The Paradox of Aging-Related Fears: Fear of Loneliness in Old Age as a Motivator for Loneliness Preventive Activities.

INTRODUCTION: Aging is often seen as a challenging process, prompting individuals to form emotional reactions in response to the perceived challenges associated with growing older, manifested as aging-related fears. The present study focuses on the fear of loneliness in old age, a significant concern considering the socioemotional importance of close relationships in later life. Drawing from proactive coping theory, the study explores the association between fear of loneliness and aging preparation. This research aims to investigate whether the fear of loneliness motivates individuals to engage in activities aimed at preventing loneliness in old age. For exploratory purposes, we consider both linear and non-linear effects at the inter-individual level, as well as the intra-individual level differences between fear levels and behavioral outcomes. In addition, we also investigate the moderating role of trait Neuroticism in these associations. METHODS: Data from the "Ageing as Future (AAF)" project in Germany (N = 1,183) spanning from 2012 to 2023 were utilized. A multilevel model considered both intra- and inter-individual variations, incorporating time-varying variables and covariates. RESULTS: Linear mixed model analysis revealed that increased fear of loneliness corresponded to heightened engagement in preventive activities linearly, while a quadratic term indicated an inverted U-shaped relationship. The inclusion of occasion-specific deviation scores showed that individuals were more inclined to engage in preventive activities when experiencing heightened fear of loneliness than usual. This impact of deviation in fear perception was particularly evident among those with high levels of trait Neuroticism. CONCLUSION: The study reveals that fear of loneliness in old age is associated with proactive engagement in preventive activities, with those prone to higher levels of fear or worry being particularly affected. These results emphasize the importance of a moderate level of fear in driving action without succumbing to excessive pessimism or unrealistic optimism. The findings contribute to understanding the motivational role of aging-related fears and hold implications for gerontological practices, emphasizing the need for a balanced fear perception in addressing potential negative impacts of aging. Future research could explore moderators and long-term consequences of motivational aging-related fears.

COVID-19 Worries Predict Aging Preparation: Culture- and Domain-Specific Perspectives.

OBJECTIVES: We investigated whether worrying about coronavirus disease 2019 (COVID-19) predicts people's engagement in aging preparation. Furthermore, we expected that this association would have culture- (i.e., Hong Kong and Germany) and domain-specific (i.e., finances, housing, care needs, connectedness, and end-of-life) tendencies, as the culture and domains that are most severely hit by the pandemic differ. METHODS: A total of 360 and 1,294 adults (aged 18-98 years) living in Hong Kong and Germany, respectively, participated in a web-based study. We fitted our data to a multilevel model in order to take into account the interdependence of domains (i.e., Level 1) within the same individual (i.e., Level 2). RESULTS: The results revealed that reporting higher COVID-19 worries were associated with pandemic-induced aging preparation, and this association was particularly apparent for Germans in comparison to those from Hong Kong. When domains were specified, this cultural difference appeared significantly stronger for the domains of care, connectedness, and end-of-life than finances and housing. DISCUSSION: Findings imply that worrying about the COVID-19 pandemic predicts people to engage in aging preparation particularly in the culture and domains most affected by the pandemic. These results from those worried about the virus may be attributed to the increased self-relevance to the topic and hence motivation.

COVID-19 and perceiving finitude: Associations with future time perspective, death anxiety, and ideal life expectancy.

The coronavirus pandemic threatens the health, future, and life of individuals and might hence accentuate perceptions of the fragility and finitude of life. We investigated how different perceptions of the pandemic (regarding the virus as a health threat and perceiving social and financial restrictions due to the pandemic) relate to different perceptions of life's finitude (i.e., future time perspective, death anxiety, and ideal life expectancy). Using longitudinal data from 1,042 adults (68% women; aged 18-95 years) gathered within the first and within the second peak of the pandemic in Germany, we expected decreases in future time perspective and ideal life expectancy, as well as increases in death anxiety in response to threatening perceptions of the pandemic. The results indicated decreasing future time perspectives, an accentuation of death anxiety right at the beginning of the pandemic, as well as stable ideal life expectancies. There was a tendency for more pronounced change among older adults. Initial levels and changes in the perceptions of finitude could partly be explained by initial and changing perceptions of the pandemic. Next to perceptions targeting the threat of the virus itself, perceptions of strong social and financial restrictions during the pandemic contributed to an altered stance toward the finitude of life. Concluding, we discuss stability and variation in perceptions of the finitude of life during a time of major societal change and a potentially life-threatening pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Aging-related fears and their associations with ideal life expectancy.

