Dying with motor neurone disease, what can we learn from family caregivers?
Article first published online: 19 APR 2012
© 2012 John Wiley & Sons Ltd
Volume 17, Issue 4, pages 466–476, August 2014
How to Cite
Ray, R. A., Brown, J. and Street, A. F. (2014), Dying with motor neurone disease, what can we learn from family caregivers?. Health Expectations, 17: 466–476. doi: 10.1111/j.1369-7625.2012.00773.x
- Issue published online: 17 JUL 2014
- Article first published online: 19 APR 2012
- Accepted for publication 30 January 2012
- advance care planning;
- family caregiver;
- motor neurone disease
Background Increasingly, people with neurodegenerative illness are cared for at home until close to death. Yet, discussing the reality of dying remains a social taboo.
Objective To examine the ways, family caregivers of people living with motor neurone disease (MND) experienced the dying of their relative and to identify how health practitioners can better prepare families for end-of-life care.
Design Secondary analysis was undertaken on data sets generated from two longitudinal qualitative studies employing similar data collection and analysis methods. Combining data sets increased participant numbers in a low incidence disease group.
Setting and participants Primary studies were undertaken with family caregivers in England and Australia. Interview and observational data were collected mostly in home. Participants who discussed dying and death formed the sample for secondary analysis.
Results Combined data revealed four major themes: planning for end of life, unexpected dying, dignity in the dying body and positive end to MND. Despite short survival predictions, discussions among family members about dying were often sporadic and linked to loss of hope. Effective planning for death assisted caregivers to manage the final degenerative processes of dying. When plans were not effectively communicated or enacted, capacity to preserve personhood was reduced.
Discussion and Conclusion Returning death and dying to social discourse will raise the level of community awareness and normalize conversations about end-of-life care. Strategies for on-going, effective communication that facilitates advance care planning among patients, their families and practitioners are essential to improve dying and death for people with MND and their family caregivers.