Technology and "natural death": a study of older people

This paper reports a qualitative study in which the aim was to examine older peoples' beliefs and risk perceptions regarding the use of innovative health technologies in end-of-life care and to relate these beliefs to their ideas about 'natural death'. Pictures, story boards and media extracts were used during interviews and focus groups, and the research team was assisted by an advisory group which included participants. Seventy-seven older people from three age cohorts (65-74; 75-84; 85 years and over) and from three contrasting areas of Sheffield, UK took part. Key messages are for the need to ensure that 'life prolonging' and 'basic care' technologies are provided in ways that respect a variety of understandings about love, comfort, obligation and burden during dying. The study highlights: the role that older people have in caring for the dying and their needs for support and training; information needs about issues of ethics, clinical practice and advance care planning; and the willingness of older research participants to discuss these matters and to enjoy the process of so doing. Developing a programme of public education and information was identified as an issue which should be addressed urgently if older people and their family carers are to be better equipped to make informed choices about these aspects of care. The study draws together issues previously considered under the largely separate remits of palliative care and gerontology. It is being used to provide advice on palliative and end-of-life care, especially to nursing and medical practitioners and to voluntary sector organisations as they begin to assess the need for action in this field.