Fears regarding various aspects tend to stimulate individuals to escape or to avoid the sources of the threat. We concluded that fears associated with the future aging process, like the fear of aging-related diseases, the fear of loneliness in old age, and the fear of death, would stimulate patterns of avoidance when it comes to ideal life expectancy. We expected fear of aging-related diseases and fear of loneliness in old age to be related to lower ideal life expectancies. We expected fear of death to be related to higher ideal life expectancies. In two adult lifespan samples [N 1 = 1065 and N 2 = 591; ages ranging from 18 to 95 years, M (SD)1 = 58.1 (17.2) years, M (SD)2 = 52.6 (18.1) years], we were able to support our hypothesis regarding fear of death. We furthermore found significant interactions among the fears, indicating that individuals fearing diseases or loneliness but being unafraid of death opted for the shortest lives. Our results indicate that fears regarding life in very old age might be associated with the wish to avoid this age period; the fear of death was however associated with the wish for particularly long lives, and thus, with distancing oneself from the dreaded event of death. We conclude that fears seem to be associated with how individuals approach old age and with what they wish for in their own future as aged people.

Perceived personal deadlines for late-life preparation across adulthood.

Throughout adulthood, individuals follow personal timetables of deadlines that shape the course of aging. We examine 6-year-longitudinal data of perceived personal deadlines for starting with late-life preparation across adulthood. Findings are based on a sample of 518 adults between 18 and 88 years of age. Multilevel regression analyses were conducted to explore changes in personal deadlines for preparation in five domains (i.e., finances, end of life, housing, social connectedness, caregiving) in relation to calendar age, self-rated health, subjective position in life, and sociodemographic variables. Findings suggest that personal deadlines for starting preparatory activities differ depending on calendar age and domain of late-life preparation. Older adults as compared to younger adults are likely to report narrower deadlines for beginning with late-life preparation. Perceived deadlines for late-life preparation were furthermore found to be preponed and slightly dilated over time. Findings suggest that depending on age-graded opportunity structures, individuals flexibly adjust their personal deadlines for late-life preparation.

Daily experiences of subjective age discordance and well-being.

Subjective age discordance (SAD) captures the difference between how old one feels and how old one would ideally like to be. We investigated the presence, strength, and fluctuation of this discordance in daily life as well as its relationship to various indicators of physical and psychological well-being with an 8-day diary study. Participants were 116 older and 107 younger adults who completed daily measures of felt age, ideal age, positive and negative affect, physical symptoms, and stressors. We operationalized SAD as felt age minus ideal age divided by chronological age and compared the utility of this discordance to the more established proportional discrepancy of felt age from chronological age. Daily SAD was present in both age groups, such that individuals idealized younger ages than they felt. This discordance was larger in older than younger adults, although younger adults exhibited more daily fluctuations in SAD. Within-person increases in SAD were associated with lower positive affect, whereas larger SAD at the between-person level was associated with more physical symptoms and stressors. These relationships were over and above the associations of felt and chronological age with the outcomes suggesting the utility of daily SAD for understanding daily physical and psychological well-being. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Participation in activities mediates the effect of Internet use on cognitive functioning in old age.

Research indicates that Internet use positively influences cognitive functioning in later life, but we do not know the behavioral pathways that explain this association. This study explored the role of participation in activities as a potential mediator of the relationship between Internet use and cognitive functioning over a 4-year period. We analyzed representative data from the Survey of Health, Ageing and Retirement in Europe (SHARE). The sample included 8353 European participants between 50 and 97 years of age. We used data from 2013 (T1), 2015 (T2), and 2017 (T3). Participants reported whether they participated in a diverse range of social and leisure activities. In addition, they provided information about their Internet use as well as cognitive functioning measures. Findings from cross-lagged panel analysis indicated a positive association between Internet use and change in cognition over the course of 4 years. This relationship was partly mediated by the number of reported activities. Internet use was positively associated with the change in activities after 2 years, which, in turn, positively predicted cognitive functioning 2 more years later. This is the first study that explores the temporal sequence of Internet use, participation in activities, and cognitive functioning. It sheds light on the mechanisms that account for the positive effects of Internet use on healthy aging.

