• Qian Chen, Joseph Henry Flaherty, Ju Hong Guo, Yan Zhou, Xue Mei Zhang, and Xiu Ying Hu.
• 1 Department of Geriatrics, West China Hospital and National Clinical Research Center for Geriatrics, Sichuan University, Chengdu, Sichuan Province, China .
• J Palliat Med. 2017 Dec 1; 20 (12): 138913941389-1394.

BackgroundDue to the aging population of China, the need for palliative care will increase. However, one of the barriers to utilization of palliative care is the traditional belief that talking about death and dying is taboo.ObjectiveThe aim of this study was to examine to what extent older Chinese patients were willing to answer questions about death and dying by asking them about "fear of death" and their desire to "use advanced life support when dying."DesignSurvey questionnaire.Setting/SubjectsConvenience sample (N = 993 hospitalized patients).ResultsOnly 215 (21.7%; 95% confidence interval [CI] 16.2%-27.1%) and 99 (9.9%; 95% CI 4.1%-15.8%) patients did not answer the questions related to "fear of death" and "use of advanced life support when dying," respectively, while 439 (44.2%; 95% CI 38.7%-49.7%) answered "yes" and 339 (34.1%; 95% CI 28.7%-39.6%) answered "no" for "fear of death" and 382 (38.5%; 95% CI 32.6%-44.3%) answered "yes" and 512 (51.6%; 95% CI 45.7%-57.4%) answered "no" for "use of advanced life support when dying." In multinomial logistic regression analysis, fear of death was associated with younger age, lowest level of function, and desire to use advanced life support.ConclusionsThe majority of older patients were willing to answer the two questions about death and dying. About one-third of patients were not afraid of death, and older patients were less likely to be afraid of death. More than 50% of patients answered that they would not choose advanced life support when dying. More research in this area is needed to help advance palliative care in China.

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