Adult Children as Informants About Parent’s Psychosocial Preferences

• Author: Kimberly S. Van Haitsma,Monica Lee,Katy Ruckdeschel,Brian D. Carpenter,Penny H. Feldman
• Date: 01 December 2006
• DOI: http://doi.org/10.1111/j.1741-3729.2006.00425.x
• Published date: 01 December 2006

Adult Children as Informants About

Parent’s Psychosocial Preferences

Brian D. Carpenter Monica Lee Katy Ruckdeschel Kimberly S. Van Haitsma Penny H. Feldman*

Abstract: Utilizing data from 80 adult children–older parent dyads, this study examined the degree to which adult

children could predict the psychosocial preferences of their older parents. Overall, children demonstrated good

knowledge about parent preferences, although there was wide variability within the sample and across preference

domains. Children underestimated how important parents considered continued enrichment and personal growth.

Knowledge was associated with parents’ functional status and mood. Parent, but not child, perceptions of family

flexibility and cohesion were related to children’s knowledge. Findings suggest that family life education and inter-

vention programs need to address contextual factors as a means to improve intergenerational knowledge and

enhance the likelihood that parent preferences are considered in care planning.

Key Words: adult children, family gerontology, intergenerational relations, psychosocial preferences, long-term care

planning.

When older adults face decisions about housing,

finances, or medical care, they often turn to their

adult children for guidance. And if older parents

cannot express their own preferences because of

a physical or cognitive impairment, adult children

may be required to act as surrogate decision makers

by articulating their parent’s preferences. Many state

laws have codified the role of adult children as surro-

gate decision makers (American Bar Association,

2004), reflecting the belief that family members

know each other well or are likely to act in each

other’s best interests. Recent research suggests, how-

ever, that family members may have inaccurate

beliefs about the care and life preferences of their

older adult relatives. For instance, family members

were inaccurate when estimating older adults’

medical treatment preferences (Roberto, 1999),

housing preferences (Mattimore et al., 1997), and

interest in research participation (Muncie, Magaziner,

Hebel, & Warren, 1997). The current study ex-

tends previous work by examining an additional

domain surrogates may need to know—psychosocial

preferences.

Psychosocial preferences are personal affinities

that guide the selection of experiences and environ-

ments. These preferences are manifested in the

choices people make during the hour-by-hour pass-

ing of each day. As examples, people have preferen-

ces regarding their daily routine, environmental

features such as decor, leisure pursuits, foods that

are enjoyed (or avoided), and social relationships

that are valued (or avoided). Paying attention to psy-

chosocial preferences makes it more likely that older

adults will have the kind of life they want. Indeed,

efforts to individualize care in nursing homes, assis-

ted living facilities, and community care emerged

from the belief that assessment and accommodation

of older adults’ preferences can influence quality of

life (Ross, Steward, & Sinacore, 1993).

Because adult children are often asked to guide

care that could incorporate preferences, it is impor-

tant for children to know the psychosocial priorities

*Brian D. Carpenter is an Assistant Professor in the Department of Psychology, Campus Box 1125, Washington University in St. Louis, St. Louis, MO 63130

(bcarpenter@wustl.edu). Monica Lee is a graduate student in the Department of Psychology, Campus Box 1125, Washington University in St. Louis, St. Louis,

MO 63130 (mmlee@artsci.wustl.edu). Katy Ruckdeschel is an Assistant Professor in the Department of Psychiatry, University of Pennsylvania and Philadelphia

Veteran’s Affairs Medical Center, MIRECC/116, University and Woodland Avenues, Philadelphia, PA 19104 (ruckdesc@mail.med.upenn.edu). KimberlyS.Van

Haitsma is a Senior Research Scientist at Polisher Research Institute, Madlyn & Leonard Abramson Center for Jewish Life, 1425 Horsham Road, North Wales, PA

19454 (kvanhaitsma@abramsoncenter.org). Penny H. Feldman is a Director at the Center for Home Care Policy and Research , Visiting Nurse Service of New York,

107 E 70th Street, New York, NY 10021 (Penny.Feldman@vnsny.org).

Family Relations, 55 (December 2006), 552–563. Blackwell Publishing.

Copyright 2006 by the National Council on Family Relations.