Late-Life Preparedness and Its Correlates: A Behavioral Perspective on Preparation.

OBJECTIVES: The present study examined the extent of late-life preparedness and its correlates. In accordance with behavior theories, we postulated that those who have prior experience with caregiving and who perceive such activities as more useful and less risky are more likely to engage in late-life preparatory activities. Because the perceived distance until aging-related life challenges become prevalent may play a role in late-life preparedness, we hypothesized that the effects of the correlates would vary depending on one's subjective remaining life expectation (SRLE). METHODS: Building upon cross-sectional data including 581 German adults from 18 to 93 years, we fitted a hurdle model that separately analyzes the presence and variety of self-reported action engagement to better handle the zero-inflated count measure of preparatory activities. RESULTS: The results revealed that the effects of perceived utility, caregiving experience, and SRLE were significant for both the presence and variety of activities. SRLE was found to moderate the observed effects in the models: The effect of perceived utility on the presence of at least one late-life preparatory activity was larger for those with lower SRLE. In contrast, among those with higher SRLE, having provided care increased the variety of preparatory activities. DISCUSSION: Findings suggest that some of the examined psychosocial factors are similarly associated with both the presence of at least one and the variety of late-life preparatory activities, although the extent of their effects varies depending on one's subjective life stage.

For a better me? Or for a better us? Perceived utilities of aging preparatory activities and positive future thinking in Germany, USA and Hong Kong.

Engaging in aging preparatory activities that is perceived to be utile for oneself (e.g., to retain autonomy and independence) and for others (e.g., to retain a harmonious relationship with important others) may have a functional effect on one's aging process. We examined how perceived self- and other-related utilities of aging preparatory activities were associated with positive future thinking across adulthood, and whether these associations differed by culture. Building upon cross-sectional data from a web-based study conducted in Hong Kong (n = 283, M age = 55.12, aged 18-85 years), the USA (n = 264, M age = 51.06, aged 20-85 years) and Germany (n = 402, M age = 51.65, aged 19-90 years), we observed different patterns of associations across these three cultures. Perceiving self-related utilities was linked to positive future thinking in the USA and Germany, but not in Hong Kong. In contrast, perceiving other-related utilities of aging preparatory activities was positively associated with future thinking in Hong Kong, but not in the USA or Germany. Perceived risks, on the other hand, showed a negative association with positive future thinking across all cultures. Findings suggest that there might be a culture-specific tendency for individuals to appraise their future, based on their perceived self- or other-related utilities of aging preparatory activities.

Personal ideals of aging and longevity: The role of subjective discordances.

Following theoretical models on wishful thinking, we investigated (a) whether personal aging ideals are discordant from self-perceptions of aging, (b) how such aging discordances evolve across adulthood, (c) whether current aging discordances are related to anticipated future aging discordances, and (d) whether aging discordances are related to a lower psychological well-being. We captured subjective age discordance (SAD) as the discrepancy between current perceived age and ideal age, and we captured subjective life-expectancy discordance (SLED) as the discrepancy between perceived life expectancy and ideal life expectancy. For the analyses, we used cross-sectional data from 1,015 individuals (M = 40.0 years, SD = 17.9 years; 52.1% women) and 2-year longitudinal data from 258 individuals (M = 55.3 years, SD = 17.3 years; 70.5% women). Both aging discordances were clearly present across the adult life span; that is, ideal ages were lower than perceived ages, and ideal life expectancies were higher than perceived life expectancies. A stronger SLED was associated with a stronger SAD, both cross-sectionally and longitudinally. Both discordances were also associated with lower psychological well-being in the cross-sectional analyses. Over time, lower life satisfaction predicted increases in SAD, and SLED predicted increases in negative affect. The results indicate that SAD and SLED are both highly prevalent and potentially functional because they seem to be related to psychological well-being. The discussion focuses on SAD and SLED as constructs for future research, their antecedents, and potential consequences. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Technology Adaptivity Mediates the Effect of Technology Biography on Internet Use Variability.

