Exploring the concept of a “friendly relationship to death” in geriatric patients

Abstract Background Positive attitudes toward death are common among geriatric patients, yet their distinction from mental illness and suicidality remains insufficiently understood. This study sought to characterize the concept of a “friendly relationship to death” (FRD), including its frequency in a geriatric sample and identifying variables from the geriatric assessment associated with a FRD. Methods A cross-sectional study was conducted in a geriatric unit, surveying N = 99 patients aged 65 years and older. Attitudes toward death were assessed using The Multidimensional Orientation Toward Dying and Death Inventory (MODDI-F), supplemented by one question addressing a FRD (“I have a friendly relationship to death.”), as well as eight additional questions on attitudes toward death, dying and religiosity/spirituality. Furthermore, depression, suicidality, disease burden, frailty, and loneliness were evaluated using validated questionnaires. Results A total of 70% of patients endorsed a FRD. A FRD was associated with greater acceptance of one’s own dying and death, lower fear and rejection of death, greater religiosity/spirituality, and a stronger sense of “satisfied hunger for life.” A FRD was not associated with depression, suicidality, overall disease burden, frailty or loneliness. Conclusion Among geriatric patients, a FRD appears to prevail, extending beyond a neutral acceptance of death’s inevitability and existing independently of suicidality, depression, frailty, or disease burden. Understanding a FRD may help contextualize older individuals’ acceptance of aging and could impact geriatric treatment outcomes.