Running Head: A VOYAGE TO THE TWILIGHT

A Voyage to the Twilight: Exploring Death Preparation among the Elderly Carlo Paul C. Sana Saint Louis University / Virgen Milagrosa University Foundation

Running Head: A VOYAGE TO THE TWILIGHT Author Information:

Author: Carlo Paul C. Sana Tertiary Education: Bachelor of Science in Nursing; Graduated, March 20, 2010 (Saint Louis University, Baguio City) Graduate Education: Master of Arts in Nursing, Major in Administration of Nursing Service; Graduated, October 21, 2012 (Virgen Milagrosa University Foundation, San Carlos City, Pangasinan)

Faculty, Saint Louis University School of Nursing, Saint Louis University, Bonifacio Street, Baguio City, Philippines, 2600

Contact Number: +63827-795-98-83; (075) 532-34-23 e-mail address: carlopaulsana@yahoo.com

Running Head: A VOYAGE TO THE TWILIGHT Acknowledgments:

The author would like to direct his earnest words of recognition, appreciation, and gratitude to the many whom he is much indebted to, for the encouragement, guidance, scholarly criticisms, support and succor they have rendered in the successful completion of his work. To Dr. Jose Emmanuel C. Mandapat, Dean of the Graduate School of Virgen Milagrosa University Foundation, for his valuable suggestions and administrative excellence; To his Thesis Adviser, Dr. Remedios V. Fernandez, for not only teaching him the process of Research, but also taught him the crucial lessons of life; for her encouragement, patience, and competence in providing guidance and constructive suggestions in every phase in the conduct of this study; To his research mentors, Professor Alison A. Gutierez and Professor Jimmy G. Catanes, for sparing most of their time imparting all their exhaustive ideologies on Research which led to the development of this modest work; To Professor Analita G. Gonzales, Dean of the College of Nursing of Virgen Milagrosa University Foundation, and Dr. Jennelyn V. Ramos, for the inspirations, guidance and scholarly suggestions in improving this masterwork; To Dr. Angelina C. Irapta, the Founder of the Research and Educational Development Training Institute, for sharing her invaluable knowledge with regards to the making of an impeccable research work. To the valuable others who played significant roles in my life: God, my late father Leopoldo, my mother Carmelita, and my sister, Carlea.

Running Head: A VOYAGE TO THE TWILIGHT Abstract: A. Purpose of the Study

The study entitled, A Voyage to the Twilight: Exploring Death Preparation Among the Elderly was conducted to determine the philosophies and attitudes of the elderly in accordance with their ethnicities in relation to the physical, psycho-social, and spiritual aspects of death preparation. It also sought for the importance of having a support system as the elderly persons faced or are facing near-death experiences and / or terminal illnesses.

B. Research Design The study is qualitative in nature, and it has utilized descriptive phenomenology as its research design. Informants of this study were from the different cities and municipalities of Pangasinan which included San Carlos City, Dagupan City, Urdaneta City, and Villasis. There were eight informants of the study. They were chosen through purposive sampling in the form of extreme case sampling. Extreme case sampling included the selection of informants within the following criteria: must either be a male or a female resident of Pangasinan, 60 years old and above, must possess a sound mind, must have had a near death experience before or is presently having a terminal illness during the time of the interview, must be a pure Pangasinense or a pure Ilokano, and they must be living with others. Four of them are pure Ilocanos, and the other four are pure Pangasinenses.

Running Head: A VOYAGE TO THE TWILIGHT C. Methods

There was no preset number of informants. Instead, data was exhausted until saturation point was reached. This was a point in data gathering where no new data was obtained. All of them have been involved in a near-death experience and / or are in a dying state. This extreme case criterion was made in order for the researcher to determine his informants preparations while they are going through such trials on death and dying. The researcher studied the way of living of each informant before they were interviewed. He made use of social integration as a strategy to do this by being one with the people he wished to deal with (in this case, his informants). This was done to build rapport. Data was gathered in the form of a semi-structured interview by utilizing standardized open-ended questions. The researcher came in contact with his informants twice. Third contact from the informants was made for clarifications, and this is not applicable to all eight of them. First contact was spent for social integration. Social integration means to be one with the people. That is why, the researcher made some strategies to become a part of them. This included participating to their activities, assisting them in their needs, and conversing to them normally using their dialects (conversations done during the first contact were beyond the scope of the interview questions, however all data gathered from this point provided a good source of information about the informants) until such time that the informants would feel comfortable with the researcher. The scope of the first contact time also included the full explanation of the purpose and objectives of the study. The researcher asked the informants to have another set of contact time, and it will be allotted for the interview proper. The first contact time lasted for a minimum of two (2) hours and a maximum of four (4) hours per informant, depending on their willingness. When the researcher has established rapport with the informants he then introduced his primary purpose, which is to conduct an interview.

