Family carers’ experiences of goals of care conversations in acute hospital settings

Kitty Vivekananda, Jayamini S. Jayawardene, Moira O’Connor, Kaaren J. Watts, Anton D. Leonard, Sharon Keesing, Georgia Halkett, Josephine Shaw, Valerie Colgan, Kevin Yuen, Renate Jolly, Simon C. Towler, Anupam Chauhan, Margherita Nicoletti, Claire E. Johnson

Research output: Contribution to journalArticleResearchpeer-review

Abstract

End-of-life Goals of Care (GoC) discussions aim to support care that is consistent with patients’ preferences and values. This study uses an exploratory qualitative design drawing upon a social constructivist epistemology to examine family carers’ perspectives on GoC within acute Australian hospital settings. Twenty-five family carers of aging inpatients were recruited from six Australian hospitals to participate in recorded, semi-structured interviews. Data were transcribed and analyzed using reflexive thematic analysis. Three main themes were developed. Theme 1 explored carers’ experiences of GoC discussions—identifying varying levels of preparedness and carers' hopes for open, two-way discussions initiated by empathic Health Care Professionals (HCPs). Theme 2 examined carers’ unmet needs for time, space, consistency, and support to make careful decisions. Theme 3 identified carers advocating for patients' needs when they could not do it themselves. Preparing carers and normalizing GoC discussions relating to end-of-life care maximizes benefits for patients, carers, and HCPs involved.

Original languageEnglish
Pages (from-to)2304-2312
Number of pages9
JournalJournal of Applied Gerontology
Volume42
Issue number12
DOIs
Publication statusPublished - Dec 2023

Keywords

  • decision-making
  • end of life
  • family
  • goals of care
  • qualitative methods

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