Implicit decision-making in family caregiving

Thirty-six independent, community-dwelling mothers (aged 54-87 years) and their adult daughters (aged 26-58 years) were interviewed regarding how they would go about making caregiving decisions in the future. The mothers indicated that they would involve their daughters in the decision-making process. However, the vast majority (78.99%) indicated that they had not had, nor did they feel a need to have, explicit discussions regarding caregiving preferences. Two mechanisms were identified that help explain this feeling that further explicit discussions are not needed. One mechanism involved the daughter 'knowing' the mother's preferences because the daughter knew the mother so well or had observed the mother providing care to an earlier generation. This building up of knowledge over the course of many years reflects an implicit decision-making style. The second mechanism involved denial. These mothers and daughters simply did not want to talk, or even think, about the mother declining, physically or mentally. As a consequence of this denial, the daughter, again, may have to rely on implicit assumptions about her mother's wishes should the mother need care.