Advancing theory of family conflict at the end of life: a hospice case study.
BACKGROUND
Although family conflict is a common occurrence for families involved in caregiving for a dying family member, it has not been examined in the hospice context.


OBJECTIVE
The purpose of this study was to advance theory of family conflict at the end of life through replication and expansion of a case study involving professional perspectives in the context of a managed care program for low-income elders with advanced chronic disease in their last six months of life, by exploring the perceptions of professionals and family caregivers experiencing conflict in the hospice context.


METHODS
Data were gathered through in-depth interviews with 15 hospice family caregivers experiencing substantial family conflict, and focus groups with 37 professionals employed in a large multicounty and nonprofit hospice in the Midwest U.S. Dimensional analysis, a method for the generation of grounded theory, was used to refine and expand an explanatory matrix of family conflict at the end of life.


RESULTS
The initial matrix was expanded through the inclusion of eight new and two refined categories, strengthening our understanding of family conflict as a complex phenomenon influenced by salient contextual variables, conditions, and factors that may contribute to a number of negative outcomes for patients, family members, and professionals.


CONCLUSIONS
The study findings are discussed in terms of implications for assessment and intervention.
Department of Sociology and Social Work, University of Wisconsin-Stevens Point, Stevens Point, WI 54481, USA. amboelk@uwsp.edu
Amy Z
AZ
Boelk
Betty J
BJ
Kramer
D000368:Aged; D017028:Caregivers; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D017051:Hospice Care / Q000523:psychology*; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D008484:Medicaid; D006278:Medicare; D008875:Middle Aged; D011203:Poverty; D011368:Professional-Family Relations; D014481:United States