Planning in advance: exploring end-of-life hopes and fears among healthy young people

ABSTRACT

Discussions regarding end-of-life (EOL) preferences often occur late in the course of a disease leading to rushed clinical decisions misaligned with patient goals. Thus, the purpose of the current study was to identify EOL goals among a healthy sample of young adults (N = 305) through a possible selves framework. Common EOL hopes included: having loved ones present, closure, and living a full life. Common EOL fears included: pain and suffering, specific types of death, and dying alone. Hopes and fears related to religiosity were rare. Overall, participants felt more confident attaining EOL hopes than avoiding EOL fears. Even in young adulthood, when concerns related to ageing, illness, and dying are not acute, individuals have clear ideas regarding what they do and do not want to experience at their end of life. Conversations regarding EOL preferences should therefore be initiated with adult patients of all ages. Clinically, end-of-life training and care should integrate these psychological insights.

KEYWORDS:

• Possible selves
• death attitudes
• end-of-life goals
• mixed methods

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Alissa Dark-Freudeman

Alissa Dark-Freudeman, PhD, is an Associate Professor in the Department of Psychology at the University of North Carolina Wilmington. She is a developmental psychologist who specializes in adult development and aging. Dr. Dark-Freudeman’s research explores the content of our hopes and fears as they relate to health, aging, loss, and dying. She is particularly interested in how these hopes and fears ultimately relate to psychological well-being, death anxiety, and health-related behaviors. Additional information about her current research projects can be found at http://people.uncw.edu/freudemana/.

Christian Terry

Christian Terry, M.A. is a doctoral candidate in the Clinical Psychology program at the University of North Carolina Wilmington at the time of this publication. He has conducted research with the UNCW RISE Lab for eight years since his undergraduate involvement at the university began. Through that time, he has assisted in and led empirical investigations of death anxiety, death memories, and hopes and fears related to death and dying. His clinical and research interests additionally include mindfulness-based interventions in older adults, as well as neurocognitive assessment and self-awareness of neurocognitive deficits in adult and geriatric populations.

Jason Fleming

Jason Fleming, MS, is the Information Technology Librarian at the University of North Carolina Wilmington. His research interests include gamification, makerspaces, and information discovery.

John Hollander

John Hollander, MA, is a graduate student in the Experimental Psychology Ph.D. program at the University of Memphis. His psycholinguistic research foci include semantic representation, cognitive mechanisms of language pragmatics, and the use of eye-tracking methodologies.

Benjamin Bensadon

Benjamin Bensadon, Ed. M, Ph.D., is an associate professor in the division of geriatric medicine through the department of aging and geriatric research at the University of Florida. He is also a licensed clinical gero-psychologist. Dr. Bensadon’s training and professional experience is centered on integrating psychology and medicine, with the goal of transforming primary care and creating an age-friendly health care system.