section_path: Frailty/Death
section_name: Death
paragraph_text: Death
  
  Old age, death, and frailty are closely linked, with approximately half the deaths in old age preceded by months or years of frailty.
  
  Older Adults' Views on Death is based on interviews with 109 people in the 70–90 age range, with a mean age of 80.7. Almost 20% of the people wanted to use whatever treatment that might postpone death. About the same number said that, given a terminal illness, they would choose assisted suicide. Roughly half chose doing nothing except live day by day until death comes naturally without medical or other intervention designed to prolong life. This choice was coupled with a desire to receive palliative care if needed.
  
  About half of older adults have multimorbidity, that is, they have three or more chronic conditions. Medical advances have made it possible to "postpone death", but in many cases this postponement adds "prolonged sickness, dependence, pain, and suffering", a time that is costly in social, psychological, and economic terms.
  
  The longitudinal interviews of 150 age 85+ people summarized in Life Beyond 85 Years found "progressive terminal decline" in the year prior to death: constant fatigue, much sleep, detachment from people, things, and activities, simplified lives. Most of the interviewees did not fear death; some would welcome it. One person said, "Living this long is pure hell." However, nearly everyone feared a long process of dying. Some wanted to die in their sleep; others wanted to die "on their feet".
  
  The study of Older Adults' Views on Death found that the more frail people were, the more "pain, suffering, and struggles" they were enduring, the more likely they were to "accept and welcome" death as a release from their misery. Their fear about the process of dying was that it would prolong their distress. Besides being a release from misery, some saw death as a way to reunite with deceased loved ones. Others saw death as a way to free their caretakers from the burden of their care.