- The Washington Times - Monday, January 1, 2018

When Kenneth Doka’s father was dying of cancer, the family got together for one last Thanksgiving. It was a somber event, the disease had taken a harsh toll on the man’s health.

When he died a few days later, the family took comfort that they had spent one last holiday together.

“Thanksgiving used to be one of his favorite holidays — so there was a sadness to that dinner. But we did take comfort from the fact that Dad got to live through this last Thanksgiving,” Mr. Doka, a family grief counselor, said in an interview with The Washington Times.

To enjoy one last holiday, to see a graduation, to wait until the last family member arrives home — stories abound of terminally ill people seemingly postponing death to experience one last significant or religious event. But research on the subject on whether people can postpone death is inconclusive.

“I think there’s a lot of anecdotal material, whether or not it’s scientific, I don’t know of a family that doesn’t have a story like that,” Mr. Doka said, adding that his uncle, who also died from cancer, lingered until his daughter made it home for the holidays.

“He seemed to just hold on until she finally arrived for Christmas vacation, within a day or two after she arrived, he died,” he said.

In the 1970s, University of California sociologist David Phillips started exploring the relationship between death days and significant events.

In one of his first research papers, he examined whether famous people died after their birthdays because of the public attention: These subjects also provided more accurate records at a time when death certificates for the general population were not as readily available.

Of the 1,251 subjects, 86 died in the month before their birth month — this was 17 percent fewer deaths than expected if it was totally independent, Mr. Phillips wrote.

Later, he looked at the influence of race and culture on postponing death. In a 1990 paper published in the Journal of the American Medical Association, Mr. Phillips and his co-authors found that for Chinese, deaths dipped by 35.1 percent in the week before the Harvest Moon Festival, one of their most significant holidays, and then peaked by 34.6 percent the week after.

This methodology was further explored with Jewish subjects and Passover — as both groups celebrate holidays based on lunar calendars and are therefore independent of any influence of specific months or weather.

In looking at 1,919 death certificates between 1966 and 1984 for people with Jewish surnames, the total number of deaths were lower than expected in the week before Passover and higher than expected in the week after the holiday, Mr. Phillips wrote.

“There’s nothing scientific — as far as empirical data — of hope,” said Malene Davis, CEO of Capital Caring Hospice, which has been serving the populations of Virginia, West Virginia and Maryland for nearly half a century. “We know that hope is very strong and also the human will to live, we absolutely do see [people postpone death].”

In more recent research, there’s little replication of these findings.

In 2004, researchers Donn Young and Errin Hade analyzed more than 300,000 cancer deaths in Ohio that occurred between 1989 and 2000. They found no evidence to suggest people postpone their deaths because of significant “religious, social or personal events.”

Ten years later, German researchers embarked on a similar study, looking at more than 3 million cancer deaths in that country, and found little data to support that people put off death until after birthdays or major Christian holidays like Christmas or Easter.

In fact, cancer deaths increased slightly before Dec. 25, the author’s wrote, and “the prospect of Christmas seemed to reduce the chance to survive this date.”

Other research has supported that more deaths, of any cause, occur during the holidays and in the winter months.

In a 2004 paper, Mr. Phillips further found that during the Christmas and New Year’s holiday, there are 4.65 percent more cardiac deaths and 4.99 percent non-cardiac deaths compared to any other time of the year in the U.S.

The findings were replicated by researchers in New Zealand in 2014, chosen for the fact that the country has a year-round mild climate and Christmas takes place during their summer months.

Despite the difference in geography and temperature, the researchers found that cardiac deaths increased by 4.2 percent over the Christmas holiday compared to all other times of the year.

Mr. Phillips and his co-authors hypothesized that the greatest factor in these observed spikes is because people are more likely to delay seeking treatment until after the holidays.

Other explanations didn’t pan out, he wrote. More alcohol and sweets at Christmas parties didn’t support the death spikes, with a greater number of deaths observed among hospitalized patients with strict diet and nutritional oversight.

Emotional stress during this period also didn’t provide a good enough reason for the high number of deaths, particularly among Alzheimer’s patients who were possibly unaware of the time of year.

The belief that people can postpone death until after the holidays was proved wrong in this research — death rates would have dipped where they actually spiked.

“Delays in seeking treatment could result in sicker patients, some of whom die as inpatients,” Mr. Phillips and his co-authors wrote in the 2004 study, adding that medical staff changes could also effect this trend.

Ms. Davis, the hospice CEO, said it’s important for terminally ill patients and their families to take advantage of end-of-life care that can provide a support system, relieve stress and alleviate patients’ pain over their final days.

In some cases, it can even extend life — a 2007 study showed that people in hospice care lived an average of 30 days longer than those who didn’t have it.

“When [pain is] alleviated, even though there’s an underlying, serious illness, they will feel like talking on the phone and visiting or getting dressed, all of this — we’re not just biological beings,” Ms. Davis said. “We’re spiritual, emotional, social beings and so, all of these things, when they’re all working the best that they can, given a very sick body, people will live longer.”


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