Death Preparation and Its Mediating Effect between Social Activities and Life Satisfaction Among Older Adults Living Alone

Background/Purpose: The fact that death is inevitable may cause much more fear and discomfort, particularly, among older adults. Usually, chances of losing a confidant or significant other rise with age. These changes may provoke older adults to think that I have to prepare something before my death by myself. Furthermore, many of them think death preparation is one last life task as well as a stressful task before termination. Studies show death preparation varies among older adults. Especially, older adults living alone seem to be under the worse conditions in comparing the other group, due to limited accessibility to diverse resources. Death education has been studied extensively, but few studies have examined the relationship between life satisfaction, death preparation, and the social activities of older adults living alone. Considering the relationship between life satisfaction and social activities, this study examines the mediating effect of death preparation among older adults living alone.

Methods: Data and samples: Among 10,079 community-dwelling older adults aged 65 years and older from 2020 National Survey of Older Koreans, 2,996 (79.1% female, mean age=75.2 years ± 6.8) cases were analyzed in South Korea.

Measures: Participation in social activities was measured through categorized into 0 to 6 across four types of activities such as religion, club activities, social gathering, and political groups. Life satisfaction was measured with 6 items such as health status, economic status, with children, social/leisure/cultural activities, friends or community relationships, and life in general. Eight categories of death preparation were used including shrouds, cemeteries, mutual aid societies, will writing, funeral planning lectures, preparation of advance directives, organ donation pledges, and arrangements for funerals.

Results: As they become older, the degree of death preparations has appeared to increase (p<.001). Findings show that age (r = − .264, p < 0.01), economic status (r = − .333, p < 0.01), anxiety (r = − .118, p < 0.01), social activities (r = .163, p < 0.01), and death preparation (r = .046, p < 0.01) were each correlated with life satisfaction among older adults living alone. A multiple regression analysis reveals that social activities appear to significantly affect both life satisfaction and death preparation positively (F = 258.331, p < 0.01; R² = .238). As a result of verifying the effect through SPSS PROCESS Macro bootstrap, the mediating effect coefficient was .0053 (95% Confidence Interval [CI]=.0001~.0112). That is, the analysis indicates that death preparation is a significant either complete or partial mediating role between participation in social activities and life satisfaction among older adults living alone.

Conclusions and Implications: Death preparation among older adults may be more than one final life task before termination in life. Based on the results, this study suggests developing and strengthening death preparation programs for community-dwelling older adults, and such educational programs should be provided in priority for older adults living alone.