Putting your house in order - an exploration of the idea of a good death among people dying in mid-life

[摘要] This qualitative study set out to explore the idea of a good death throughin-depth interviews with six terminally ill patients with cancer aged betweenthirty-seven and fifty-two, in other words in mid-life. Thematic content analysiswas used to examine overt and covert themes revealed in semi-structuredinterviews that had been transcribed verbatim. Significant fear of dying wasrevealed and although respondents did not seem to have a conscious idea of agood death, they had a clear concept of good dying. Two key components ofgood dying were not being in pain or distress from physical symptoms, andwanting to drift off into a final 'sleep” rather than being fully alert until the end. Itwas noticeable that, whether or not patients had religious convictions, relativelylittle attention appeared to be paid directly to what might or might not follow themoment of death itself, for example an afterlife. Preparation for good dyingincluded completing a will, sorting out financial affairs and, for some patients,planning a funeral. At times this preparation also included trying to mendconflicted relationships and make plans for the ongoing care of familymembers. It is postulated that these preparations helped re-constitute a senseof order that had been shattered by the chaos of being declared terminally ill ata time of life when this was non-normative. Moreover, taking care of practicalneeds re-established a sense of agency, helped achieve some sense of closureand symbolised a measure of acceptance of their dying status. Respondentsdid not seem to experience external pressure from others to die in a certainway, although two people were particularly aware of their influence on howothers in the family felt and thus tended to pretend to feel better than they did.

[发布机构] University of the Witwatersrand