Dying at the best time

These are the results of two surveys of relatives, and others who knew people who had died, describing events in the year before death and their views on the time of the person's death. Those surveyed were identified from death certificates in England. The main focus is on a sample of 3696 people dying in 1990 in 20 health authorities, with supporting analysis from an earlier national sample of 639 people dying in 1987. Variation in peoples' views about whether an earlier death would have been better is reported, in the context of debate about euthanasia. Spouses were less likely than others to feel that it would have been better if the person had died earlier, and this held true even when controlling for the deceaseds' levels of pain, distress, dependency and age. Spouses were more likely than others to say that a later death would have been better, though not in cases where the deceased was reported as having said they wanted to die sooner. Spouses were influenced by the loss which the death of the person represented for them, being more likely than others to say they missed the person who died a great deal, and feel loneliness was a big problem. Non spouses (children and other relatives of the deceased, friends, neighbours and a few officials) on the other hand were more likely than spouses to say an earlier death would have been better, even when levels of pain, distress, dependency and age were controlled for. They were also more likely than spouses to say this when the deceased was not said to have wanted to die earlier. This was influenced by the fact that they experienced care as more burdensome than spouses, finding that it restricted their lives. The consequences of all this is that the very old were more likely to be cared for by people who, in retrospect, felt that it would have been better if the old person had died earlier. The views of the very old, particularly of women, suggest that they themselves often take on the view that they are 'too old'.