The effects of ego integrity and readiness for death on the preferences of care near the end-of-life of hospitalized older adults in long-term care hospitals: A cross-sectional correlation study

Abstract

Purpose: This study aimed to investigate ego integrity, readiness for death, and preferences of care near the end-of-life among hospitalized older adults in long-term care hospitals and identify factors that influence end-of-life care preference. Methods: A total of 181 older adults in long-term care hospitals participated in the study, and data collection was conducted from July 20th, 2020 to September 20th, 2020. Descriptive statistics, t-test, ANOVA, Pearson’s correlations, and multiple regression were used for data analysis. Results: The older adults in hospitalized in long-term care hospitals preferred pain management even at the risk of hastened death, while the least preferred option was autonomous decision-making, including artificially prolonging human life. Regarding end-of-life care preferences, ego-integrity (β=-.18, p=.004) and death-readiness (β=-.18, p=.005) were factors that only influenced the spiritual domain and in the pain domain, it was confirmed that only the ego-integrity (β=-.16, p=.013) was affected. Conclusion: Although ego integrity and readiness for death did not affect all areas of end-of-life care preference among older adults in long-term care hospitals, they represent significant variables denoting positive acceptance of death and life satisfaction. As such, it is necessary to provide various opportunities for these factors to be considered in the overall process of aging. Furthermore, it has been confirmed that other variables can influence each subdomain of end-of-life care preference. Therefore, nurses should support hospitalized older adults in receiving end-of-life care according to their preferred domains.