What does this research mean for the field?

End-of-life healthcare decision-making for older adults with multimorbidity is an ongoing, existential, and relational process characterized by tensions between personal experiences, the medical gaze, and fragmented healthcare systems. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To examine how older adults with multimorbidity, their relatives, and healthcare professionals experience and navigate end-of-life healthcare choices over time.

September 10, 2026The GerontologistOpen Access

“I don’t know whether I really have choices”: a multiperspective and longitudinal exploration of healthcare choices of older adults with multimorbidity

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Authors

TTThessa W. Thölking YEYvonne Engels YSYvonne Schoon

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Overview

Longitudinal qualitative study reveals complex tensions shaping end-of-life decision-making in older adults with multimorbidity, highlighting the need for holistic and better-integrated care.

Key Points

To examine how older adults with multimorbidity, their relatives, and healthcare professionals experience and navigate end-of-life healthcare choices over time.
Conducted a longitudinal, multiperspective study using phenomenological and ethnographic approaches.
Followed 9 six-month patient trajectories involving 11 relatives and 58 healthcare professionals.
Collected qualitative data through 73 direct observations of clinical interactions and 63 in-depth interviews.
End-of-life decision-making emerged as an ongoing, entangled, existential, and relational process that extends well beyond formal healthcare encounters.
Identified four defining tensions: feeling forced to make decisions despite sensing a lack of genuine choices, a clash between patients' existential lived experiences and the clinical medical gaze, the frequent exclusion of supportive relatives from care decisions, and the burden of navigating fragmented services across multiple co-occurring illnesses.

Cite This Study

Thölking et al. (2026) studied this question.

synapsesocial.com/papers/6aa27ae958559d80afc73c8a https://doi.org/10.1093/geront/gnag216

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September 10, 2026The GerontologistOpen Access

“I don’t know whether I really have choices”: a multiperspective and longitudinal exploration of healthcare choices of older adults with multimorbidity

View Full Paper

Ask AI

Bookmark

Authors

TTThessa W. Thölking YEYvonne Engels YSYvonne Schoon

Discussion

Member takes

Overview

Longitudinal qualitative study reveals complex tensions shaping end-of-life decision-making in older adults with multimorbidity, highlighting the need for holistic and better-integrated care.

Key Points

To examine how older adults with multimorbidity, their relatives, and healthcare professionals experience and navigate end-of-life healthcare choices over time.
Conducted a longitudinal, multiperspective study using phenomenological and ethnographic approaches.
Followed 9 six-month patient trajectories involving 11 relatives and 58 healthcare professionals.
Collected qualitative data through 73 direct observations of clinical interactions and 63 in-depth interviews.
End-of-life decision-making emerged as an ongoing, entangled, existential, and relational process that extends well beyond formal healthcare encounters.
Identified four defining tensions: feeling forced to make decisions despite sensing a lack of genuine choices, a clash between patients' existential lived experiences and the clinical medical gaze, the frequent exclusion of supportive relatives from care decisions, and the burden of navigating fragmented services across multiple co-occurring illnesses.

Cite This Study

Thölking et al. (2026) studied this question.

synapsesocial.com/papers/6aa27ae958559d80afc73c8a https://doi.org/10.1093/geront/gnag216

View Full Paper

Ask AI

Bookmark