Maureen P. Keeley

Exploring Children/Adolescents’ Final Conversations with Dying Family Members

In the current study, the authors expanded on a program of qualitative inquiry exploring final conversations (FCs) to the understudied population of children/adolescents. Participants were 61 children/adolescents aged 5–18, who participated in semi-structured interviews regarding their FCs with a dying family member. Inductive coding analysis led the authors to discover four overarching themes of children/adolescents’ FCs messages, in order of descending prominence, are: everyday communication, messages of love, messages of individual identity, and messages related to religion/spirituality. The authors applied Functional Theory to further delineate how participants used, and continue to use, the messages from each theme within their FCs. Discussion of results, including limitations and directions for further research, is outlined.

Final Conversations, Phase 2: Children and Everyday Communication

This qualitative study examined messages of everyday communication (small talk and routine interactions). The importance of these messages was highlighted in light of their role in creating structure, safety, and meaning making in the family at the end of life. In addition, family rituals that developed from childrens everyday communication were explored and discussed. Retrospective interviews were completed with children. Descriptions of small talk topics revolved around school, daily activities, sporting events, and shared experiences about mutual hobbies. Routine interactions included reading bedtime stories, doing chores together, and doing other everyday activities with one another. Interviews demonstrated that everyday communication helped children make sense of the death of their loved one. These innocuous, common, and routine behaviors also gave children avenues for humor and positive talk and provided comfort, a sense of security, and normalcy during the familys negotiation of the death of a loved one.

Advice From Children and Adolescents on Final Conversations With Dying Loved Ones

To understand more about final conversations (communication between loved ones from the point of terminal diagnosis until death), 49 children/adolescents provided final conversation advice for other youth and for the dying person. Advice for fellow youth included (a) confirming the relationship with the dying person, (b) remaining positive throughout the death process, and (c) using external support networks. Advice for the dying person included (a) confirming the relationship with the youth, (b) engaging in open, honest communication with youth, and (c) confirming the identities of the youth. The main implication is that youth should be included in the death process.

Wished for and avoided conversations with terminally ill individuals during final conversations

ABSTRACT The current investigation examines retrospectively wished for and avoided conversations during the end of life with a deceased relational partner. Participants reported on conversations they wished they had engaged in and conversations that they intentionally avoided, as well as reasons why they did not engage in the conversations. Analyses revealed the following wished for and avoided conversations: negative relationship characteristics; death and dying; postdeath arrangements; and personal information. Furthermore, participants indicated the following reasons for not discussing the aforementioned topics during final conversations: emotional protection, relational differences, and condition of the dying. Theoretical and practical implications for end-of-life communication are discussed.

Family Communication at the End of Life

ABSTRACT This article presents a brief review examining what research has been conducted exploring family communication at the end of life (EOL) and suggestions for future research at the end-of-life context. Future research areas include: 1) the role of culture, 2) family member role and relational climate, 3) ethical considerations in regard to methodological choices, 4) the role of emotional and cognitive development on EOL communication, 5) EOL backstage communication, 6) death circumstances, and 7) the use of interdisciplinary research teams.

The Challenges of Final Conversations: Dialectical Tensions During End-of-Life Family Communication

This study examines how participants recall the challenges they encountered during final conversations they had with a family member who has since died. We use relational dialectics as a theoretical framework to interpret participants’ responses. The dialectical tensions evident in these conversations are influenced primarily by a chronemic pressure: the impending death. The overarching tensions discovered were acceptance–denial and openness–closedness (including expression of emotion–concealment of emotion). Practical and theoretical implications are discussed.

When Family Talk is Difficult: Making Sense of Nonverbal Communication at the End-of-Life

In this article, we assess transcripts of interviews with 55 people who participated in end-of-life conversations with a family member or relationally close other. Nonverbal cues are studied often for the diverse meanings that can be given to them, and this study reports strong qualitative evidence that nonverbal cues can be understood as performing important communicative functions in this context. These perceived functions were categorized as relational messages, emotional expression, interaction management, social support, and transitioning. Many of the identified functions also had unique subtypes, and these more specific meanings were often associated with particular cues. Together, the findings help reveal the nature of sense-making for nonverbal communication family members recall at the end-of-life and ways in which survivors use that sense-making to find peace with a loved one’s death.

Final Conversations: Overview and Practical Implications for Patients, Families, and Healthcare Workers

The current paper presents a summary of a 12-year body of research on final conversations, which will be useful for healthcare providers who work with patients and family nearing the end-of-life, as well as for patients and their family members. Final conversations encompass any and all conversations that occur between individuals with a terminal diagnosis and their family members (all participants are aware that their loved one is in the midst of the death journey). Final conversations take the family member’s perspective and highlights what are their memorable messages with the terminally ill loved one. In this paper the authors highlight the message themes present at the end-of-life for both adults and children, the functions each message theme serves for family members, and lastly, the communicative challenges of final conversations. Additionally, the authors discuss the current nature and future of final conversations research, with special attention paid to practical implications for healthcare providers, patients, and family members; also, scholarly challenges and future research endeavors are explored.