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Elderly people tend to be anxious about dying, not death
The three themes already mentioned all converge here. Dying and death are realistic concerns in later adult years; one can no more escape from mortality than one can escape from one’s own skin; and the process of departing from this life to the unknown is as universal and normative a transition as birth.
There is no firm evidence for the proposition that elderly men and women are more anxious about death than the general population. In fact, the available data suggest that younger adults have higher levels of everyday death anxiety than do healthy senior adults.
Peaks of death-related anxiety usually are seen only in elderly adults who are having a psychotic or trauma-evoked reaction, or as a fleeting reaction to an emergent situation (e.g., learning that one has cancer).
Studies usually find that age itself explains relatively little about an individual’s anxiety or other attitudes toward death.
Death-related anxiety is quite different, however, from fear or anxiety regarding death as such. For example, many people at any age have life concerns that are exacerbated by the prospect of death.
An elderly woman who has lived for many years with a variety of painful and disabling conditions may be ready to see her life end, but anxious about who will look after her “old man.” Another elderly person may be more concerned about what will become of the family estate when it falls into squabbling hands after his death.
Would-be counselors or other service-providers will be more useful if they learn to distinguish between existential anxiety regarding death and the variety of life-oriented concerns that can perturb people who are nearing the end of their lives.
Dying is perhaps the most salient of all death-related issues. Anxiety in the last phase of life often arises from dread of prolonged suffering and helplessness, feeling burdensome on others, and draining the family’s financial resources.
Again, a distinction must be made between how a person copes with the problem once it is directly at hand, and the fears and apprehensions that one may have lived with when thinking about a final ordeal.
Experience with hospice care has found that many elderly adults cope very well with their terminal illness, or serve as effective caregivers for a dying spouse.
With competent and caring support from others, including state-of-the-art symptom relief, elderly men and women often can remain comfortable and secure, still a valued part of their families, until their last breath.
Anxiety-reduction approaches, then, can take two general forms: relieving apprehensions about the dying process in advance through emotional support and information-giving, and preventing or ameliorating suffering and isolation during the dying process by competent and sensitive care.
Counselors or other caregivers who are themselves highly anxious about their own mortality may not be in a position to provide either of these services.
