Thousands and thousands of older people die every year. Yet, contrary to popular belief, most of them do not die of 'old age.'
'Old age' is not a disease. Most older people who do not die of an accident, murder or suicide actually die of a life-threatening disease that often becomes more prevalent in late adulthood (e.g., heart disease, cancer).
Another of the myths about aging is that people become increasingly more fearful and anxious of death as they grow older. In general, older people think about death more often than do younger people, but healthy, normally aging older adults usually express less fear and anxiety about death than do younger adults.
In a more recent survey conducted by AARP, nearly 2,000 Americans age 45 and older were questioned about their fear of dying. More younger people (about 30 percent of those 45-49) expressed fear of dying than older people (about 15 percent of those 75 and older). More women overall (24 percent) than men overall (18 percent) were afraid of dying.
The role of religious conviction and belief in an afterlife is ambiguous in reducing the fear of death for older people. In some cases, a strong conviction does seem to help. But in other cases it may actually increase the intensity of fear. In general, older people who face old age with the feeling of integrity in their lives (their lives were worth living) have less fear than do older people who are confronted by despair that their lives were not worth living.
Is there any consistent pattern to how people face death when they know they have a terminal illness and will die fairly soon? This question is of particular interest in gerontology because a large proportion of the terminally ill population consists of older people.
In the early 1960s Dr. Elizabeth Kubler-Ross provided evidence to suggest that many terminally ill people progress through a series of emotional stages. Her stage theory was based on interviews with 200 terminally ill individuals.
According to Kubler-Ross, the first stage is one of shock and disbelief in which the individual feels a diagnostic mistake must have been made and denies the reality of the diagnosis.
However, most terminally ill individuals eventually accept the diagnosis and move into the second stage, one characterized by the expression of anger and hostility directed toward healthy people. This stage is followed by a bargaining stage in which they may appeal to a higher being, pledging that they will be better persons if they are allowed to live.
Eventually they realize the bargaining is ineffective, and they enter a stage in which they experience depression, guilt and shame about their lives.
Discussing their life experiences with others helps them enter the final stage in which they accept the inevitability of their own deaths.
Yet, Kubler-Ross said not all terminally ill people progress through these stages. And even those who do may move through them at different rates.
Dr. Donald H. Kausler, emeritus professor of psychology at the University of Missouri-Columbia, is author of 'The Graying of America: An Encyclopedia of Aging, Health, Mind, and Behavior.' His e-mail address is dkausler2@aol.com. He is a regular columnist for Scripps Howard News Service.
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