A Longitudinal Examination of Enacted Goal Attention in End-of-Life Communication in Families

Drawing on theoretical principles related to goal pursuit and inference, the present study investigated the extent to which specific message features led to better or worse conversational outcomes of end-of-life discussions between older adults and their adult children. Actor-partner interdependence modeling analysis of longitudinal reports from 66 parent/child dyads revealed that tactical attention to identity, relational, and task goals in conversation predicted change over a 1-year period in advance directive completion, concordance accuracy, and relationship satisfaction and closeness. Quantity features of communication (i.e., number of conversations, number of topics discussed) were not related to the measured outcomes. Routine relationship maintenance and explicit decision making had a positive impact on the outcomes, and underaccommodation, strategic relationship maintenance, avoidance, elaboration, and implicit decision making had a negative impact on the outcomes of end-of-life family talk. The findings provide insight on how to practically improve the quality of end-of-life conversations in families.