing as one of the public health measures to reduce COVID-19 transmissions in the community. Such measures could have negative effects on the mental health of the population. The aims of this study are to (1) track the impact of COVID-19 on self-reported mood, self-rated health, other health and psychosocial indicators, and health services utilization of people who have an interRAI assessment during the first year of COVID-19; (2) compare these indicators with the same indicators in people who had an interRAI assessment in the year before COVID-19; and (3) report these indicators publicly as soon as data analysis is completed every 3 months. Methods interRAI COVID-19 Study (iCoS) is an observational study on routinely collected national data using the interRAI Home Care and Contact Assessment, which are standardized geriatric assessment tools mandated for all people assessed for publicly funded home support services and aged residential care in New Zealand. Based on the 2018/19 figures, we estimated there are 36,000 interRAI assessments per annum. We will compare the four post-lockdown quarters (from 25th March 2020) with the respective pre-lockdown quarters. The primary outcomes are self-reported mood (feeling sad, depressed or hopeless: 0 = no, 1 = yes) and self-rated health (0 = excellent, 1 = good, 2 = fair, 3 = poor). We will also analyze sociodemographics, other secondary health and psychosocial indicators, and health services utilization. Descriptive statistics will be conducted for primary outcomes and other indicators for each of the eight quarters. We will compare the quarters using regression models adjusted for demographic characteristics using weights or additional variables. Key health and psychosocial indicators will be reported publicly as soon as data analysis is completed for each quarter in the 12-month post-lockdown period by using a data visualization tool. Discussion This rapid translation of routinely collected national interRAI data will provide a means to monitor the health and psychosocial well-being of vulnerable older New Zealanders. Insights from this study can be shared with other countries that use interRAI and prepare health and social services for similar epidemics/pandemics in the future.

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“…The experience of wishes to die among older adults has been studied before worldwide and prevalence estimates ranged between 4.6 and 9.5% [ 1 – 5 ]. In the Netherlands, two studies including also middle-aged adults have been performed.…”

Section: Introductionmentioning

confidence: 99%

“…The aforementioned studies have identified factors associated with having a wish to die in many of these domains. However, most of these studies were able to include limited sets of factors, while it is known that death wishes in older adults develop in complex contexts and often implicate a broad range of factors [ 5 ]. It is currently unknown which factors are the most important within the four domains of vulnerability for having a wish to die.…”

Section: Introductionmentioning

confidence: 99%

Current wishes to die; characteristics of middle-aged and older Dutch adults who are ready to give up on life: a cross-sectional study

et al. 2021

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Background Literature shows that middle-aged and older adults sometimes experience a wish to die. Reasons for these wishes may be complex and involve multiple factors. One important question is to what extent people with a wish to die have medically classifiable conditions. Aim (1) Estimate the prevalence of a current wish to die among middle-aged and older adults in The Netherlands; (2) explore which factors within domains of vulnerability (physical, cognitive, social and psychological) are associated with a current wish to die; (3) assess how many middle-aged and older adults with a current wish to die do not have a medically classifiable condition and/or an accumulation of age-related health problems. Methods Data of 2015/16 from the Longitudinal Aging Study Amsterdam were used for this cross-sectional study (1563 Dutch middle-aged and older adults aged between 57 and 99 years), obtained through structured medical interviews and self-reported questionnaires. Three experienced physicians assessed whether the participants with a current wish to die could be classified as having a medically classifiable condition and/or an accumulation of age-related health problems. Results N = 62 participants (4.0%) had a current wish to die. Having a current wish to die was associated with multiple characteristics across four domains of vulnerability, among which: self-perceived health, problems with memory, self-perceived quality of life and meaningfulness of life. Fifty-four participants with a current wish to die were assessed with having a medically classifiable condition, of which one was also assessed with having an accumulation of age-related health problems. Six people were assessed to have neither, and for two people it was unclear. Conclusion A small minority of middle-aged and older adults in the Netherlands have a current wish to die. Most of them can be classified with a medical condition and one person with an accumulation of age-related health problems. Furthermore, the findings show that having a current wish to die is multi-faceted. There is still a need for more knowledge, such as insight in to what extent suffering stemming from the medical classifiable disease contributes to the development of the wish to die.

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Death wishes among older people assessed for home support and long‐term aged residential care

Cited by 23 publications

References 55 publications

Wish to Die in Older Patients: Development and Validation of Two Assessment Instruments

Wish to Die in Older Patients: Development and Validation of Two Assessment Instruments

Impact of COVID-19 on the health and psychosocial status of vulnerable older adults: study protocol for an observational study

Current wishes to die; characteristics of middle-aged and older Dutch adults who are ready to give up on life: a cross-sectional study

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