Life Journey of Death Acceptance in Thai Buddhist Older Persons with Advanced Chronic Organ Failure

Abstract

This study purposed to discover the process of death acceptance in Thai Buddhist older persons with advanced chronic organ failure. Grounded theory was used as a method of the study. Sixteen Thai Buddhist older persons with advanced chronic organ failure in out-patients in the South of Thailand were the participants. Inclusion criteria included 1) Aged more than 60 years old and belief in Buddhism religion; 2) Diagnosed with advanced chronic organ failure such as congestive heart failure functional class III/IV, end stage of renal disease, and chronic obstructive pulmonary disease and readmitted to the hospital more than three times per year due to exacerbation; 3) Have normal levels of consciousness and not taking anxiety and depression medications; 4) Ready to talk about death by showing positive emotions when hearing about death and confirmed the accepting of own death. Data were analyzed and systematized using Strauss and Corbin's approach. Trustworthiness of the study was established following Lincoln and Guba's criteria. This study discovered that the process of death acceptance in Thai Buddhist older persons with advanced chronic organ failure consisted of four stages: 1)Negotiating of their own death, included 3 sub-categories; recognizing their own death but not ready to die; taking actions to maintain health; hoping for longer life.; 2) Neutralizing fear of death, consisted of 3 sub-categories; realizing that death is inevitable, tamjai: reflecting their own death, and accept the truth of life and death.; 3) Affirming their impending death, consisted of 3 sub-categories of mobilizing Buddhist faith, engaging in religious practices, and accepting their own death.; and 4) transcending of death acceptance, consisted of 3 sub-categories: having mindfulness and being in a peace of mind, preparing a peaceful death, and living-well and dying- well. The findings of this study showed the relationship components of the conditions, actions, and the consequences of death acceptance. Healthcare providers can implicate the process of death acceptance to develop a program to enhance death acceptance based on Buddha's teaching to promoting a peaceful death for patients especially in the older persons with advanced chronic organ failure. Future study should be a testing of this process or model of death acceptance to develop a formal theory.