scholarly journals Prevalence and characteristics of older adults with a persistent death wish without severe illness: a large cross-sectional survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Iris D. Hartog ◽  
Margot L. Zomers ◽  
Ghislaine J. M. W. van Thiel ◽  
Carlo Leget ◽  
Alfred P. E. Sachs ◽  
...  
Keyword(s):  
Older Adults ◽  
Assisted Suicide ◽  
Oldest Old ◽  
Severe Illness ◽  
Physician Assisted Suicide ◽  
Cross Sectional Survey ◽  
Questionnaire Response ◽  
Cross Sectional ◽  
Death Wishes ◽  
Death Wish

Abstract Background Some older persons develop a persistent death wish without being severely ill, often referred to as “completed life” or “tiredness of life”. In the Netherlands and Belgium, the question whether these persons should have legal options for euthanasia or physician-assisted suicide (EAS) is intensely debated. Our main aim was to investigate the prevalence and characteristics of older adults with a persistent death wish without severe illness, as the lack of this knowledge is a crucial problem in de debate. Methods We conducted a survey among a representative sample of 32,477 Dutch citizens aged 55+, comprising questions about health, existential issues and the nature of the death wish. Descriptive statistics were used to describe the group with a persistent death wish and no severe illness (PDW-NSI) and several subgroups. Results A total of 21,294 respondents completed the questionnaire (response rate 65.6%). We identified 267 respondents (1.25%) as having a persistent death wish and no severe illness (PDW-NSI). PDW-NSI did not only occur among the oldest old. Although qualifying themselves as “not severely ill”, those with PDW-NSI reported considerable health problems. A substantial minority of the PDW-NSI-group reported having had a death wish their whole lives. Within the group PDW-NSI 155 (0.73%) respondents had an active death wish, of which 36 (0.17% of the total response) reported a wish to actually end their lives. Thus, a death wish did not always equal a wish to actually end one’s life. Moreover, the death wishes were often ambiguous. For example, almost half of the PDW-NSI-group (49.1%) indicated finding life worthwhile at this moment. Conclusions The identified characteristics challenge the dominant “completed life” or “tiredness of life” image of healthy persons over the age of 75 who, overseeing their lives, reasonably decide they would prefer to die. The results also show that death wishes without severe illness are often ambiguous and do not necessarily signify a wish to end one’s life. It is of great importance to acknowledge these nuances and variety in the debate and in clinical practice, to be able to adequately recognize the persons involved and tailor to their needs.

scholarly journals Complexities in consultations in case of euthanasia or physician-assisted suicide: a survey among SCEN physicians

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Tessa D. Bergman ◽  
H. Roeline W. Pasman ◽  
Bregje D. Onwuteaka-Philipsen
Keyword(s):  
Psychiatric Disorders ◽  
Assisted Suicide ◽  
Public Debate ◽  
Main Diagnosis ◽  
Physician Assisted Suicide ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Age Related ◽  
Attending Physician ◽  
Complex Cases

Abstract Background In the Netherlands, euthanasia or physician-assisted suicide (EAS) is allowed if due care criteria are met. One criterion is consultation of a second independent physician, often SCEN physicians. The public debate about EAS focuses on patients with psychiatric disorders, dementia, and tired of living, as complex cases. What complexities SCEN physicians perceive during consultation is unknown. This study aims to assess the frequency of EAS consultations that are perceived difficult by SCEN physicians, to explore what complexities are perceived by SCEN physicians during consultation, and to assess what characteristics are associated with difficult consultations. Methods Data from 2015 to 2017 from an annual cross-sectional survey among SCEN physicians was used. In 2015, the survey focused on the most difficult consultation that year and in 2016/2017 on the most recent consultation. Frequencies of coded answers to an open-ended question were done to explore what complexities SCEN physicians perceived during their most difficult consultation. Univariable and multivariable logistic regression analyses were used to assess what characteristics were associated with difficult consultations. Results 21.6% of cases consulted by SCEN physicians is perceived difficult. Complexities that SCEN physicians perceive were mainly in contact with patients (79.7%) and in the assessment of due care criteria (41.0%). Characteristics that were associated with a higher likelihood of a consultation being difficult are the attending physician being less certain to perform the EAS, patients staying in the hospital, main diagnosis heart failure/CVA, and accumulation of age-related health problems/psychiatry/dementia, and the presence of a psychiatric disorder, or psychosocial or existential problems besides the main diagnosis. Characteristics that were associated with a lower likelihood of a consultation being difficult are high patient’s age and physical suffering as reason to request EAS. Conclusion Complexities perceived by SCEN physicians in EAS consultations are not limited to the ‘complex’ cases present in the current public debate about EAS, e.g. patients with psychiatric disorders, dementia, and tired of living. Attention for these complexities in intervision could indicate if there is a need among SCEN physicians to enhance knowledge and skills in training and to receive specific support in intervision on these complexities.

