Older rural nonsurvivors: their prediction and terminal care

This research reports on nonsurvivorship by comparing two groups of older rural adults: 138 survivors and 45 nonsurvivors from the third wave of a longitudinal study. They were part of a sample of 418 adults aged 65 and older, first interviewed in 1976. The purposes of these analyses were to examine (a) the predictors of nonsurvivorship to very old age, (b) the final health crises of rural nonsurvivors, and (c) the formal and informal supports addressing their terminal health needs. Average age at death was 83. Results showed that only minimal variance in nonsurvival to very old age could be predicted using standard demographic and psychological variables. The relative importance of predictors varied according to time of measurement (age). Terminal illnesses were similar in type to those of the general aging population. Final illnesses were usually multiple and lengthy, and deaths seldom occurred in the older rural adults' county of residence. Families usually cared for older members without the assistance of formal supports except for a physician, who usually lived out of the county or in the adjoining state. Implications for practitioners are discussed.