Holding On and Letting Go: Making Sense of End-of-Life Care Decisions in Families

Ohs, Jennifer E.; Trees, April R.; Gibson, Corinne

doi:10.1080/1041794x.2015.1081979

Cited by 14 publications

(24 citation statements)

References 11 publications

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“…When making end‐of‐life decisions, family members are forced into a dialectical tension between holding on and letting go (Ohs et al . ). Pausing at the last moment signifies that this tension still remains.…”

Section: Analysis and Discussionmentioning

confidence: 97%

“…If patients are unconscious, surrogate decision‐makers (‘proxies’) are often ignorant of their end‐of‐life preferences (Ohs et al . ). Their unease is exacerbated when healthcare professionals delay discussing the situation with them or provide mixed messages about treatment plans and outcomes (Curtis and Vincent , Kitzinger and Kitzinger , ).…”

Section: Introductionmentioning

confidence: 97%

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Dying on television versus dying in intensive care units following withdrawal of life support: how normative frames may traumatise the bereaved

Chartrand

2020

Sociology Health & Illness

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While treatment is often withdrawn from patients in intensive care units (ICUs), few people outside the healthcare profession have witnessed a death under such circumstances. Family members who have made the decision to withdraw treatment may have expectations about the dying process, what constitutes a good death and how they should behave in an ICU based on popular prime-time television series. An inductive comparative thematic coding strategy is therefore used to examine how death following treatment withdrawal as depicted in a US medical drama (Grey's Anatomy) differs from realities observed for 6 months fieldwork at an ICU in Canada. Three common frames (privacy, emotional control and memorialising) help patients' intimates normalise the unfamiliar experience and guide their behaviour during the event. However, discrepancies between media representations and experiences in the ICU, especially around the frames of timing of death and the physicality of the unbounded body (incontinence and agonal breathing), can traumatise them. The bereaved may be left viewing ventilator withdrawal and dying as chaotic processes and believing their loved one suffered through a bad death. Understanding these normative and discrepant frames should help healthcare professionals better prepare the public to witness death.

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Section: Analysis and Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

Dying on television versus dying in intensive care units following withdrawal of life support: how normative frames may traumatise the bereaved

Chartrand

2020

Sociology Health & Illness

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“…These contexts include spousal relationships (Baxter, Braithwaite, Golish, & Olson, 2002;Moore, Kienzle, & Grady, 2015;Sahlstein, Maguire, & Timmerman, 2009;Toller, 2005;Toller, 2008;Toller & Braithwaite, 2009), parent-child relationships (Harrigan & Miller-Ott, 2013;Scharp & Thomas, 2016), siblings (Halliwell, 2016;Halliwell & Franken, 2016), stepfamilies (Baxter et al, 2009;Braithwaite & Baxter, 2006;Braithwaite & Schrodt, 2013;Braithwaite, Toller, Daas, Durham, & Jones, 2008), and communication with in-laws (Prentice, 2009). Researchers also have applied RDT to issues that face families such as inheritance planning (Pitts, Fowler, Kaplan, Nussbaum, & Becker, 2009), transgender identification (Norwood, 2012), lesbian co-mothering (Suter, Seurer, Webb, Grewe, & Koenig Kellas, 2015), mental illness (Sporer & Toller, 2017), end-of-life decisions (Ohs, Trees, & Gibson, 2015), and forgiveness (Carr & Wang, 2012). Through these two iterations, RDT's focus remains centered on exploring how family members create their shared reality through ongoing interaction, with particular emphasis placed on the "tensions" (contradictions) that represent the different goals and desires of each member (Baxter, 2011;Baxter & Montgomery, 1996).…”

Section: Relational Dialectics Theorymentioning

confidence: 99%

“To Meet Her, that Changed Everything”: Adult Adoptees’ Discursive Construction of the Meaning of “Parent” following Birth Parent Contact

