Influencing Factors to Perception of Death in the Elderly

The elderly represent the end of the human life cycle. The physical and psychological state of the elderly will alter at this time. The elderly sometimes believe that death will strike at any moment when circumstances are unfavorable. Even if this awareness of the look of death appears, each person's or group's perception or understanding of death may differ. The purpose of this study is to ascertain how elderly people see death. Methods: This study employed the phenomenological design for qualitative research literature review approach, which is derived from three databases (PubMed, Scient Direct, and Google Sholar) for prior investigations. The papers were published between 2016 and 2020. Results and analysis: One international journal and three national periodicals were the primary sources for this study. Discussion and Conclusion: According to research findings based on multiple journals, elderly people have a very diverse understanding of death. However, it is clear that elderly people view death as an inevitable event that cannot be rejected or avoided, so they are aware that it may happen at any time. For the elderly, better oneself and growing closer to God is also a form of self-evaluation. Every person has a different perspective on mortality in the elderly. Spiritual considerations, familial support factors, and experience factors are all elements that have an impact on how older people perceive death. The experience factor is the end consequence of the major component influencing perception of death.


INTRODUCTION
Elderly (elderly) is the final stage of human life which experiences various declines in its life functions (Hope, Sabrian, & Utomo, 2014) .Sooner or later, some elderly people will experience a decline in physical and psychological quality (Reza, Muzdalipah, & Zaharuddin, 2018) .The elderly also face psychological problems, namely the emergence of anxiety in the face of death (Naftali, Ranimpi, Anwar, Sakit, & Ario, 2017) .Elderly humans in the judgment of many people are humans who are no longer productive.The average physical condition has decreased so that this condition causes various diseases.Thus, at this advanced age the thought arises that they are in the remnants waiting for death (Muzdalipah, 2017) .
Based on data from BPS East Java, the number of elderly people in East Java Province in 2017 was 3.14 million people (8.01% of the total population) (Central Bureau of Statistics for East Java Province, 2017) .Indonesia is in the top five countries with the highest number of elderly people in the world.Based on the 2018 census, the number of elderly people in Indonesia is 24.4 million people (9.27% of the total population (Central Bureau of Statistics, 2018) .
Based on research (Naftali et al., 2017) on elderly participants in the study, some said that death was something that could not be refused, some said death was the separation of the soul from the body, and some said death was the way to heaven. .
Based on research (Muzdalipah, 2017) on the two elderly participants in his research, one of the participants said there was a feeling of concern about the process of approaching death in themselves.Other participants said that even though they were old they had to be enthusiastic about learning, attending recitations and continuing to perform acts of worship such as praying.
Research conducted by Camile and Claibourne (2002) entitled "Thanatologic Realization And Life Integration: A Study Of The Dying Experience And How People Prepare For Death" which states that spiritual preparation is a high priority in the process of dealing with death.In (Hope et al., 2014) .
Based on existing phenomena and various opinions of experts, researchers are interested in further studying how perceptions of death in the elderly and what factors influence the emergence of perceptions of death.

RESEARCH METHODS
This research design uses study literature review by examining 4 related journals consisting of 3 international journals and 1 national journal .Literature search was carried out by searching accredited journal sites from three databases (PubMed, Scient Direct, Google Sholar) with the keywords Perception, Mortality, Elderly .The search results that have been obtained are then screened based on the title and based on the eligibility of the inclusion and exclusion criteria .The results of various studies This literature will be used to explain perceptions about death in the elderly.

RESEARCH RESULT
The results of research based on several journals can be concluded that the understanding of death in the elderly is very diverse, but it can be concluded that the elderly understand death is an event that cannot be rejected or avoided, therefore the elderly are aware that death can occur at any time.This is also a self-evaluation for the elderly by improving themselves and getting closer to God.Perceptions about death in the elderly can vary for each individual.Factors that influence perceptions of death in the elderly are spiritual factors, family support factors, experience factors.The result of the dominant factor affecting perception of death is the experience factor.

Understanding of death
Based on the results of 4 iterations, various kinds of understanding of elderly individuals about death were obtained.According to research results (Naftali et al., 2017) the understanding of death is something that cannot be rejected, some say death is the separation of the soul from the body, and some say death is the way to heaven.Furthermore, the results of the study (Muzdalipah, 2017) indicate that all elderly subjects understand that death is an event and warning that must be felt by every human being.According to research (Pratiwi, Fahmi, & Supenawinata, 2018) death for the subject can change his behavior as he gets older, so the subject begins to understand death as a self-evaluation for him because in his youth the subject feels unfamiliar with religion, so in old age at this time the subject began to improve himself, namely by getting closer to Allah SWT.
In this case the researchers argue that the understanding of death for the elderly varies widely, but it can be concluded that the elderly understand death as an event that cannot be rejected or avoided, therefore the elderly are aware that death can occur at any time.This is also a self-evaluation for the elderly by improving themselves and getting closer to God.

