Challenging the belief that no one should
die alone
Glenys Caswell
Nottingham Centre for the
Advancement of Research into
Supportive, Palliative and End of
Life Care
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Plan
• Explore what it might mean to die alone
• Consider implications of accepting some
people may prefer to die alone
• Draw on research literature and pilot study
findings
2
Pilot study
Exploring perspectives on dying alone: A pilot
study of sociological autopsy as research
methodology
1. Coroner records to explore 2 deaths alone at
home
2. Interviews with 12 older people living alone
3. Focus group & joint interview with hospice at
home nurses
3
Accompanied dying
en.wahooart.com
4
No one should die alone
‘Horror as body of lonely
pensioner is found in her flat five years after her death’
Daily Record, 4/7/2009
5
End of life care practice
Hospice at home nurse:
‘…a patient sort of waiting ‘til (their) family’s left
the room because they don’t want them there
when they die...personally I wouldn’t want
somebody to die by themselves, no. But again, it
wouldn’t be my choice, it would be theirs.’
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Lack of inquiry
• Bradshaw et al. 1978 & Howse 1997
• Seale 1995 & 2004
• Kellehear 2009: ‘…this form of dying may not
represent failures of care but rather individual
triumphs of agency, resistance and dissent’.
(p.6)
• Caswell & O’Connor 2015
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Dying alone
• By chance, when death is sudden and
unexpected
• In a single room in a care home or hospital
• Unnoticed, in a bed in a busy hospital ward
• Living alone and isolated
• Through exercise of agency
• When living alone and deciding not to
summon help
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Implications
• Views about dying alone grounded in cultural
assumptions and survivors’ perspectives
• Need for more research
• Accept that some people might wish to be
alone
• Enable this to happen
• Ensure family understand
• Ask the difficult questions
9
Conclusions
• Some people may prefer to die alone, we
should respect that
• Dying largely relational – affects more than
just the dying individual
• We need to talk more openly about the issue
10
References
Bradshaw, J., Clifton, M. & Kennedy, J. (1978) Found dead a study of old
people found dead. London: Age Concern.
Caswell, G. & O’Connor, M. (2015) ‘Agency in the context of social death:
Dying alone at home’, Contemporary Social Science, 10 (3),
DOI:10.1080/21582041.2015.1006806
Howse, K. (1997) Deaths of people alone. Centre for Policy of Ageing: London
Kellehear, A. (2009) ‘Dying old – and preferably alone? Agency, resistance and
dissent at the end of life’, International Journal of Ageing and Later Life, 4 (1)
5-21.
Seale, C. (1995) ‘Dying alone’, Sociology of Health & Illness, 17 (3), 376-392.
Seale, C. (2004) ‘Media constructions of dying alone: a form of ‘bad death’’,
Social Science & Medicine, 58, 967-974.
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