Wisdom at the end of life: Hospice patients’ reflections on the meaning of life and death

Abstract

The processes of aging and confronting mortality are often accompanied by unique psychological challenges. From the perspective of positive psychology, such challenges can yield opportunities for growth, including increased wisdom. This qualitative study explored 15 terminally ill hospice patients’ perspectives on wisdom, the dying process, and the meaning of life using consensual qualitative research methods. Most participants cited humility as a key component of wisdom, emphasizing that “Wisdom is when we realize ‘I don’t really know much’.” Other components of wisdom included self-knowledge, rationality, experiential learning, listening to and learning from others, and sharing knowledge with others. Participants also suggested that the process of facing illness and death presents opportunities for positive growth, including changing priorities and learning to appreciate life more fully in the present moment. In considering the sources of meaning in their lives, participants emphasized relational connections, personal growth, spirituality, vocational fulfilment, and living a full life. Participants also shared their reflections on important past experiences and regrets. Lastly, participants offered advice to others based on their experiences facing illness and mortality. Implications for psychological care of the dying and future research are discussed.

Keywords:

• wisdom
• terminal illness
• positive psychology
• end-of-life
• posttraumatic growth
• hospice
• meaning

Acknowledgements

The authors would like to acknowledge the Hubbell family (in memory of Jayne Hubbell), the Mary and Antonio Napoli Endowment Fund and the Dr. Elmer and Mollie Milch Endowment Fund for their generous donations that made this research possible. We would also like to thank Dr. Christopher Kerr, Dr. Myrna L. Friedlander, and Dr. Robert Milch for their support and guidance in conducting this study.

Disclosure statement

No potential conflict of interest was reported by the authors.