The influence of autonomy and paternalism on communicative behaviors in mother-daughter relationships prior to dependency.

Parents and their adult children rarely have discussions regarding caregiving preferences, especially before the onset of dependency. Families develop decision-making practices during caregiving, ideally, ones that maintain the care recipient's autonomy. Maintaining autonomy is essential because limiting autonomy leads to potentially negative health consequences. This study examined the attitudes of older, independent mothers and their adult daughters (n = 36 dyads) as well as their communication behaviors during decision making. All the mothers and daughters (100%) held strong beliefs in shared autonomy. Mothers (55.6%) and daughters (58.3%) were about evenly split in their strength of belief in independent autonomy. More mothers (63.9%) held strong beliefs in paternalism than did daughters (36.1%). In their conversations, daughters talked more when the mother and daughter held stronger beliefs in paternalism. These findings suggest that an individual's attitudes toward paternalism influence who controls conversations between parents and their adult children regarding caregiving, even before the parent has begun to show any signs of dependency. Once caregiving begins, it can be too late to change already ingrained patterns of decision making. Although this study takes a step toward establishing an understanding of how families develop decision-making processes utilized during caregiving, the sample size and composition limit generalizability. Future studies should follow families, as the parents make the transition from independence to dependence, to develop a better understanding of the factors involved in successfully making such a critical transition in the family's life.