Date of Conferral



Doctor of Healthcare Administration, DHA


Health Services


Raymond Thron


End-of-life (EOL) care decisions present a challenge for family caregivers. Despite the increasing number of terminally ill patients in need of pain management and comfort care, there is limited qualitative data about how populations in the developing world can access culturally appropriate resources and EOL support. In this phenomenological study, 17 Garifuna family caregivers in southern Belize were interviewed about their experience caring for terminally family members. The conceptual frameworks were Kübler-Ross’s hospice approach and Watson’s theory of human caring. The two theories were selected based on their significance to this process: Kübler Ross’s hospice approach and its impact on the family system during the end stage of life and Watson’s theory of human caring for its emphasis on the impact of the importance of meeting the basic needs of individuals. NVivo 12 was used to code and generate themes for further analysis. Caregivers who said they would not utilize support outside of the home were those who were committed not do so at the request of the patient. Caregivers who cared for their family member and those who could financially afford to hire caregivers in their home to assist with their relative said they would not utilize nonfamily support. All others, regardless of relationship to the patient, indicated they would have accepted care if the environment were safe, caring, and culturally sensitive. Additionally, the caregivers saw their needs as secondary and insignificant compared to the comfort and care of the patient. This study may contribute to positive social change by revealing strategies and services that could be included in the design of a health services delivery system to meet the needs of individuals facing EOL decisions.