The association between illness perception and family functioning with good death expectations in community-dwelling older adults with chronic diseases

Objective To examine the association between good death expectations and family functioning in community-dwelling older adults with chronic diseases, and the association with illness perception. Methods In this cross-sectional study (Nov 2025–Mar 2026) of 300 community-dwelling older adults (≥60 years, ≥1 chronic disease) from three districts of a city in China, validated tools measured key variables. Mediation analysis used PROCESS bootstrapping (5,000 samples) with sociodemographic adjustment. Results Family functioning positively correlated with good death expectations ( r = 0.561, p < 0.01) and negatively with illness perception ( r = −0.482, p < 0.01). Illness perception negatively correlated with good death expectations ( r = −0.506, p < 0.01). Illness perception showed a significant indirect effect in the relationship [indirect effect = 0.1317; 95% CI (0.0804,0.1912)], accounting for 26.12% of the total effect. Conclusion Family functioning was associated with good death expectations and illness perception showed a significant indirect association. Future research is needed to determine whether interventions targeting these factors could improve end-of-life expectations.