“My Son Is Still Walking”: Stages of Receptivity to Discussions of Advance Care Planning Among Parents of Sons With Duchenne Muscular Dystrophy

Erby, Lori Hamby; Rushton, Cynda; Geller, Gail

doi:10.1016/j.spen.2006.06.009

« PreviousSeminars in Pediatric Neurology
Volume 13, Issue 2 , Pages 132-140, June 2006

“My Son Is Still Walking”: Stages of Receptivity to Discussions of Advance Care Planning Among Parents of Sons With Duchenne Muscular Dystrophy

Preliminary findings were presented at the American Society of Bioethics & Humanities 2004 Annual Meeting, October 28-31, Philadelphia, PA.

Lori Hamby Erby, PhD, ScM
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
- Address reprint requests to Lori H. Erby, PhD, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Room 750, Baltimore, MD 21205.
Cynda Rushton, DNSc, RN
- Phoebe Berman Bioethics Institute, Johns Hopkins University, Baltimore, MD.
- School of Nursing, Johns Hopkins University, Baltimore, MD.
- Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD.
Gail Geller, ScD, MHS
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
- Phoebe Berman Bioethics Institute, Johns Hopkins University, Baltimore, MD.
- Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD.
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD.

Duchenne muscular dystrophy is an inherited progressive neuromuscular disease that generally results in death by early adulthood. Because of its life-threatening nature, discussions of advance care planning are extremely relevant to families with affected children and adolescents. Seventeen parents of sons with Duchenne muscular dystrophy were interviewed about their attitudes, experiences, and the nature of their discussions about these topics. Parents showed a lack of familiarity with and experience communicating about advance care planning. They also discussed opportunities for communication that centered on transitional life events. Parents appeared to vacillate between hope for future treatments, avoidance of emotionally difficult aspects of the disease, and presence with the fullness of life’s experiences. These data suggest a model for future research in which windows of opportunity for discussion may exist as sons are approaching significant transitional milestones and parents are able to see the world through a lens of “presence.”

Keywords: Duchenne muscular dystrophy, advance care planning, parent-child relationship, ethics