The “Reckoning Point” as a Marker for Formal Palliative and End-of-Life Care in Mexican American Families

Abstract

Palliative and end-of-life care (PEOLC) in Mexican American (MA) caregiving families remains unexplored. Its onset was uncovered in our mixed methods, multisite, interdisciplinary, qualitative descriptive study of 116 caregivers, most of whom had provided long-term informal home care for chronically ill, disabled older family members. This subanalysis used Life Course Perspective to examine the "point of reckoning" in these families, where an older person is taken in for care, or care escalates until one recognizes oneself as the primary caregiver. Ninety-three of 116 caregivers recognized and spontaneously reported a "reckoning point" that initiated the caregiving trajectory, while eight cited "gradual decline" into caregiving for elders in their homes. This "reckoning point," which marks the assumption of this role, may afford a fertile opportunity for referral to community resources or initiation of formal PEOLC, thereby improving the quality of life for these older individuals and their families.

“Tipping point” concept analysis in the family caregiving context

“…Contexts in which tipping points related to aging changes and caregiving families were also represented. For example, Evans and Coon placed tipping point within the context of family caregiving by describing it as the “point at which the older person is taken in for care or care escalates to the point where one recognizes and reconciles oneself to the role of primary caregiver” (p. 609). Brady (2017) put tipping point within the context of palliative and end‐of‐life care for persons with end‐stage renal disease.…”

“…Because changes are key to the concept “tipping point”, we also searched literature using MeSH headings including “Self‐Efficacy” or “Life Change Events” or “Social Change” or “Organizational Culture” or “Stress, Psychological” or “Learning” and “tipping point.” We conducted supplemental searches of scholarly works by authors we knew had addressed changes that might be considered tipping points even if their work was not identified in the literature searches. In particular, we searched for research conducted by Rantz et al and Evans and Coon related to family caregiving.…”

Family experience living with advanced neoplasm: a glance at the rural population

“…Mutuality is also manifested by attitudes and words of support and involvement. Faith leads families to see care as part of their journey, connects family to God, which makes them find comfort and security, allowing better acceptance and adaptation (36)(37)(38) .…”

Translation and Testing of the Italian Version of FAMCARE-2: Measuring Family Caregivers’ Satisfaction With Palliative Care

“…Family caregivers play an important role in supporting and managing the patient’s care and are, themselves, a focus of palliative care. A terminal illness causes numerous disruptions and distress in those family members most involved in the patient’s care, and when the patient’s disease progresses, family caregivers encounter a myriad of stressors that are both physically and emotionally demanding (Evans & Coon, 2016; Tanco et al, 2017). Knowing the elements that contribute to care satisfaction may enable health care providers to better anticipate and address family members’ concerns and stressors.…”