Understanding the wish to die in elderly nursing home residents

The wish to die has many facets: it can be a wish that death comes naturally, but it can also be an explicit wish for assisted suicide or active euthanasia. In palliative care, the wish to die has been studied in people with end-stage cancer. But up to now little is known about the wish to die in elderly persons living in nursing homes, even though these elderly persons are often in poor health and do not infrequently express a wish to die.

This study looks at 380 elderly residents of nursing homes in three different regions of Switzerland (in the cantons of Vaud, Ticino and St. Gallen). All new residents at the participating institutions will be asked to take part to the study. Consenting participants will be assessed with regard to their death wish, their spiritual distress and their psychological state. Qualitative interviews will be conducted with some of the participants. Frequency, strength and cause of the wish to die will be determined. The study will focus particularly on elucidating the links between spiritual distress, depression and the wish to die.

The results of this study will help medical staff and health professionals in nursing homes to better understand why some elderly people wish to die. In addition, the study - taking great care to safeguard the personal integrity and dignity of the individual - will make possible the development of concrete measures for care of persons whose wish to die is the expression of a distress.

Understanding the wish to die in elderly nursing home residents: a mixed method approach