scholarly journals Attitudes towards physician-assisted suicide and euthanasia in Spanish university students

2019 ◽  
Vol 27 (3) ◽  
pp. 490-499 ◽  
Author(s):  
María Sol Rodríguez-Calvo ◽  
José Luis Soto ◽  
Isabel María Martínez-Silva ◽  
Fernando Vázquez-Portomeñe ◽  
José Ignacio Muñoz-Barús
Keyword(s):  
Medical Students ◽  
University Students ◽  
Undergraduate Students ◽  
Assisted Suicide ◽  
Willingness To Participate ◽  
Physician Assisted Suicide ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Assisted Death ◽  
Academic Degree

Abstract Attitudes toward physician-assisted death among medical students differ between populations. The aim of this study was to explore attitudes towards euthanasia and physician-assisted suicide among Spanish university students. A cross-sectional survey was conducted by asking undergraduate students (Medicine, Nursing and Law) of the University of Santiago de Compostela to complete an anonymous 17-item questionnaire. Most participants exhibited a positive attitude towards physician-assisted suicide (54%) and euthanasia (75%), as well as towards their legalization. Attitudes were consistent with the underlying ethical reasoning, with no differences in terms of age, gender or academic degree. In addition, consistency was found between attitudes and willingness to participate in physician-assisted suicide and euthanasia, should they be legal. The results showed that the attitudes of medical students towards euthanasia and physician-assisted suicide were positive and similar to non-medical students.

Non-physician-assisted suicide in The Netherlands: a cross-sectional survey among the general public

2013 ◽  
Vol 40 (12) ◽  
pp. 842-848 ◽  
Author(s):  
Merel Kristi Schoonman ◽  
Ghislaine José Madeleine Wilhelmien van Thiel ◽  
Johannes Jozef Marten van Delden
Keyword(s):  
The Netherlands ◽  
General Public ◽  
Assisted Suicide ◽  
Physician Assisted Suicide ◽  
Cross Sectional Survey ◽  
Cross Sectional

Health Concerns of Older Adults: Observations from a Survey and Public Education Programme in Bhubaneswar, India

2019 ◽  
Vol 15 (1) ◽  
pp. 10-16
Author(s):  
Shreyan Kar ◽  
Tushar Kanti Das ◽  
Prasanta Kumar Mohapatra ◽  
Brajaballav Kar ◽  
Anupama Senapati ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cardiovascular Risk ◽  
Mood State ◽  
Physical Symptoms ◽  
Considerable Proportion ◽  
Cardiovascular Risks ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Concerns

Background: While it is apparent that old age is associated with multiple health concerns, the extent of its multiplicity and burden is often not clear. It was intended to find out self-reported health concerns for one month and cardiovascular risk factors in middle and older adults. Methods: In the cross-sectional survey, attendees of a Healthy Ageing Conference were approached with a semi-structured questionnaire about their health concerns and cardiovascular risks. Risk of a cardiovascular event in 10 years based on QRISK3 was calculated. Results: A considerable proportion of older adults had a range of physical symptoms, depressive mood state and memory problems. Mean number of health problems reported were 4.8±3.3 (male 4.4±3.1 and female 5.0±4.3). Cardiovascular risk was high, mean QRISK3 score for males were 22.2% (±14.4), and for females 10.3% (±6.6) (p<0.05). On average, the heart age was increased by 7.9±6.2 years (8.6±6.6 years for males and 5.0±3.3 for females). The relative risk of participants was 2.1 for males and 1.5 for females for heart attack or stroke within the ten years, compared to healthy persons. The symptoms and risk factors were elicited easily, and the process probably facilitated improving the awareness about the health concerns holistically. The survey also identified issues related to the engagement of older adults in the existing health care systems. Conclusions: The results suggested that questionnaire-based health screening in a community can identify a range of health concerns and identify multi-morbidity in general and cardiovascular risks in particular. This process may help to focus on the appropriate public health awareness and intervention programmes required in the community.

