A study of the dying process in elderly hospitalized males

The dying process was studied by questioning nurses and next of kin of 40 consecutive patients who died in an acute care Veterans Hospital. Information regarding problems commonly thought important in the dying process was elicited and attempts were made to relate this information to global assessments of quality of life during the preterminal week and quality of the moments surrounding death. Despite long-standing awareness of many of these problems, important pain, respiratory difficulty, mood problems, blunted alertness, stooling problems, urination problems, and oral intake problems each was present in at least 50% of patients. Multivariate analysis did not define a convincing relationship between these problems and global assessments of quality. Responses of nurses and next of kin were similar most of the time, but nurses systematically rated pain as less severe than next of kin and next of kin systematically demonstrated less awareness of urinary and stooling problems than nurses.