05/10/2010 - Articles

Fear of dying increases with supportive family network

By: Susan Aldridge, medical journalist, PhD

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Fear of dying is one factor influencing where people might choose to spend their final days – whether at home or in hospital. It is a sensitive subject but it is important to know how people feel about death in order to plan end of life care. Researchers at University College, London, now reveal that a person’s social networks and their ethnic background have a big impact on their level of fear of dying. Surprisingly, perhaps, those from ethnic minority backgrounds, with a large number of supportive relatives, seem to have the most fear of dying.

The researchers looked at attitudes on death and dying in a group of 1,000 people aged 65 or more. The group was made up on an ethnically diverse sample and a sample of white British people. They were asked about fear of dying, fear of manner of death, of losing control over their death and of suffering pain.

One third of those from an ethnic minority background lived with four or more adults, compared to just 1% of those with a white British background. Only one in 20 of those from an ethnic minority background lived on their own, compared to around half of the white British sample. Two thirds of those in the ethnic minority group had large family networks prepared to help them out, compared to only one in three of the white British group.

More than half of the ethnic minority participants had the worse scores on fear of dying, although this was mitigated among those having better quality of life, which was also assessed in this study. More than three out of four of those from an Indian, Pakistani, Black and Chinese background had a high degree of fear of dying, of the manner of death, of not being able to control their death and of being in pain. If anything, the presence of supportive relatives increased their fear of dying and related issues. Being in poor health, having a long-term illness and finding it hard to walk increased fear of dying. Older age tended to reduce fear of dying but only among the white British. The researchers say that fewer than one fifth of deaths in most developed countries, including the UK, occur at home and on current trends the figure will be fewer than one in 10 by 2030. One factor driving people into hospital in their final days might be fear about quality of care in the community. These findings suggest that the need for such care ought to be addressed. And that we should be aware that people’s fear of dying is influenced by their family and cultural situation and this needs to be taken into account when assessing their end of life care needs.

 

Source:

Bowling A et al Fear of dying in an ethnically diverse society: cross-sectional studies of people aged 65+ in Britain Postgraduate Medical Journal March 2010;86:197-202

 

Created on: 05/10/2010
Reviewed on: 05/10/2010

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