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Family Matters: Effects of Birth Order, Culture, and Family Dynamics on Surrogate Decision-Making

Posted: May 12, 2014

Researchers in New York, Chicago and San Francisco held focus groups in which ethnically diverse participants discussed end-of-life or other serious medical decisions for others (surrogate decision-making). The study found that in all cultures, firstborn children play critical roles as surrogate decision makers, leading to increased feelings of emotional stress, and loneliness.

The 69 participants ranged in age from 55-74, spoke Spanish or English, and were selected from county and Veteran's Affairs hospitals, senior centers, and cancer support groups. Clinicians should be aware of stress on firstborns and help facilitate communication between the surrogate, patient and extended family. 

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[From the Caregiving Policy Digest, Volume 4, #2, March 10, 2014]