2024 Volume 44 Pages 188-198
Objective: To identify family caregivers’ surrogate decision-making processes regarding withholding or withdrawing artificial hydration and nutrition in the end-of-life care of older adults.
Methods: Nine family caregivers were interviewed, and the data were analyzed using a modified grounded theory approach.
Results: Family caregivers searched for meaning in the turmoil of having to make medical decisions but felt distress when others’ voices disrupted their decision-making about the patient’s gastrostomy and end-of-life care. Respondents reported experiencing remorse, and the feeling that they were abandoning the patient’s life. Caregivers questioned whether the provision of intravenous fluids constituted a cure or a life extension, but they had hope for a natural and peaceful end to the patient’s life. Caregivers made sense of their experience of surrogate decision-making in an uncertain life, not as surrogate decision-makers but simply as family members watching over an older adult in their final days.
Conclusion: Family caregivers experienced anguish and conflict when making surrogate decisions about withholding or withdrawing artificial hydration and nutrition for older adult family members, and they tried to make sense of these difficult experiences in the context of their relationships with those family members.