BACKGROUND AND OBJECTIVES: Increasing numbers of older adults use the internet, but relatively little is known about the range and determinants of different online activities among older internet users. This study explores the interplay between technology-related biographical experiences and subjective technology adaptivity to explain the variability of internet use. Older adults who report having had more biographical experiences with technologies were expected to use a greater range of online activities. In addition, subjective technology adaptivity was expected to serve as a mediator of this relationship. RESEARCH DESIGN AND METHODS: The analyses are based on a sample of 707 community-dwelling older participants of the University of the Third Age between 60 and 95 years of age (mean age = 72.49 years; 48% female) who use the internet. The measures include self-reports of online activities, technology-related biographical experiences, subjective technology adaptivity, and personal characteristics (age, gender, education, income, living-together status, and subjective health). Correlations and a path model with mediator effects were used to explore the research hypothesis. RESULTS: The bivariate effects on the variability of internet use showed that study subjects participated in a greater range of online activities when they lived together with other people and were male, younger, and had higher levels of subjective technology adaptivity, technology-related biographical experiences, and educational level. The direct effects on the mediator show higher levels of subjective technology adaptivity for people who reported greater technology-related biographical experiences and for those who reported higher levels of subjective health. DISCUSSION AND IMPLICATIONS: The results show that the positive association between people's past experiences with and stances toward technology in their own lifetimes and their range of diverse internet activities is mediated by subjective technology adaptivity. The findings also help to illustrate which biographical factors and which current individual factors explain differences in actual online behavior.

Internet Use and Cognitive Functioning in Late Adulthood: Longitudinal Findings from the Survey of Health, Ageing and Retirement in Europe (SHARE).

OBJECTIVES: Research suggests that cognitive functioning is associated with technology use in late life, but longitudinal research in this domain is still sparse. This study explored the reciprocal association between Internet use and cognitive functioning over a 2-year period. METHOD: We analyzed representative data across 14 countries from the Survey of Health, Ageing and Retirement in Europe (SHARE). The sample included 29,576 participants between 50 and 100 years of age. We used data from 2013 (Wave 5) and a 2-year follow-up in 2015 (Wave 6). Participants provided information on cognitive functioning measures and Internet use at both time points. RESULTS: Cross-lagged panel analysis indicated reciprocal effects between cognitive functioning and Internet use. Internet use had a greater impact on cognitive functioning than vice versa. DISCUSSION: This study sheds light on the direction of the association between cognitive functioning and Internet use. Findings indicate that using the Internet positively affects cognitive functioning in late life.

Negative Self-perception of Aging and Mortality in Very Old Chinese Adults: The Mediation Role of Healthy Lifestyle.

OBJECTIVES: Previous literature has consistently shown a positive association between negative self-perception of aging and mortality in middle-aged and older adults. However, two questions remain unsolved: (a) whether such association holds among very old people (i.e., the fourth age) and (b) the potential mediators that could contribute to the positive association. This study sought to fill in the research gap by examining the association between self-perception of aging and mortality in a group of very old Chinese participants (i.e., aged over 78 years). METHODS: Four waves of data across a span of 8 years (2000-2008) were obtained from the Chinese Longitudinal Healthy Longevity Survey, which measured a total of 9,683 participants' negative self-perception of aging, survival status, cognitive functioning, diet, as well as other demographic information. RESULTS: Latent growth models with survival analysis were conducted, and the results replicated previous findings indicating an association between negative self-perceptions of aging and reduced survival. Moreover and more importantly, a potential mediator-healthy lifestyle (e.g., eating fresh vegetables and fruits, exercising regularly, and no smoking)-was identified, such that older adults with more negative self-perception of aging tended to engage in less healthy lifestyle, which could lead to increased risk of mortality. DISCUSSION: The findings provided support for a longitudinal behavioral pathway of health, linking negative perceptions of aging to mortality, and also yielded important practical implications for older adults to reach longevity.

Social support is associated with technology use in old age.

BACKGROUND: The use of technological innovations can play a significant role in healthy aging and social participation in old age; however, it is not well understood how social contexts can influence or support older adults' use of technology. This study explored the associations between technology use, perceived technology-related support and actual technology-related social support. It was expected that older adults who perceived having more supportive resources available would be more likely to receive actual support in technology-related issues, which, in turn would explain a greater use of technology in everyday life. MATERIAL AND METHODS: The data are based on a sample of 107 community-dwelling older adults between 60 and 93 years of age (mean age = 73.66 years, 40% male). Measures included self-reports of actual technology-related support, perceived technology-related support, the use of different devices related to digital information and communication technology and personal characteristics (e.g. chronological age, gender, education and functional limitations). A path model was used to explore the research hypotheses. RESULTS: Actual technology-related support received was positively associated with a greater number of devices used. Participants received more support with technology when they perceived a greater availability of supportive resources. The actual support received mediated the influence of perceived support and functional limitations on technology use. CONCLUSION: The results of this study show that the provision of supportive behavior is associated with the actual use of technology. Moreover, the findings shed light on the individual and contextual factors that explain differences in actual support received.

