People over the age of 95 tend to approach life one day at a time, knowing that death could come at any moment but not necessarily fearing it, according to a rare study on the attitudes of death among the very old conducted by researchers at the University of Cambridge in the U.K.
A growing number of people are living to a very old age due to advancements in medicine and healthcare as well as greater knowledge of healthy living. In fact, the number of people who live to the age of 90 or more has tripled in the past three decades in the U.K., according to a report published last year by the Office of National Statistics.
“Despite the dramatic rise in the number of people living into very old age, there is far too little discussion about what the ‘oldest old’ feel about the end of their lives,” says study leader Dr. Jane Fleming from the Department of Public Health and Primary Care at the University of Cambridge. “We know very little, too, about the difficult decisions concerning their end of life care.”
For the study, researchers interviewed 33 people over 95 years old from Cambridge City. For those participants too frail to be interviewed in-person, a relative or caregiver was interviewed in their place to help explain the elderly participants’ attitudes towards death, dying, and end-of-life care. Responses varied from heart-felt to humorous and provided a fascinating perspective on the views of an often overlooked minority.
For the oldest old, most of their friends and peers had died, so death was a regular part of life and many spoke of living on borrowed time. Many participants referred to “taking each day as it comes,” expressing gratitude for where they were in life and content, at this stage, to take life one day at a time, not worrying too much about tomorrow. There was a sense of life ticking along until something drastic happened. “It is only day-from-day when you get to ninety-seven,” said one.
One son-in-law describes his elderly mother-in-law giving a long-life light bulb to her granddaughter, saying, “Something for you, it’s not worth me having.”
Most of the interviewees felt ready to die. “I’m ready to go,” said one woman. “I just say I’m the lady-in-waiting, waiting to go.” Some felt they were a burden to others, while others were more desperate in their desire to reach the end, suggesting they had simply lived too long. “Please don’t let me live ’til I’m a hundred,” said an elderly woman.
Most expressed no fear of dying. For some this absence of fear was rooted in positive experiences of others’ dying: One interviewee said of her parents, “They were alive, then they were dead, but it all went off as usual. Nothing really dramatic or anything. Why should it be any different for me?”
The manner of death was of more concern than its imminence. Many explicitly expressed the wish to die peacefully, pain free, and preferably while asleep. “I’d be quite happy if I went suddenly like that,” said one interviewee, snapping their fingers.
When asked whether, if they had a life-threatening illness, they would want to receive treatment that would save their life or prefer treatment that would just make them comfortable, few people chose life-saving treatment. “Make me comfortable” was a far more typical response and proxy informants tended to echo the older people’s dominant preference for comfort rather than life-saving treatment.
“Now so many more people have reached a great age before they die, it’s important we know about their views and their concerns, particularly in relation to end-of-life care,” says Dr. Morag Farquhar, the study’s other lead author.
“These are difficult conversations to have and no one wants to have to face their own death or that of a loved one. But having these conversations before it is too late can help ensure that an individual’s wishes, rather than going unspoken, can be heard.”
The findings are published in the journal PLOS ONE.
Source: University of Cambridge