The Process of Dialogue in Families With Dependent Children About Home-Based End-of-Life Care for Grandparents in Japan

Abstract

Background

The death of a close relative has profound psychological effects on children. Dialogue between parents and their children before the death of a close relative is important for helping to reduce grief reactions in children. This study aimed to identify the process that facilitates dialogue in Japan within families with dependent children regarding grandparents’ home-based end-of-life (EOL) care.

Methods

Interviews using the semi-structured interviewing method were conducted between January 2022 and March 2025 with 15 parent–child dyads of families with dependent children who had participated in the home-based EOL care of a grandparent. The participants consisted of children aged 9 to 22 years and their parents (sandwich generation caregivers). The collected data were analyzed using the grounded theory approach.

Results

Four categories—[Efforts made to openly share information], [Common understanding related to lifestyle readjustments], [Collaborative experience of facing the EOL stage of a grandparent], and [Sharing feelings about the approaching death of a grandparent]—and 12 subcategories emerged as the process of facilitating dialogue in families with dependent children related to the home-based EOL care of a grandparent. Early, honest sharing about the grandparent’s condition enabled families to readjust routines and build shared understanding, which supported parent–child collaboration and reciprocal emotion-sharing, advancing reflective, anticipatory dialogue of home-based EOL care.

Conclusions

Dialogue was enabled by four processes (open information sharing, shared understanding of lifestyle readjustments, collaborative caregiving, and sharing emotions about impending death) that provide levers for interprofessional home-care teams supporting families with dependent children during EOL care.