Mental Health of Older Adults at the End of Life

With advanced age, older adults (aged ≥65 years) become increasingly aware of the finality of their lives and many accept death as an unavoidable universal event. Over the past few decades, end-of-life treatment preferences shifted in the United States toward hospice and palliative care over curative treatment, with the ulti-mate goal of facilitating a good death. In addition to physical comfort, emotional well-being is essential in older adults at the end of life. Despite high prevalence of depression, patients on hospice are rarely screened for depressive symptoms. Left untreated, depression increases the risk for complicated grief and suicide. Provider education and training are needed to facilitate early detection of symptoms and timely treatment for depression and grief at the end of life. Family caregivers should also be included in mental health support, as they care for their loved ones and beyond, includ-ing post-death bereavement support.