scholarly journals Being useful among persons aged over 65: social representations from a cross-sectional European study

2021 ◽  
Author(s):  
Paul de Boissieu ◽  
Serge Guerin ◽  
Véronique Suissa ◽  
Fiona Ecarnot ◽  
Aude Letty ◽  
...  
Keyword(s):  
Social Representations ◽  
Oldest Old ◽  
Educational Status ◽  
Well Being ◽  
European Countries ◽  
City Size ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Socially Isolated ◽  
Quota Sampling

Abstract Background There is a compelling need to prepare our societies and healthcare systems to deal with the oncoming wave of population ageing. The majority of older persons maintain a desire to be valued and useful members of society and of their social networks. Aims We sought to investigate the perception of usefulness among persons aged 65 years and over in four European countries. Methods We performed a cross-sectional survey with a representative sample of individuals aged 65 years or older from the population of retired persons (including recently retired persons and oldest-old individuals) from 4 European countries selected using quota sampling. In February 2016, an internet questionnaire was sent to all selected individuals. The characteristics used for the quota sampling method were sex, age, socio-professional category, region, city size, number of persons in household, autonomy, marital status, place of residence, income and educational status. The questionnaire contained 57 questions. Sociodemographic characteristics were recorded. Responses were analysed with principal components analysis (PCA). Results A total of 4025 persons participated; 51% were males, and 70% were aged 65–75 years. PCA identified six classes of individuals, of which two classes (Classes 2 and 3) were characterized by more socially isolated individuals with little or no sense of usefulness, low self-esteem and a poor sense of well-being. These two classes accounted for almost 20% of the population. Younger and more autonomous classes reported a more salient sense of usefulness. Conclusions The loss of the sense of usefulness is associated with dissatisfaction with life and a loss of pleasure, and persons with profiles corresponding to Classes 2 and 3 should, therefore, be targeted for interventions aimed at restoring social links.

scholarly journals Functional Limitations and Perceived Neighborhood Walkability Among Urban Dwelling Older Adults

2021 ◽  
Vol 9 ◽  
Author(s):  
Rie Suzuki ◽  
Jennifer Blackwood ◽  
Noah J. Webster ◽  
Shailee Shah
Keyword(s):  
Older Adults ◽  
General Education ◽  
Functional Limitations ◽  
Walking Distance ◽  
Lower Income ◽  
Cross Sectional Survey ◽  
General Education Development ◽  
Education Development ◽  
Cross Sectional ◽  
Neighborhood Walkability

Older adults with functional limitations (FLs) often experience obstacles to walking. Although health promotion programs targeting physical activity are available in lower-income areas, few studies have compared the walking experiences of older adults who have FLs with those who do not in the community. The purpose of this cross-sectional survey was to compare perceptions of neighborhood walkability among older adults living in lower-income communities with and without FLs. Participants (N = 132) were recruited in 2018 at regional health clinics in Flint, Michigan. To be eligible, participants had to be 65 years of age or older, report no cognitive decline, and be Flint residents. Of the 132 participants, the mean age was 69.74 (SD = 4.97). The majority were female (66%); African American (77%); single, divorced, or widowed (72%); educated below the General Education Development level (57%), and had a FL (67%). Older adults with FLs were significantly (p &lt; 0.05) less likely than those without to visit many places within walking distance, to have well-lit neighborhoods at night, and to reside in neighborhoods where sidewalks were separated from the road and traffic. Multiple regression analyses revealed that having a FL was associated with poorer neighborhood perceptions of mixed-land-use (b = −0.19, p &lt; 0.05) and more walking hazards (b = −0.26, p &lt; 0.05). Findings suggest that a FL is associated with perceptions of walkability. It is essential to develop disability-friendly support systems and accommodations to encourage walking in lower-income communities.

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