Table 4.

Detrimental factors that led family caregivers to feel shocked in the context of lack of decision-making options (Path 2)

Factors that led to paralyzing shock
Insufficient preparation	• „Ups and Downs “in the disease trajectory: hope and disappointment • Physicians don’t take family caregivers through the individual steps • Not feeling prepared for changing goal of care, occurring symptoms, deteriorating health status, dying and death
No truthful communication with the patient	• Patient autonomy over caregiver’s needs • Patient withholding information • Patient not wanting to talk about the disease, death and dying • No agreement with the patient about medical decisions • Reciprocal protection
Communication and cooperation problems with physicians	• Lack of empathy • Unclear statements • False hope • Indecision and inconsistency