Family members' perspectives on potential discussions about life prolongation for their older relatives

Garnett, D., Vandrevala, T., Hampson, S., Daly, T. and Arber, S. (2008) Family members' perspectives on potential discussions about life prolongation for their older relatives. Mortality, 13(1), pp. 65-81. ISSN (print) 1357-6275

Abstract

Family members (or health-care confidants) of incapacitated patients are often consultedby doctors when making life-prolongation decisions. Little research has beenconducted on confidants’ views on life prolongation and advance care planning. This study investigated the health-care confidant’s view on life prolongation and their involvement in being a potential decision-maker for their relatives in the event of incapacitation. Confidants (N¼12) were interviewed and interviews were analysed using Interpretative Phenomenological Analysis. The analysis revealed three themes relating to their perception of being a potential decision-maker for a relative’s life prolonging measures: ‘‘good’’ and ‘‘bad’’ death based on past experience and perceptions of quality of life, a sense that discussions were inappropriate at present, and strategies which might be used to encourage discussion. The implications of these findings for family involvement in life-prolongation decisions and how to encourage family discussions about life prolongation are discussed. KEYWORDS: life-prolonging treatments; proxy decision-making; family decision-making; advance care planning

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