People are living longer lives all around the industrialized world, which, of course, implies that more and more of them will be exceedingly old by the time they die. People over the age of 85 account for over half of all fatalities in the United Kingdom, compared to only one in every five just 25 years earlier.

Growing older can result in a different kind of death, such as getting increasingly frailer in both body and mind over a long period of time and having a wide range of health issues over many years. Whereas years following retirement were historically seen as simply old age, a longer life expectancy implies that the later years now have variety, which is expressed in labels such as younger old and older old, respectively.

According to our prior study, persons who are over 90 at the time of their death require greater assistance with everyday activities in their final year than those who die in their late 80s. In the United Kingdom, around 85 percent of people who died at the age of 90 or older were severely crippled, requiring assistance with even the most basic of self-care duties. Only 59 percent of people between the ages of 85 and 89 at the time of death had this level of impairment.

There are ramifications for this understanding in terms of planning support for life and death in various care settings. However, what do we know about what elderly people (those aged 95 and above) genuinely desire when it comes to making decisions about their care as they near the end of their life is limited.

What the elderly think about death as they grow older

The elderly and frailest members of our society are becoming increasingly invisible, since many of those who require the most assistance, such as those suffering from dementia, are either in care facilities or less able to travel around. However, their perspectives are critical in the development of end-of-life care services.

In our most recent study, we spoke with 33 women and men who were at least 95 years old, some of whom were over 100, as well as 39 of their relatives or carers, about their care experiences and preferences. Eighty-eight percent of those were women, 86 percent were widowed, and 42 percent were residents of nursing facilities.

A large number of elderly persons stated that death was an unavoidable part of life, and that they were content to live each day as it came rather than worrying too much about tomorrow. A lady explained that after she reached 97, "it was merely day-from-day." Most people were prepared to die, and some even looked forward to it: "I just say I'm the lady-in-waiting, waiting to depart," one woman explained.

The drive to reach the end of the tunnel was even stronger in other people. "I wish I had the ability to snuff it. "I'm merely getting in the way," was a common emotion among individuals who believed they were being a hindrance. Others pleaded with the authorities not to allow them to live until they were a hundred years old, claiming that there was no use in keeping them alive.

Those that remained were mostly concerned about their loved ones: "The only thing I'm concerned about is my sister," said one. "I hope she will not be depressed and will be able to come to grips with the situation."

The dying process itself was the source of the majority of concerns. A quiet and painless death, especially while still asleep, was a popular wish among people who wanted to die. The majority of those interviewed desired to be made comfortable rather than get treatment, expressing a desire to avoid being sent to a hospital.

Families' knowledge of their relative's preferences was only infrequently inaccurate, according to our findings (just twice). Someone stated that they wanted to be treated as long as they possibly could, although a family member assumed that they would prefer palliative care, for example. This demonstrates the necessity of attempting to discuss possibilities with the elderly person rather than presuming their family is aware of their preferences and concerns.

In our research, we discovered that most people were eager to discuss their end-of-life desires, and many people stated that prior discussion of death was unusual, typically just referred to or couched in humor. A small number of people were uninterested in these talks.

The majority of the elderly are not afraid of death, and some even look forward to it.

We need to have a conversation with the elderly.

However, there have been some studies that have looked at the perspectives of persons in their tenth or eleventh decade, thus it is possible to learn more about their perspectives. The majority of these have been directed towards residents in nursing homes, with a few exceptions directed at people who live at home.

A study of the literature undertaken in Sweden in 2013 discovered a total of 33 research conducted all over the globe that investigated attitudes on death and dying among older people, however only a small number of them sought the perspectives of the elderly.

The findings of a 2002 study indicated that elderly residents of Ghana were looking forward to death, seeing it as a welcome guest who would provide serenity and relaxation after a stressful existence. In addition, according to a 2013 research conducted in the Netherlands, many patients altered their preferences for how they wished to die when their care requirements changed.

According to a recent research, older people's opinions regarding advance care planning, as well as their preferences for when to begin such conversations, have changed over time. It found 24 research, the majority of which were conducted in the United States and involved people in their early to mid-fifties. The findings revealed that, while a minority of participants avoided discussions on end-of-life care, the majority were open to them but were seldom given the opportunity to do so.

According to our results, older people are willing to address typically taboo themes, they embrace the fact that they will die, and they are concerned about what the dying process will bring: increased dependency, becoming a burden, and the impact of their own death on those who will be left behind.

We must understand the priorities of individuals who are nearing the end of their lives in order to create services that will best serve the growing number of people who are dying at progressively older ages in a variety of settings.