I play with aging off also. My elder Sims usually die after woohoo or going jogging, telling jokes etc.
The other night when I was playing my Sims were having a party and the last time I seen my Sims' elderly uncle alive he was making a drink and conversing with party guests. I was too busy with party goals to notice the very playful mood and the jokes must have been flowing because he died and was too far gone to plead for his life even if I wanted to. By the time I moved back over to the to see what was going on there was already an urn. I only know he died a hysterical death is because of the notification.
IMO I don't think they need to change things in the game. Emotions already do in enough Sims.
