Understanding death wishes in later life: a narrative review
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By
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Richard C. Oude Voshaar
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Radboud M. Marijnissen
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June 19, 2026
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Clinical Scorecard: Exploring End-of-Life Desires in the Elderly: A Comprehensive Narrative Review
At a Glance
| Category | Detail |
|---|
| Condition | Death wishes in older adults |
| Key Mechanisms | Psychological, social, and cultural influences on end-of-life desires |
| Target Population | Older adults aged 55 and above |
| Care Setting | Geriatrics, psychiatry, and palliative care |
Key Highlights
- Death wishes are complex and not solely linked to mental illness or terminal conditions.
- Existential factors, such as loss of autonomy and social disconnection, contribute significantly to death wishes.
- A multidimensional approach is necessary to understand and address death wishes in older adults.
Guideline-Based Recommendations
Diagnosis
- Distinguish between psychiatric-driven suicidal ideation and existentially rooted death wishes.
Management
- Employ narrative competence and existential sensitivity in clinical responses.
Monitoring & Follow-up
- Recognize the spectrum of death wishes, from passive thoughts to explicit requests for assisted dying.
Risks
- Consider the impact of loneliness, perceived burdensomeness, and societal narratives on older adults' death wishes.
Patient & Prescribing Data
Older adults experiencing death wishes
Responses should be informed by an understanding of the individual's narrative and contextual factors.
Clinical Best Practices
- Adopt a multilevel framework to assess and address death wishes.
- Incorporate discussions about autonomy and suffering within the context of legal and ethical considerations.
Related Resources & Content