Perception of death
Based on the results of the 4 literatures, there are various kinds of perceptions of elderly individuals about death.According to (Naftali et al., 2017) death is seen as something that is inevitable and can happen at any time, so that it can cause anxiety in someone.Whereas the elderly who have a positive view of the death of their partner can respond to this matter naturally, so that the elderly will feel calm about themselves and the death of their partner.This is in accordance with what Chusairi stated (in Wijaya & Safitri, 2015) that anxiety in facing death will increasingly make the elderly unprepared in facing death.Readiness is the overall condition that makes a person ready to respond to a situation (Slameto, 2010).The condition of the elderly who are ready to face and accept death does not cause any regrets or fear when death occurs.However, the elderly have different perceptions when facing death (Hope, Sabrian, Utomo, 2014).This result is in accordance with the theory (Donsu, 2017) that each individual has his own perception and has a different form of perception about death.Some perceptions are positive, and some are negative.The theory of personal meaning of death explains that death has a double meaning for humans.First, if death is interpreted as a positive thing then humans will do many good things such as improving themselves, drawing closer to God.However, it is different if humans interpret death as a negative thing, then humans will raise anxiety when they remember death and do things that tend to be negative (Cicirelli, 1998) .In (Putra, Arifin, & Hermawati, 2016) .
In this case the researchers argue that the results from a theoretical perspective on the perception of the elderly in viewing death can vary for each individual.This is because the older humans are, they realize that death will come at any time and cannot be avoided.So it can be interpreted that the perception of death in the elderly is the perspective of elderly individuals in interpreting events towards the end of life.

Perception of death
Based on the results of the 4 literatures, several factors influence the perception of death in the elderly.According to (Muzdalipah, 2017), the perception factors regarding death in the elderly are spiritual factors, family support and experience factors.The spiritual factor is by worshiping and getting closer to God, the family support factor by expecting the full support of the family and seeing the process of death while the experience factor is with the events that have been experienced in life so that it influences the perception.In line with research (Pratiwi et al., 2018) spirituality affects perceptions of death in the elderly.Subjects in their research said they only focused on increasing religious activities because according to them one of the provisions to take with them when they died was worship that was practiced while in the world.According to research (Naftali et al., 2017) the factor that influences perceptions of death in the elderly is the experience factor.Elderly who live in orphanages or at home state that they have experienced the loss of their loved ones.When dealing with the death of a loved one, the elderly experience depression and sadness and describe it through words that express deep longing or despair, causing a person to experience prolonged sadness, have feelings of hopelessness and recurring thoughts of death.According to (Fleming, Farquhar, City, & Ccc, 2016) for some subjects the absence of fear is rooted in the positive experiences of others but where other people's experiences of death are negative there is worry.These results are in line with the results of research (Hope et al., 2014) that perceptions of death in the elderly are influenced by 3 factors, namely: spiritual factors, family support factors, personal experience factors.The spiritual factor is a form of human longing for its creator, something that is transcendental.The family support factor is the existence of comfort, attention, appreciation or helping people with an attitude of accepting their condition, family support is obtained from individuals and groups.The factor of personal experience is everything that has been experienced or felt by someone.
In this case the researchers argue that the factors that influence perceptions of death in the elderly are spiritual factors, family support factors, experience factors.The result of the dominant factor affecting perception of death is the experience factor.Experience is the main factor for the elderly in viewing death because human perception will emerge over the span of life and as people get older they will find experience in their lives.The experience of death is obtained from the event of death in his life.When humans see a death, humans start to find out how that death can happen and start to think about what happens after that death.

CONCLUSION
The understanding of death in the elderly varies greatly, but it can be concluded that the elderly understand death as an event that cannot be rejected or avoided, therefore the elderly are aware that death can occur at any time.This is also a selfevaluation for the elderly by improving themselves and getting closer to God.Perceptions about death in the elderly can vary for each individual.The results of the study showed that there were those who saw death as a scary thing and were worried if death would come and there were also those who saw death as a normal thing and accepted death as an event in the process of life.Factors that influence perceptions of death in the elderly are spiritual factors, family support factors, experience factors.The result of the dominant factor affecting perception of death is the experience factor.The experience of death is obtained from the events of death that have been encountered in his life.When humans see a death, they begin to find out how death can occur and begin to think about what will happen after that death.The suggestion is Elderly individuals should inspire enthusiasm to increase positive perceptions of death so they can do good things and be more enthusiastic about worship.This research is expected to test the effectiveness and validity.It is expected that more references are used so