Death Depression Among Older Adults: A Concept Analysis Utilizing An Evolutionary Approach

Background and Purpose: The reality of death is a source of concern for humans. Managing issues associated with preparation for the inevitability of death may contribute to onset of death depression for aging individuals. The study purpose was to clarify the death depression concept in older adults including relevant features, antecedents, and consequences to further nursing knowledge development. Methods: Rodgers' evolutionary concept analysis was performed using the following steps: determination of concept and appropriate scope; collection of data for identifying concept attributes, antecedents, and consequences; and evaluation of relevant and alternative concepts for further clarification. A search for articles published between 1995 and 2020 relevant to death depression in older adults was conducted in the databases PubMed, Ovid, ProQuest, CINAHL and Persian databases SID and Magiran. Fifty-three articles met the inclusion criteria and final sampling. Findings were reviewed by two independent researchers familiar with the field. Result: Based on the study findings, death depression is characterized by cognitive, affective, and behavioral attributes. Antecedents of death depression include: health concerns associated with aging such as life-limiting or psychiatric illnesses; loneliness and loss perceptions related to social relationships; socio-cultural context; identity issues; and environmental changes. Consequences of death depression include negative adjustment in later life and the potential for adaptation. Implications for Practice: Death depression in older adults may contribute to adverse mental health sequelae. Therefore, assessment for ruminative death cognitions in older adults may lead to interventions that help prevent the onset of death depression. This study provides a foundation for further research, and it contributes to the development of nursing knowledge via concept clarification.