Predisposing Factors and Coping Strategies for Death Anxiety in Older Adults: A Qualitative Study Based on Thematic Analysis

Background: The study aimed to identify the underlying causes of death anxiety and coping strategies among Iranian older adults.
Method: The participants of this qualitative study included 10 older adults (5 women and 5 men) aged 62 to 84 years, selected through purposive sampling with maximum variation. Data were collected via in-depth semi-structured interviews and analyzed using Braun and Clarke's (2006) six-step thematic analysis.
Findings: Data analysis resulted in the extraction of 7 main themes and 19 sub-themes, including: 1) multidimensional aspects of death anxiety experience (including fear of the dying process, other-oriented concerns, death-wish, active acceptance, rumination, and emotional ambivalence); 2) emotional and social loneliness as a context for exacerbating death anxiety; 3) perceived social support as a protective shield; 4) spirituality and religiosity as a source of coping with death anxiety (emphasizing the quality of relationship with God over the quantity of religious practices); 5) meaning and purpose in life as an antidote to meaninglessness; 6) psychological flexibility (acceptance, mindfulness, gratitude, and humor); and 7) active coping strategies and cultural barriers (social stigma of help-seeking, gender stereotypes, and the taboo of death).
Discussion and Conclusion: Acording to the findings it can be said that death anxiety in old age is a multidimensional and multifactorial phenomenon intensified by loneliness, lack of social support, weak spiritual health, and meaninglessness. However, employing a diverse set of coping strategies—particularly spiritual-religious strategies, social support-seeking, meaning-making, acceptance, and mindfulness—can significantly reduce this anxiety. The findings support integrated and multifaceted intervention approaches sensitive to the cultural-religious context of Iran.
Keywords: Death Anxiety, Older Adults, Phenomenology, Thematic Analysis