Variations in and factors influencing family members' decisions for palliative home care

Author:

Stajduhar Kelli I1,Davies Betty2

Affiliation:

1. Centre on Aging, University of Victoria and Vancouver Island Health Authority, Victoria, BC

2. University of California San Francisco School of Nursing, San Francisco

Abstract

The purpose of this paper is to describe the variations in and factors influencing family members' decisions to provide home-based palliative care. Findings were part of a larger ethnographic study examining the social context of home-based palliative caregiving. Data from participant observations and in-depth interviews with family members (n=13) providing care to a palliative patient at home, interviews with bereaved family members (n=47) and interviews with health care providers (n=25) were subjected to constant comparative analysis. Findings indicate decisions were characterized by three types. Some caregivers made uninformed decisions, giving little consideration to the implications of their decisions. Others made indifferent decisions, whereby they reluctantly agreed to provide care at home, and still others negotiated decisions for home care with the dying person. Decisions were influenced by three factors: fulfilling a promise to the patient to be cared for at home, desiring to maintain a ‘normal family life’ and having previous negative encounters with institutional care. Findings suggest interventions are needed to better prepare caregivers for their role, enhance caregivers' choice in the decision-making process, improve care for the dying in hospital, and consider the development of alternate options for care.

Publisher

SAGE Publications

Subject

Anesthesiology and Pain Medicine,General Medicine

Reference71 articles.

1. The Ecstasy and the Agony of Family Caregiving

2. Enhancing Caregiver Outcomes in Palliative Care

3. Statistics Canada. Who cares? Caregiving in the 1990s. 1996. Retrieved from: www.statcan.ca. Last accessed 13th May 2001.

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