Accepted paper:

Autonomy at the end of life: choosing where and how to die


Renske Visser (University of Surrey)

Paper short abstract:

This paper will discuss the autonomy and agency of elderly at the end of life. How do elderly and their social network make it possible to die at home?

Paper long abstract:

In contemporary Western societies life expectancy is increasing and many medical treatments available make it possible to prolong life. This has caused the emergence of a Third Age, a time of leisure, personal achievement and self-fulfillment. In sharp contrast to this stands the Fourth Age where people's health deteriorates and people slowly lose their agency and become more dependent on others. This paper will explore the how the concepts of Third and Fourth age relate to issues concerning independence and decision-making at the end of life. A main aim of the 2008 ' End Of Life Care Strategy' from the Department of Health is to make it possible for people in the United Kingdom to age and die in their preferred place. In Britain, the home is the most preferred place of death, however most deaths still occur in the hospital setting (Gomes and Higginson, 2013). With both political and personal incentives for people to die and age at home this raises questions on how this works in practice. My paper will look at this issue and to what extent older people remain autonomous at the end of life. The majority of people over 85 still live at home and most of them have multiple health problems. This means that in order for them to 'age in place' a care network needs to be in place. In my paper I will discuss the dichotomy between being autonomous and being a dependent older person.

panel P69
Designing death: fashioning ends of life and beyond