Older Danes' Preferences for Their Final Days: A Survey of 1499 Participants.

Background: Death is inevitable, yet documentation on wishes for the final days of life remains scarce in the literature. Meanwhile, the growing elderly population has brought increased focus on end-of-life care. This study explored wishes and expectations regarding end-of-life care and preferences for the place to die. Methods: An electronic survey including 12 questions was distributed in May 2024 to approximately 6000 members of the DanAge Association, a Danish nonprofit organization of older adults. The questionnaire was developed in collaboration with health care professionals and DanAge members. Respondents reported gender, age, and postal code but remained otherwise anonymous. Results: The response rate was approximately 25% with 1499 respondents (72% female, mean age 67 years [standard deviation or SD = 13]). Above half of respondents expressed fear of experiencing pain in their final days (57%), and the majority 87% preferred to be drowsy rather than in pain during this time. Many were also concerned about dying alone (69%) or becoming a practical burden to their loved ones. The preferred place to die was home (61%) followed by hospice (46%). Almost all respondents (94%) wanted to decide on further treatment and their preferred place of death, yet nearly half had not documented their wishes for their final days. Conclusions: The findings reveal widespread fears about end-of-life experiences, including pain, loneliness, and burdening loved ones. Although most respondents preferred to die at home or in hospice, a significant proportion had not documented their preferences in legal documents. These results highlight the importance of addressing end-of-life concerns and promoting advance directives to align care with individual wishes.