Anzur

Myers

2019

Journal of Family Communication

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This dissertation examined the competing discourses that emerged as adult adoptees constructed the meaning of the term "parent" following contact with a birth parent. As a type of nontraditional family, adoptees have "dual membership" (Colaner, Halliwell, & Guignon, 2014) in both their adoptive and birth families. When making contact with a birth parent, adoptees may have to renegotiate the meaning of the term "parent" to include the birth parent. Relational Dialectics Theory (Baxter, 2011; Baxter & Montgomery, 1996) was used because it is an interpretive theory that allows researchers to study contradictory feelings-or competing discourses-that emerge in nontraditional families. Semi-structured interviews were conducted with 30 adult adoptees who had made contact with a birth parent. Contrapuntal analysis (Baxter, 2011) uncovered two primary discourses that emerge as participants constructed a definition of "parent" following contact with their birth parent. The first discourse, discourse of parent as a specific person (DPSP), emerged when participants felt that "parent" referred exclusively to their adoptive parents; these participants did not change their definition of "parent" when they made contact with their birth parent. The second discourse, discourse of parent as a label (DPL), emerged when participants defined "parent" as a flexible role that could be filled by multiple people. These participants felt that their definition of "parent" changed only after making contact with their birth parent, and they included their birth parent in their definition of "parent." These discourses demonstrated interplay through negating, countering, and entertaining. The results of this dissertation add to the body of literature on adoptive family communication and RDT, and have implications for adoption practitioners. Three primary limitations should be considered: the use of a sample recruited from an adoption forum, the use of a sample that is not representative of the adoptee population, and three assumptions of birth family contact that were made prior to data collection. Despite these limitations, the results offer potential avenues of research for adoptive family communication researchers. iii ACKNOWLEDGEMENTS This is the part of the dissertation where I recognize the many wonderful individuals who helped me in my journey through this program. There will never be enough space, nor the right words, for me to fully acknowledge everything that these people have done for me, but this is a start. To my parents, Lynette and Dan, thank you for your unwavering support and for never failing to be proud of me, even when you weren't sure exactly what it was that I was doing. You instilled in me a work ethic and determination that got me to this point (and also a stubborn streak that has gotten me in trouble occasionally). To my sister, Kayla, my very first and best friend, thank you for being an endless source of entertainment whenever I needed a pick-me-up. Tante Angela, thank you for providing support in every sense of the w...

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“…Living wills, for example, do not always provide insight into the specific decision that must be made [ 23 ]. Additionally, when family members are aware of the patient’s wishes, they still may encounter a contradiction between their own desires and the patients’ desires [ 24 ], often experienced as a tension between holding on and letting go [ 25 ]. Family members also may struggle to make sense of the decision and of a loved one’s likely death.…”

Section: Introductionmentioning

confidence: 99%

Family Communication about End-of-Life Decisions and the Enactment of the Decision-Maker Role

Trees

Ohs

Murray

2017

Behavioral Sciences

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End-of-life (EOL) decisions in families are complex and emotional sites of family interaction necessitating family members coordinate roles in the EOL decision-making process. How family members in the United States enact the decision-maker role in EOL decision situations was examined through in-depth interviews with 22 individuals who participated in EOL decision-making for a family member. A number of themes emerged from the data with regard to the enactment of the decision-maker role. Families varied in how decision makers enacted the role in relation to collective family input, with consulting, informing and collaborating as different patterns of behavior. Formal family roles along with gender- and age-based roles shaped who took on the decision-maker role. Additionally, both family members and medical professionals facilitated or undermined the decision-maker’s role enactment. Understanding the structure and enactment of the decision-maker role in family interaction provides insight into how individuals and/or family members perform the decision-making role within a cultural context that values autonomy and self-determination in combination with collective family action in EOL decision-making.

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Holding On and Letting Go: Making Sense of End-of-Life Care Decisions in Families

Cited by 14 publications

References 11 publications

Dying on television versus dying in intensive care units following withdrawal of life support: how normative frames may traumatise the bereaved

Dying on television versus dying in intensive care units following withdrawal of life support: how normative frames may traumatise the bereaved

“To Meet Her, that Changed Everything”: Adult Adoptees’ Discursive Construction of the Meaning of “Parent” following Birth Parent Contact

Family Communication about End-of-Life Decisions and the Enactment of the Decision-Maker Role

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