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Characterizing end-of-life communication in families.

Melanie A Horning1, Mary Elizabeth Bowen2

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Summary

Family communication patterns influence end-of-life discussions. Pluralistic families, with open communication, engaged in more end-of-life talks than protective families, highlighting communication

Keywords:
chronic diseaseend-of-life decision-makingfamily communication pattern theoryhospiceolder adult

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Area of Science:

  • Social Sciences
  • Health Communication
  • Family Studies

Background:

  • Uncertainty in chronic disease progression often delays crucial end-of-life discussions within families.
  • Delayed discussions can lead to unexpressed wishes, increased decision-making uncertainty, and postponed hospice care.
  • Family Communication Patterns Theory (FCPT) posits that family communication styles impact end-of-life dialogue, hospice use, and the experience of a 'good death.'

Purpose of the Study:

  • To examine how family communication patterns, defined by conversation and conformity orientations, relate to the frequency and timing of end-of-life discussions.
  • To identify associations between four family communication patterns (consensual, pluralistic, protective, laissez-faire) and end-of-life communication.

Main Methods:

  • A cross-sectional study involving 56 family members of individuals who died from chronic illnesses while receiving hospice care.
  • Participants completed online surveys assessing family communication patterns (modified RFCP) and chronic illness severity (CIRS).
  • Survey questions also captured the number, timing of end-of-life discussions, and hospice enrollment timing; descriptive analysis was performed using SPSS.

Main Results:

  • The majority of families identified as pluralistic (42.9%), characterized by high conversation and low conformity orientation.
  • A significant portion of families were protective (39.29%), with low conversation and high conformity orientation.
  • Pluralistic families reported a greater number of end-of-life conversations compared to protective families.

Conclusions:

  • Findings suggest a link between specific family communication patterns and the likelihood of engaging in end-of-life discussions.
  • This study provides initial support for using FCPT to identify families at risk for delayed or ineffective end-of-life communication.
  • Future research should explore the impact of hospice enrollment timing and the quality of the dying experience; clinicians may use these insights for timely interventions.