Motivation for Longevity Across the Life Span: An Emerging Issue.

Over the past decades, increases in life expectancy in most modern societies have raised questions about whether and to what extent individuals value possible extensions of their personal lifetime. In this vein, a new field of research emerged that investigates the determinants, concomitants, and consequences of longevity values and personal preferences for an extended lifetime across adulthood. Based on a review of available theoretical and empirical work, we identified 3 mindsets on the challenges and potentials of human longevity common in research as well as personal views: (a) an essentialist mindset that builds on ideal principles of an infinite life, aimed at conquering or significantly postponing a biologically determined aging process, (b) a medicalist mindset that appraises aging as being primarily based on quality of health, and (c) a stoicist mindset that associates longevity and lifetime extension with the experience of grace and meaning. In this regard, we submit that motivation for longevity and its behavioral consequences differ depending on what mindsets individuals adopt in a given developmental context. We suggest that mindsets of longevity motivation are embedded in personal belief systems (e.g., death acceptance) that may depend on health, and on context influences (e.g., culture). Mindsets of longevity motivation may be related to differences in health behavior and late-life preparation. We illustrate such ideas with an exploratory analysis from a cross-cultural data set. We discuss the possible implications of these mindsets of longevity motivation for the aging sciences, and with regard to individual ways of approaching old age.

The Detrimental Consequences of Overestimating Future Health in Late Life.

OBJECTIVES: Although forecasting a positive future can be adaptive, it may not be when expectations are unmet. Our study examined whether such inaccurate expectations about future health status (overestimation) were maladaptive for older adults who commonly experience late life declines in physical functioning. METHOD: We analyzed data from the nationally representative German Aging Survey (DEAS; 1996-2011; n = 2,539; age range 60-85 years) using multilevel growth models that assessed the influence of inaccurate health expectations on older adults' physical functioning over a 9-year period. RESULTS: Overestimating future health status predicted reduced day-to-day physical functioning when age, gender, and self-rated health were controlled. A Time × Overestimation interaction indicated that the negative effects of overestimation on physical functioning became more pronounced over the 9-year period. DISCUSSION: Results suggest that repeatedly unmet health expectations may undermine motivational resources and accelerate late life declines in physical functioning.

A healthy dose of realism: The role of optimistic and pessimistic expectations when facing a downward spiral in health.

RATIONALE AND OBJECTIVES: Whether expectations about future health are adaptive or maladaptive in late life likely depends on the extent to which they conform to or defy a future reality of declining health. Our premise was that, when adults face a downward spiral in health, it can be adaptive to realistically expect poorer future health and maladaptive to unrealistically expect good health. METHOD: This 18-year-long study of community-dwelling older Canadians (n = 132, 72-98 years) involved a baseline interview to identify those who anticipated heath would decline (pessimistic expectation) or improve/remain stable (optimistic expectation). We determined initial (baseline) health status by assessing the severity of chronic conditions. An objective within-person measure of actual health change was derived by documenting hospital admissions (HAs) over time to capture a continuum that ranged from no declines (HAs remained stable) to greater declines in health (increasing numbers of HAs). Our a priori hypotheses examined the effects of health expectations (pessimistic, optimistic) and actual health change on the outcomes of depressive symptoms and mortality. RESULTS: Support was found for our premise that it is adaptive to be realistic when forecasting future health, at least at low levels of initial chronic condition severity. Regression analyses showed that realistically pessimistic (vs. unrealistically optimistic) expectations predicted significantly fewer depressive symptoms and a lower risk of death. The results also supported our premise that it is maladaptive to be unrealistically optimistic when health subsequently declines in reality: The risk of death was 313% higher for those with optimistic expectations that were unrealistic (vs. realistic). CONCLUSION: These findings provide insights for health care professionals regarding the messages they communicate to their patients. Together, they imply that, when good health is slipping away, it seems optimal to encourage a healthy dose of realism.

Development and Validation of Social Motivation Questionnaire.

