Spiritual self-care can help prepare people to take on the challenging role of surrogate decision-maker, suggests a recent study.1

“Surrogate decision-making can be extraordinarily stressful and potentially traumatic for families, especially for those who aren’t prepared for the role when the time comes,” says J. Nicholas Dionne-Odom, PhD, RN, ACHPN, the study’s lead author.

In palliative care, there is increasing focus on finding ways to help patients and their families prepare for this role much earlier so that the end of life is not as traumatic for all concerned.

“We wanted to do this study to see if there were characteristics of families that we might be able to intervene on early in the course of illness,” says Dionne-Odom, an assistant professor at the University of Alabama at Birmingham’s School of Nursing.

The researchers sought interventions that would ready people for the possibility of being a surrogate decision-maker in the near future. They found that family members who practiced more day-to-day activities to foster their spiritual self-care felt more confident in taking on this role.

“This may highlight the need for spiritual and faith-based support earlier in the course of cancer,” says Dionne-Odom. Such interventions may facilitate conversations about the patient’s future and advance care planning.

“It could be that individuals who are comfortable finding and connecting to meaning in life have better coping skills that endow more confidence in undertaking a future decision-making role,” suggests Dionne-Odom.


1. Dionne-Odom JN, Ejem D, Azuero A, et al. Factors associated with family caregivers’ confidence in future surrogate decision-making for persons with cancer. J Palliat Med 2018 Aug 21. doi: 10.1089/jpm.2018.0148. [Epub ahead of print].


• J. Nicholas Dionne-Odom, PhD, RN, ACHPN, Assistant Professor, School of Nursing, University of Alabama at Birmingham. Phone: (205) 934-7597. Email: dionneod@uab.edu.