END-OF-LIFE PERSPECTIVES AND NEEDS FOR HOSPICE CARE AMONG RURAL CHINESE OLDER ADULTS IN ISOLATED MOUNTAIN AREAS

Sep 28, 2026

Uploaded by Miles

Hospice care in China has expanded since 2017, yet remains largely inaccessible for older adults in isolated rural mountain areas. Cultural taboos around discussing death, combined with socioeconomic disadvantage, limited transportation, and weak healthcare infrastructure, contribute to major end-of-life disparities. This qualitative descriptive study examines expectations for a “good death” and perceptions of hospice care among 21 rural older adults through semi-structured interviews and thematic analysis. Five themes emerged: family accompaniment, inner peace, no physical pain, dignified departure, and preference for dying at home. Participants link these views to home attachment and affordability of hospice care.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

End-of-life care access in isolated rural China

Cultural beliefs about death and “good death”

Study design: qualitative interviews and thematic analysis

Key themes and preferences for hospice care

678 Innovation in Aging, 2025, Vol. 9, No. S2 Abstract citation ID: igaf122.2314 END-OF-LIFE PERSPECTIVES AND NEEDS FOR HOSPICE CARE AMONG RURAL CHINESE OLDER ADULTS IN ISOLATED MOUNTAIN AREAS Heshuo Yu, Fudan University, Shanghai, Shanghai, China (People’s Republic) Hospice care has become more prevalent in China since 2017; however, it remains largely inaccessible in isolated rural mountain areas. Discussions about death are often considered cultural taboos, and older adults in these remote regions face significant disparities in end-of-life care due to lower socioeconomic status, limited transportation, and inadequate healthcare infrastructure. Few studies have examined how this population perceives “good death” or their willingness to receive hospice care. This study explores the expectations and needs of rural Chinese older adults regarding “good death” and their perceptions of hospice care. Using a qualitative descriptive approach, we conducted semi-structured, open-ended interviews with 21 older adults and analyzed the data inductively through thematic analysis. Five key themes emerged: being accompanied by family, attaining inner peace, experiencing no physical pain, departing with dignity, and preferring to pass away at home. Cultural values deeply rooted in the Chinese context shape these perceptions. Many participants expressed a strong attachment to their home villages anda preference for in-home death, reflecting the belief that “fallen leaves return to their roots.” Fear of pain, particularly from terminal diseases like cancer, was common, and participants showed a strong willingness to use hospice care if affordable. The presence of adult children at the end of life was deemed crucial despite geographic challenges. Future research should explore cross-national perspectives on hospice care utilization and definitions of “good death” across cultures. Further study is also needed to incorporate the perceptions of other key stakeholders, including family caregivers and local healthcare providers.

FAQs

Why is hospice care difficult to access in isolated rural mountain areas of China?

Hospice care is largely inaccessible due to socioeconomic disadvantage, limited transportation, and inadequate healthcare infrastructure, alongside cultural taboos about discussing death.

What does the study find older adults consider a “good death”?

A “good death” is shaped by family accompaniment, attaining inner peace, experiencing no physical pain, departing with dignity, and preferring to pass away at home.

What influences participants’ willingness to use hospice care?

Participants showed strong willingness to use hospice care if it is affordable, and the presence of adult children at the end of life was viewed as crucial despite geographic challenges.

Sep 28, 2026

Uploaded by Miles