Perception of Good Death and Death Preparation Among Community-Dwelling Older Adults in South Korea

TL;DR

This study explores how older adults in South Korea prepare for death based on their perceptions of a 'good death', revealing insights into practical and conceptual preparation behaviors.

Contribution

The study provides novel insights into how specific end-of-life preferences influence death preparation behaviors among older adults in South Korea.

Findings

Preferences for dying at home strongly correlate with both practical and conceptual death preparation.

Being surrounded by loved ones is negatively associated with conceptual death preparation.

Over half of participants engaged in practical death preparation, while only a small fraction engaged in conceptual preparation.

Abstract

As societies age, preparing for a good death is becoming a critical public health concern. This study investigated how perceptions of a good death shape engagement in death preparation among community-dwelling older adults in South Korea. We conducted a secondary analysis of the 2023 National Survey of Older Koreans. The final sample included 9,140 older adults (≥65 years), excluding proxy responses and severe cognitive impairment (K-MMSE∼2 ≤17). Death preparation was assessed based on engagement in eight specific activities, categorized into practical and conceptual death preparation. Perceptions of a good death were measured using a five-item scale evaluating key end-of-life aspects. Participants were predominantly female (60.0%) and in the 65-74 -year-old group (60.7%). Among participants, 51.3% engaged in practical death preparation, while 5.5% in conceptual death preparation. Results of multiple logistic regression revealed that those who valued organizing personal affairs (aOR = 1.12, 95% CI = 1.05–1.21), minimizing the burden on family (aOR = 1.18, 95% CI = 1.11–1.26), and preferring to die at home (aOR = 1.06, 95% CI = 1.01–1.12) were more likely to engage in practical death preparation. Conceptual death preparation was most strongly associated with preferring to die at home (aOR = 1.52, 95% CI = 1.35–1.70), whereas being surrounded by loved ones was negatively associated (aOR = 0.77, 95% CI = 0.67–0.88). These findings highlight the need for tailored policies and community-based interventions to help older adults align end-of-life preferences with preparation, promoting meaningful aging and a dignified death.