The decision-making process of palliative care among male caregivers of chronically ill patients-A grounded theory study

BackgroundFamily caregivers have a vital role to play in palliative care for chronically ill patients. In Taiwan, caregiver demographics are evolving, with the number of male caregivers increasing. Gender differences influence psychosocial behaviours, thought processes and communication styles. In healthcare, acknowledgement of gender differences facilitates effective delivery of high-quality care.AimThe aim of this study is to explore male caregivers' decision-making process for palliative care for chronically ill family members.MethodsThis study employed grounded theory to generate a substantive theory of male caregivers' decision-making process for palliative care for chronically ill family members. We recruited 22 male participants from three inner-city teaching hospitals in Taiwan.FindingsRegarding the decision-making process of palliative care of chronic ill family, where male caregivers do not want their loved ones suffering anymore, the male caregivers' decision-making process was impacted, first, by caregivers' views on the last stage of life; second, by their wish for good care during the end of life; and third, by their conviction that the patients' wishes should be respected. Furthermore, caregivers' philosophy of life and death is also a supportive ground for decision-making. This philosophy was influenced by their education in palliative care, financial status and religious beliefs and practices. The core category emerging from this study is encapsulated by a participant's assertion, 'How difficult is it? There are no male and female differences'.ConclusionWe found that palliative care experiences of male caregivers are important for the decision-making process for palliative care for their chronically ill family members. Caregivers want their loved ones to receive good care as the last step in life, to respect their wishes and no more suffering for the patient. Therefore, health professionals should be familiar with the palliative care process that caregivers go through to offer updated information when needed. What is already known about this topic? Taiwanese philosophy of end-of-life care focuses on family values and shares the power of making critical decisions between patients and their relatives. Due to cultural preferences, the dedicated family caregiver often becomes the only channel for honouring the patient's wishes. Male and female caregivers can have different coping mechanisms; males are less likely to seek support and are more stressed by financial burdens.What this paper adds? The patient and the whole family should be considered in the discussion of end-of-life care. Male caregivers indicated palliative care should be linked to comfort care, avoidance of suffering and respecting patients' wishes.The implication of this paper: Male caregivers should be well supported, good care for their loved ones and fulfil the patient's wishes and no more suffering. Education in palliative care and religious and financial support should be provided along with palliative care services to both male caregivers.