Degree
Doctor of Philosophy (PhD)
Department
School of Social Work
Document Type
Dissertation
Abstract
Fear of death is a phenomenon affecting individuals of all ages, and its presence continues well into older adulthood. This study explores the associations between health-related social needs and fear of death within the theoretical framework of social determinants of health in the late stages of psychosocial stages of development. The health-related social needs of particular focus in this study match those of focus by the Centers for Medicare and Medicaid Services, which are food insecurity, housing problems, trouble paying bills, transportation problems, and safety. This study further sought to analyze the moderating effect of advance care planning on those relationships, to ascertain whether discussing or completing advance care plans may moderate the direct effects of health-related social needs on fear of death. Using the longitudinal panel study results made public by the Health and Retirement Study, waves 2020 and 2022, this study narrowed the results to include adults aged 65 and older living in the community. Results found low occurrence of worrying about food, difficulty paying bills, and fear of death in the week prior to survey. Some older adults reported having housing problems and not owning transportation. There was moderate concern about neighborhood safety after dark. Housing problems was shown to be positively associated with fear of death for the 2022 wave. Additionally, perceived neighborhood safety was inversely associated with fear of death for the 2022 wave. Both the 2020 and 2022 waves showed a positive association between trouble paying bills and fear of death. With discussion and completion of advance care planning ranging from two-fifths to nearly three-fifths of older adults, a moderating effect was found for discussion of advance care planning on the relationship between problems with housing and fear of death in the 2020 wave. The 2020 wave also showed a moderating effect for having a living will on the relationship between transportation and fear of death. The effects and implications for social work practice and research are discussed.
Date
1-8-2026
Recommended Citation
Bardales, Rhonda L., "Health-Related Social Needs and Fear of Death: Moderating Effect of Advance Care Planning" (2026). LSU Doctoral Dissertations. 6978.
https://repository.lsu.edu/gradschool_dissertations/6978
Committee Chair
Wilks, Scott E