Sorry to bring everything down for a second, but you and everyone you know and love is going to die. Depending on your age and circumstances, that fact is going to be easier to fathom for some than others, but whether you die peacefully in your sleep at 100, surrounded by friends and family, or have your skull crushed like a watermelon in one-on-one combat, one way or another, we’re all going to leave this mortal coil somehow.
That "somehow" is what a massive study has been investigating, and now researchers have identified a list of 11 factors that define the most preferable, or "successful" death.
"Death is obviously a controversial topic. People don't like to talk about it in detail, but we should. It’s important to speak honestly and transparently about what kind of death each of us would prefer," says one of the researchers, Dilip Jeste from the University of California, San Diego School of Medicine.
Jeste and his team analysed the results of 32 studies that have investigated people’s preferences for death, and focused on three groups of 'stakeholders': patients (i.e. the ones doing the dying), family members (before or after the death of a relative) and health care providers.
"This is the first time that data from all of the involved parties have been put together," said Jeste.
Across the three stakeholder groups, the researchers found that the top three most important factors when it comes to a pleasant death is exactly how a person dies, the level of pain they experience, and what their emotional state is at the time of death.
As Sarah Emerson explains at Motherboard, "These indicators aren’t achievements that need to be unlocked to have a pleasant death, but one might think of them as guidelines or themes to be considerate of when dealing with a person who’s near the end of their life."
Beyond preferences for "a specific dying process, pain-free status, and emotional well-being" being first and foremost for all three stakeholder groups, for the other factors, different groups placed different levels of emphasis on them.
For example, the patient stakeholders (the ones doing the dying) put more importance on religious/spiritual resolve in death than the family member stakeholders, who were more interested in dignity and satisfaction with the life that’s just been lived.
Which makes sense - when you’re forced to contemplate what you’re actually going to experience when you die, you’re going to be a whole lot more focussed on what comes next than those looking on.
The health care provider stakeholders tended to take a middle ground between the two, the researchers report.
"Clinically, we often see a difference between what patients, family members, and health care providers value as most important near the end of life," said one of the team, physiologist Emily Meier. "Ultimately, existential and other psychosocial concerns may be prevalent among patients, and this serves as a reminder that we must ask about all facets of care that are essential at the end of life."
So what are the 11 key indicators of a successful death?
- preferences for a specific dying process,
- pain-free status,
- emotional well-being,
- life completion,
- treatment preferences,
- quality of life,
- relationship with the health care provider
Of course, not many of us actually get to choose how we die, or have much control over other factors such as life completion, quality of life, or level of pain, but the researchers say that just knowing what a person who's dying values most - and what those around them value - will make the whole inevitable process that much better. Just "ask the patient," says Jeste.
The results of the meta-analysis have been published in The American Journal of Geriatric Psychiatry.