Caregiver Perceptions of Their Influence on Cancer Treatment Decision Making: Intersections of Language, Identity, and Illness

Serious illness of a loved one can disrupt a caregiver’s sense of self and relationships. We examined the language caregivers use to describe the cancer treatment decision making of a loved one to understand how caregivers frame their own identity relative to a patient’s illness. We analyzed transcripts from in-depth interviews conducted with caregivers (N = 58) of cancer patients to examine the intersection among language, identity, and illness. Caregivers with a patient-level personal identity frame used phrases such as their body, their decision. Caregivers with a relational identity frame used plural pronouns such as we or our when describing the treatment decision. Importantly, some caregivers perceived an illness identity gap in that the patients’ perceptions of their illness identity differed from their own. Illness identity gaps are theorized to be associated with treatment decision making more closely aligned with intergroup, rather than interpersonal, processes.