Cultural Values Influence on Rural Family Caregivers' Decision-Making for Ill Older Adult Loved Ones

Area of Science:

• Gerontology
• Palliative Care
• Health Disparities

Background:

• Rural older adults often receive intensive end-of-life treatment.
• Goals of care discussions improve care alignment with patient values.
• Discussions are less common in rural and Black communities, with family caregivers' roles understudied.

Purpose of the Study:

• Explore rural family caregivers' cultural values, beliefs, and attitudes regarding serious illness and treatment decisions.
• Understand how these factors influence goals of care decision-making for loved ones.

Main Methods:

• Embedded qualitative study within a tele-palliative care randomized trial.
• Guided by the PEN-3 theoretical model.
• Semi-structured interviews with family caregivers, analyzed using thematic analysis.

Main Results:

• Twelve rural family caregivers centered decisions around core values, with faith as a key support.
• A model illustrates the complex interplay of themes in caregiving at the intersection of race and rurality.

Conclusions:

• This study provides foundational insights into how rural family caregivers' beliefs and values shape decision-making.
• Recommends integrating these constructs into culturally responsive decision-support interventions for palliative care.