Navigating Death Anxiety in Later Life: A Grounded Theory Study of Older Women’s Coping Strategies

Abstract

Background: Population aging and the increasing number of individuals aged 60 years and older have heightened attention to the psychological challenges of later life. Death anxiety is among the most prominent concerns affecting older adults’ mental health. Objectives: This study aimed to examine the coping strategies used by older women to manage death anxiety. Methods: This qualitative study was conducted in 2025 using a grounded theory approach. Twelve women aged 65 years and older who resided in nursing homes and long-term care facilities in Tehran were recruited through purposive sampling. Data were collected through in-depth, semi-structured interviews and analyzed using the constant comparative method. Data collection continued until theoretical saturation was achieved. Results: Data analysis yielded five main categories: end-of-life tensions, including unresolved attachments and death-related fears associated with functional limitations; psychological processing of lived experience, including engagement with death-related narratives, integration of past experiences, and persistent psychological burdens; psychosocial challenges, including disrupted emotional bonds and internalized coping strategies; modes of living with death anxiety, including maintaining an active lifestyle, realistic efforts to preserve independence, and strengthening social relationships; and existential transformations, including existential satisfaction and reassurance. Conclusions: Despite age-related constraints, older women employ adaptive strategies, such as remaining active, preserving autonomy, and strengthening social ties, to cope with death anxiety. These strategies contribute to psychological calmness and improved existential well-being.