Running Head: A VOYAGE TO THE TWILIGHT

Interview proper was done during the second contact time with the informants. All responses of the informants were audiotaped in an audiotape recorder. The audiotaped facts gathered from the informants were transcribed, compared from other informants responses and were presented in narrative form. The data was presented with emic perspective. Emic perspective refers to the manner the members of the group envision their way of living, practices, and culture from their jurisdiction. Responses of the informants obtained during the interview were compared between all other informants to discriminate resemblances and alterations between their rejoinders. The aim of constant comparative method for this study is to generate a theory from the saturation of responses which would describe the lived experiences of the informants. The method of analysis of data used in this study depended on the related literatures during transcription. Moreover, non-verbal responses of the informants were noted and were written in the interview protocol sheet. These non-verbal responses were associated to the transcribed statements of the informants during the coding, recoding and reduction processes. Reduction process included condensing all salient statements until the researcher has come out from themes and sub-themes. Themes and subthemes of the study were derived from careful analysis of statements by the researcher, and no software(s) or digital application(s) were used during the scrutiny of such assemblages. The themes and subthemes were objective in nature, because they have been derived in accordance to the researchers insight of the informants statements. The audiotaped information was destroyed by the researcher after painstakingly reviewing them to ensure confidentiality.

Running Head: A VOYAGE TO THE TWILIGHT D. Findings

During the entire process of the study, the researcher has found out various concepts on death and death preparation perceived by the elderly persons in relation to their ethnicity and support system. The study also entailed their own definitions of death, and the process that they undergo when experiencing a loss (near-death experience for their cases), since they have lost their health and, are going through or have undergone a near-death involvement. The study found out that the elderly population has acknowledged death to be inescapable, thus everyone will undergo through this stage of life. Another delineation of death according to them is that, it serves as a way in entering their Creators Kingdom. The informants of the study have experienced a grieving process. The informants have gone through six stages of the process which included the following in order: Denial, Anger, Realization, Bargaining, Depression, and finally, Acceptance. These stages were met during their struggles with the near-death experiences that they had and/or are having. These stages of the grieving process were adopted from Elisabeth Kubler-Ross Theory, which included denial, anger, bargaining, depression, and anger alone. Moreover, the researcher has found another stage that the informants have undergone, which is the realization stage, where they have realized the causes and effects of their illnesses. The study also explored further into the elderly populations cultural attitudes as they have been facing death. The researcher found out that both Ilocanos and Pangasinenses have following attitudes regarding death preparations: They are passive / dependent to their significant others in terms of death preparation, leaving it all up to them when they die eventually; they also are family-oriented in a way that they still wanted to live because of their will to be with their families still; and lastly, believe that God extends life. Separately, elderly Ilocanos are optimistic

Running Head: A VOYAGE TO THE TWILIGHT

regarding their near-death experiences because of their notion that they will somehow surpass those trials. Elderly Pangasinenses on the other hand, are peace-seekers because they wanted to die without any burdens in their hearts. Finally, the study also reconnoitered further on the effects of having a support system with them, and the informants said that support system serves as a cure because without them, there will be no one to take good care of them while they were ill. Another significance of having a support system during a serious illness is that, it strengthened their personal relationships with each other

E. Conclusions When thoughts of fear and uncertainty flourish during ones journey to an end, it indicates a certain degree of unpreparedness. However, when a dying person who considers certain factors in helping himself / herself cope with the stress of dealing with the previouslystated sentiments then chances are, those gushes can be minimized or even relinquished from his / her contemplations. Three factors known to have helped the informants in coping with the distress that they have gone through / been going through are God, their Significant Others, and the Philosophies that they have cultivated all throughout their elderly lives. Those three factors made a huge impact on the preparedness of elderly as they get near to the end of life. The researcher has categorized these three factors within the lexis, imperative key. The researcher of this study therefore concludes that the imperative key has made an impact in the elderly persons lives as they face the changing temporalities of time. The imperative key paved its approach to convey an influence change on the informants view of death through: a

Running Head: A VOYAGE TO THE TWILIGHT newly-formulated meaning of death according to them,

9 the sequence that they undergo

during the grieving process, the attitudes that make them up as an elderly who have had neardeath experiences in relation to their ethnicity, and the effects of having a support system with them as they face the challenges of the changing time. The researcher also concludes that the elderly have their own views towards death preparation in terms of their ethnicity. Ilocanos are optimistic in nature, while Pangasinenses are Peace-seeking individuals. However, in comparison, they both are dependent individuals, familyoriented individuals, and individuals who believe that God helps them in extending their lives. The researcher also adds up into his conclusion that an individual with an adequate support system makes them feel recovered and feel that their relationship with each other gets stronger as well. These conclusions have satisfyingly answered the researchs statement of problems which included the following: First, what are the philosophies of the elderly on death preparation as affected by their ethnicity in terms of the physical, psycho-social, and spiritual aspects? And lastly, what is the effect of support system in an elderly who faces death? References:
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