BACKGROUND AND OBJECTIVES: Information-seeking (IS) and emotion-regulatory (ER) motivation play meaningful roles in age-related changes in social interaction across adulthood. This study aimed to develop and validate the Social Motivation Questionnaire (SMQ) to assess these two types of motivation. RESEARCH DESIGN AND METHODS: Ten items were selected from a pool as the candidate items of SMQ and were administered to 480 German adults (20-91 years old) for validation. These items were also administered to 150 U.S. (18-40 years old) and 131 Hong Kong younger adults (18 to 26 years old) for cultural-invariance examination. RESULTS: Exploratory and confirmatory factor analyses showed that a two-factor, eight-item structure fits the German adults' data well with satisfactory reliability. Multigroup comparisons showed cross-age invariance among younger, middle-aged, and older German adults, as well as cross-cultural invariance among German, U.S., and Hong Kong younger adults. DISCUSSION AND IMPLICATIONS: A new questionnaire, SMQ, was developed and validated to measure IS and ER social motivation across adulthood and across cultures.

Staff members' ambivalence on caring for patients with multidrug-resistant bacteria at their end of life: A qualitative study.

AIMS AND OBJECTIVES: To explore healthcare professionals' personal experiences, feelings and attitudes about caring for hospitalised patients with multidrug-resistant bacteria in palliative and geriatric care. BACKGROUND: Working in end-of-life care involves at times burdening demands that affect not only healthcare professionals personally but also their actions. It is suggested that multidrug-resistant bacteria and their consequences for colonised or infected patients in hospitals are among the challenges for all professionals in end-of-life care. Little is known about the feelings and experiences of staff members during healthcare activities with regard to these bacteria. DESIGN: A qualitative interview study in two German hospitals. METHODS: We interviewed 35 staff members from a German palliative care unit and a geriatric unit about their experiences with multidrug-resistant bacteria in end-of-life care and the management of colonised or infected patients. Semistructured interviews were transcribed verbatim and analysed using grounded theory. RESULTS: Interviewees represented two interdisciplinary teams with 40% nurses, 26% physicians and 34% other professionals. Salient themes that were identified included impact of multidrug-resistant bacteria on staff members' personal actions, feelings and attitudes towards the bacteria and the required isolation measures. Besides higher workload and consequences for working routines, the patients' palliative care needs were recognised, as well as the necessary protection measures to avoid contaminations in hospital. Healthcare professionals reported a dilemma that they experienced when facing these diverse demands. CONCLUSIONS: Findings point to emotional and behavioural ambivalence in end-of-life care among staff members because necessary isolation measures and particular situation in end-of-life care create unsolvable conflicts for healthcare professionals. Possible strategies to cope with ambivalence are discussed. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals in palliative and geriatric care have to deal with multidrug-resistant bacteria and have to face contradictory feelings while trying to fulfil patients' needs as well as isolation requirements.

Multidrug-resistant bacterial microorganisms (MDRO) in end-of-life care: development of recommendations for hospitalized patients using a mixed-methods approach.

PURPOSE: Palliative care professionals are frequently confronted with patients colonized or infected with MDRO. One major challenge is how to balance necessary isolation measures and social inclusion as one of the main principles of palliative and end-of-life care. To date, MDRO-specific policies and protocols vary widely between institutions. AIM: provide empirical recommendations on how to deal with hospitalized MDRO patients in end-of-life care. METHODS: Recommendations were developed based on (i) initial results of face-to-face interviews and focus groups, (ii) impartial experts' comments and consensus on the draft via online survey and (iii) a face-to-face meeting with consortium members to finalize recommendations. Findings of 158 interviews and six focus groups (39 participants) with patients, family caregivers, staff members and institutional stakeholders contributed to the recommendations. The assessments of 17 experts were considered. RESULTS: In total, 21 recommendations were approved. The recommended strategy in dealing with MDRO at the end of life allows case-based application of protection and isolation measures. MDRO diagnostics and therapy involve screening at admission. The recommendations suggest consideration of required accommodation facilities, provided material as well as staff and time resources. The recommendations further highlight the importance of providing for strategies enabling the patient's social inclusion and provision of verbal and written information about MDRO for patients and family caregivers, transparent medical documentation, and staff member training. CONCLUSION: The recommendations summarize the perspectives of individuals and groups affected by MDRO at the end of life and provide practical guidance for clinical routine. Further dissemination and implementation requirements are discussed and should contain the evaluation of the knowledge, views, worries, and anxieties of the target groups.