Decision making by families of older adults with advanced cognitive impairment: spirituality and meaning.

This qualitative study investigated the decision making of family members of institutionalized older adults with advanced cognitive impairment. Eight focus groups were conducted with 39 family caregivers at Minnesota nursing homes. Participants described their beliefs and values as central in their decision making; many said their spirituality provided guidance. Family members spontaneously described finding meaning in their decision-making roles. Many decision makers caring for their relatives with advanced cognitive impairment invoke their spirituality to guide relationships and decisions, creating meaning in the process.