Decision making by elderly patients with cancer and their caregivers

Abstract

This study explored the scope of decisions encountered by elderly cancer patients and/or their family caregivers, and the types of decision-making assistance requested and required within one practice setting. Semistructured interviews were conducted with five cancer center nurse coordinators (CCNCs). The CCNCs were interviewed weekly for 16 weeks to identify decision-making topics addressed, assistance requested, and perceptions of assistance required during telephone conversations. The CCNCs' reports of 41 telephone conversations revealed 44 specific decision-making topics. Content analysis uncovered 11 categories: symptom management, use of chemotherapy, ancillary choices selection of a medical provider, planning for end-of-life care, alternative therapy, vacation planning, weekend-pass planning, discharge planning, family survivor issues, and involvement of adult children in the elder's care. Elderly patients and/or their family caregivers requested information and assistance with making decisions. CCNCs perceived that callers also needed information clarification, reassurance about their decisions, a listener, permission to change the treatment regimen, and help with communication among health professionals, the elderly patient, and the family.

Patients with cancer and family caregivers: management of symptoms caused by cancer or cancer therapy at home

“…A nurse run telephone service to assist elderly cancer patients and family caregivers with decision-making topics also proved beneficial in symptom management [18]. Five Registered Nurses with a Bachelor’s degree, referred to as Cancer Center Nurse Coordinator (CCNC), were available to patients and caregivers via telephone.…”

Supporting Caregivers of Older Adults in Making Decisions

“…Such decisions might involve treatment and symptom management, alternative therapies and treatments, choice of healthcare providers, hospital discharge planning, active participation in self-management, involvement of adult children and other family members, vacation and other scheduling issues, and end-of-life care and survivor issues (Lewis, Pearson, Corcoran-Perry, & Narayan, 1997). The older patient is at the core of each of these decisions, but successfully managing a chronic condition involves shared decision making (SDM) among older adults, family caregivers, and healthcare providers.…”

Self-Determination and Information Seeking in End-Stage Cancer

“…How does the hospital's social environment infl uence such information seeking? events, individuals are assumed to become consumers of health information and partners in their treatment (Lewis, Pearson, Corcoran-Perry, & Narayan, 1997). Selfmanagement draws on individuals' previous life experiences.…”