A Study On Good Death Of Aged People In Pension Institutions In Leshan

Objectives: This study is intended to investigate the end-of-life expectations of the elderly people in pension institutions in Leshan so that hospitals and community can provide more targeted hospice cares for the elderly people. It also aims to provide the basis for the analysis of factors affecting end-of-life expectations of the elderly people from those institutions. The affecting factors are the elderly people’s gender, age, health status, marital status, educational status, residency, personal monthly income, religious belief, religious sects, religious time, past health history, critically ill patient contact history and history of family loss, etc. It also tends to offer evidences for the further development of hospice cares for the elderly people and present references for a better research of “Good Death” in Chinese cultural background.Methods: During July to October, 2014, 600 elderly people from 6 Leshan pension institutions(2 from large-sized ones, 2 from medium ones, and 2 from small-sized one) are involved in this research. 600 clients are firstly sampled from the institutions. Data are then collected from them through questionnaires, which are designed after Good Death Inventory by Miyashita. After the database is established by Epidata 3.0, the collected data are finally analyzed via SPSS 19.0(Statistic Package for Social Science).Results:(1) The average score for the evaluation on the “Good Death” core items(10 items) is between 3.64 and 4.26. Satisfied and completely satisfied choices are more than 60%.(2) The evaluation on the 8 optional items for the expectation of the “Good Death” is as follows. The number of the elderly who agree and completely agree that they should be told about the dying time is more than 50%; the number of those who agreed and completely agreed that they should not be told about the dying time is nearly 50%. 38.91% seniors disagree that they should feel sick while they show their weakness before their families. 78.67% seniors agree and completely agree that they should have their religious beliefs. 47.61% seniors agree that they should feel they are blessed by the God or Goddess. In a word, the elderly from the pensions have great expectations on their physiological, psychological and social needs.(3) The evaluation on the single factor affecting the expectations of the “Good Death” is revealed as follows. Marital status and history of family loss have not shown their influence on the expectations of the “Good Death” since the scores of the elderly people’s agreement on all the items are not statistically significant(P>0.05). On the other hand, the gender, the age, the residency, the educational status, the personal monthly income, the past health history, the critically ill patient contact history and religious beliefs have made their large impact on the following items, such as A1(the patient should have no pain), B3(the patient should have a satisfied place of death), D2(the patient should have a professional nurse who makes him or her feel comfort), E2(the patient should not be a burden for his or her family), F3(the patient should have families to which he or she can talk), H1(the patient’s living environment should be quiet), I2(the patient’s values and beliefs should be deemed), J3(the patient should have a satisfied life), O3(the patient should not be told to be impending of the death), P1(the patient should feel sad for his or her changes of body images), R2(the patient should have different evaluations for the agreement on beliefs); because the scores of the patient’s agreement on those above-mentioned items are statistically significant(P﹤0.05).(4) The evaluation on the multiple factors affecting the expectation of the “Good Death” is as follows. The elderly clients who have suffered from serious diseases are likely to agree that “the patient should have no pain”, “the patient should have a satisfied place of death”, and “the patient should not be a burden for his or her families”. The clients who have contacted with critically ill patients are more likely to agree that “the patient should have a satisfied place of death”, “the patient should not be a burden for his or her families”, and “the patient should not be told to be the impending of death”. The female clients are pleased to agree that “the patient should have families to talk to” and “the patient should feel sad for his or her change of body images”.The clients with higher educational status would like to agree that “the patient should have families to talk to” and “the patient’s valued and beliefs should be deemed”. The clients without religious belief would agree that “the patient should have a satisfied life”; while the clients with religious beliefs are likely to agree that “people should have beliefs”. The clients who are from the rural areas have the tendency to agree that “the patient should not be a burden for his or her families”; while the clients who are from urban city believe that “the patient should feel sad for his or her change of body images”. The health elderly agree that “the patient should have a satisfied life”.Conclusions:(1) Chinese senior citizens tend to view a “Good Death” as the fact that they could have better relationship with their families and their medical staffs and could die without pain but with respect, peace and optimistic attitude in their favorite place.(2) The factors affecting the expectations of “good death” are multiple and are likely to be thoroughly assessed. The dying seniors should be provided with a humanistic hospice care according to their individual expectations.(3) Death Education should be offered for Chinese seniors. They should be encouraged to establish correct, active, and scientific ideas about death. They should be instructed to have better choices which could better meet the requirements of the senior’s life qualities and satisfy the benefits of family and society. They should be given the rights to die with respect,peace and ideal...