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

J Fam Nurs. 2016 Nov;22(4):606-630. doi: 10.1177/1074840716677994. Epub 2016 Nov 16.

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.

Keywords: Mexican American; family caregivers; palliative and end of life care; reckoning point.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Caregivers / psychology*
  • Family
  • Female
  • Humans
  • Male
  • Mexican Americans*
  • Middle Aged
  • Palliative Care
  • Quality of Life*
  • Terminal Care*