Abstract
For older adults, approaching end-of-life (EOL) brings unique transitions related to family relationships. Unfortunately, most families greatly underestimate the need to discuss these difficult issues. For example, parents approaching EOL issues often struggle with receiving assistance from others, avoiding family conflict, and maintaining their sense of personhood. In addition, discussions of EOL issues force family members to face their parents’ mortality, which can be particularly difficult for adult children to process emotionally. This study explored aging issues identified by aging parents and their families as they traverse these impending EOL changes. Ten focus groups of seniors (n = 65) were conducted. Focus groups were organized according to race (African-American/European-American), gender, and whether the older adult was living independently or in an assisted care facility. When asked open-ended questions about discussing aging and EOL issues with family members, participants revealed tensions that led us to consider Relational Dialectics Theory as a framework for analysis. The predominant tension highlighted in this report was certainty versus uncertainty, with the two sub-themes of sustained life versus sustained personhood and confronting versus avoiding EOL issues. For these data, there were more similarities than differences as a result of gender, race, or living situation than one might expect, although culture and financial status were found to be influential in the avoidance of EOL discussions. The results of this study help to provide additional insight into relational dialectics related to aging, EOL, and the importance of communication in facilitating family coping.
Highlights
In 2014, the number of Americans 65 years and older was 45.2 million
We offer the following research questions: RQ1 : What are the inherent tensions embedded in the discourse of older adults with their families about end-of-life (EOL) issues?
The findings of this study merge with the larger corpus of relational dialectic research dealing with families
Summary
In 2014, the number of Americans 65 years and older was 45.2 million. By 2060, this group will number 98.2 million, nearly one in four U.S residents [1]. Old age creates uncertainty for parents as they struggle between receiving assistance from others, maintaining personal independence, and providing continuous nurturance and support to other family members [5] Is well-suited for investigating the interplay of opposing forces such as those experienced by older adults and their families regarding the discussion of EOL issues [6]. The core components of the theory (e.g., dialectical tensions and turning points) provide the appropriate foundation to investigate what happens to relationships as we age and face major turning points in life, such as confronting EOL decisions. We offer the following research questions: RQ1 : What are the inherent tensions embedded in the discourse of older adults with their families about end-of-life (EOL) issues?. European-American), and living situation (living independently/living in a residential care facility) of older adults?
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