Ho, Sio-Wa; Ph.D.
Program of Human Development, Gerontology
College of Human Development and Education; North Dakota State University
Perspectives on End-of-Life Decision-Making Among Older Chinese
Major Professor: Dr. Gregory Sanders
The purpose of this study was to explore the attitudes and perspectives of Chinese elders on end-of-life decision-making and death and dying issues in Chinese society. A basic interpretative inquiry approach was used to conduct interviews with eighteen older people who were living independently in Macau, China. Findings revealed how preferences on end-of-life issues and attitudes toward death and dying were influenced by cultural beliefs. Four themes were identified regarding their personal preferences on end-of-life issues: (1) institutionalized care at the end of life was preferred as not to be a burden on family, (b) life prolonging measures were not preferred, (c) funeral arrangement preferences were based on personal and religious beliefs, and (d) end-of-life decision-making would be deferred to others. These themes provided an understanding on the personal preferences of older Chinese on end-of-life issues, and their preferences were always secondary to their respects toward family and medical doctors. Additionally, five themes related to attitudes toward death and dying were identified: (a) life course is predetermined, (b) religious beliefs give strength, (c) planning for end-of-life issues is not necessary, (d) elders are hesitant to discuss end-of-life issues, and (e) life satisfaction leads to acceptance. These themes offered insight into the influence of cultural beliefs on Chinese people coping with death and dying issues. Further research is needed and will benefit our understanding of Chinese people facing these issues and thus help provide culturally appropriate care and services.