Communication Nonaccommodation in Family Conversations About End-of-Life Health Decisions

Abstract

Furthering our understanding of how communication can improve end-of-life decision making requires a shift in focus from whether people talk to how people talk about end-of-life health decisions. This study used communication accommodation theory to examine the extent to which communication nonaccommodation distinguished more from less successful end-of-life conversations among family members. We analyzed elicited conversations about end-of-life health decisions from 121 older parent/adult child dyads using outside ratings of communication over- and underaccommodation and self-reported conversational outcomes. Results of multilevel linear modeling revealed that outside ratings of underaccommodation predicted self-reported and partner-reported uncertainty, and ratings of overaccommodation predicted self-reported decision-making efficacy and change in concordance accuracy. We discuss the methodological, theoretical, and practical implications of these findings.

ACKNOWLEDGMENTS

The authors thank Erica Bauer, Corky Coryell, Theresa Gabel, Jessie Quintero Johnson, Mary Ramey, Leigh Anne Dageforde, Bethany Scott, Marcia Scott, Mike Scott, Amanda Spinka, and Sue Stranahan for their assistance in conducting this research.