Background: Children need to be prepared for the death of a parent and supported afterwards. Parents seek support from health and social care professionals to prepare their children. Support is not always forthcoming. Aim: To systematically identify, analyse and synthesise literature reporting of the experiences of health and social care professionals when supporting parents and children during, and following, the death of a parent. Design: A systematically constructed qualitative review and thematic synthesis. Registered on Prospero (CRD42017076345). Data sources: MEDLINE, CINAHL, Embase, PsycINFO, PsycARTICLES and PROSPERO, searched from January 1996 to July 2018 for qualitative studies in English, containing verbatim reporting of health and social care professionals’ experiences of supporting parents and children during, and following, the death of a parent. Qualitative data were appraised using a modified Critical Appraisal Skills Programme qualitative appraisal checklist. Results: The search yielded 15,758 articles. Of which, 15 met the inclusion criteria. A total of 13 included professionals’ experiences of supporting parents and children before parental death. Two included experiences of supporting surviving parents and children afterwards. Three analytical themes identified as follows: (1) aspiring to deliver family-focussed care, (2) health and social care professionals’ behaviours and emotions and (3) improving connections with parents and children. Connecting empathically with parents and children to prepare and support children entails significant emotional labour. Professionals seek to enhance their confidence to connect. Conclusion: Professionals struggle to connect empathically with parents and their children to prepare and to support children when a parent is dying and afterwards. Awareness of professionals’ needs would enable provision of appropriate support for parents and children.

While there remain many opportunities for contributing to the theoretical and empirical work in this field, there is sufficient evidence to propose a relational approach to supporting people affected by cancer.

Purpose The purpose of this paper is to describe the delivery of facilitated action learning sets as an integral component of a multidisciplinary end-of-life care course. Design/methodology/approach The educational intervention described in this paper is delivered by specialist palliative care practitioners to those working with dying patients and their families in non-specialist settings. The programme consists of two components: the first taught/experience-based component takes place in a hospice. The second integral component involves action learning sets which are facilitated by specialist palliative care staff over a six-month period. This paper reports the challenges, learning and benefits of using action learning sets to improve end-of-life care. Findings Action learning sets provide support which enables staff to implement changes to end-of-life care. Participants in the successful action learning sets were motivated to change practice and identified themselves as change agents. Management support was vital to allow participants the authority to implement changes to practice. Practical implications Facilitators need to gain participant and management commitment to the action learning process before the programme begins if they are to be successful in achieving changes to end-of-life care. Originality/value Hospices and other health care organisations work in partnership to deliver this programme, and this paper demonstrates how action learning sets can increase mutual understanding and communication between specialist and non-specialist end-of-life care settings.

Methods We asked patients attending Y Bwythn Newydd to complete a simple questionnaire about how they store and share information about their health in case of an emergency. We gave a Lions' tub to those patients that did not have one, explaining that the scheme provided information about their diagnosis, next of kin information, and any advanced care decisions such as preferred place of care/death. We taught patients how to use the 'emergency contacts' feature on their smartphone. Results 31 patients completed the questionnaire. Only one of the patients was already using a MIAB. 28 MIAB tubs were handed out over four weeks. 29 out of 31 patients thought the scheme was a good idea. Nine out of 31 patients had a smart phone, of which four had set up the 'emergency contacts' feature. Conclusions This project increased the use of the Message in a Bottle scheme, and the 'emergency contacts' smartphone feature. We have demonstrated how to increase the use of these methods of sharing emergency information. Advance care planning with simple interventions such helps empower patients and their families by ensuring their wishes are fulfilled at the end of life. More research is needed to further evaluate the impact of such interventions.

Differences were apparent between the two hospices in the frequency of referrals to SLT. Staff had skills in caring for patients with communication impairments but some spoke of a desire for further training and closer links to SLT. Conclusions Findings from this study and the literature suggest limited specialist communication support for patients accessing palliative care. Clinicians are encouraged to reflect upon the approach in their own setting to consider if changes could be implemented.