Facilitating family needs and support at the end of life in hospital: A descriptive study

Abstract

Background: Caring for family members of dying patients is a vital component of end-of-life care, yet family members’ needs at the end of life may be unmet. Aim: To explore hospital clinician assessment and facilitation of family needs and practices to support families at the end of life. Design: Descriptive study utilising a retrospective medical record audit. Setting and Sample: Undertaken in a large public hospital, the sample included 200 deceased patients from four specialities; general medicine ( n = 50), intensive care ( n = 50), inpatient palliative care ( n = 50) and aged rehabilitation ( n = 50). Data were analysed according to age; under 65-years and 65-years or over. Results: Deceased patients’ mean age was 75-years, 60% were Christian and Next-of-Kin were documented in 96% of cases. 79% spoke English, yet interpreters were used in only 6% of cases. Formal family meetings were held in 64% of cases. An assessment of family needs was undertaken in 52% of cases, and more likely for those under 65-years ( p = 0.027). Cultural/religious practices were supported/facilitated in only 6% of all cases. Specialist palliative care involvement was more likely for those aged 65-years or over ( p = 0.040) and social work involvement more likely for those under 65-years ( p = 0.002). Pastoral care and bereavement support was low across the whole sample. Conclusions: Prioritising family needs should be core to end-of-life care. Anticipation of death should trigger routine referral to support personnel/services to ensure practice is guided by family needs. More research is needed to evaluate how family needs assessment can inform end-of-life care, supported by policy.

Deathbed Etiquette – The Guide: A Qualitative Study Exploring the Views of Practitioners on its Introduction into End-of-Life Care Settings

“…Our findings thus support existing research on the importance of effective information and communication for relatives at the end of life. [2][3][5][6][8][9]11,[20][21][22][23] This includes research that evidences the benefits of using information pamphlets in end-of-life care for relatives' experiencing bereavement. [24][25][26] Other benefits highlighted by the study include the guide's effort to de-medicalise death and dying, thus contributing to a growing trend emphasizing the social nature of death and dying.…”

“…[2][3][4][5][6] This includes practical information about looking after their loved one in those final days or hours, exploring fears and dispelling any myths, being prepared for the physical process of dying, and given opportunities to say goodbye. 2,3,7 Yet, research shows that relatives' information and communication needs are not always met 3,8 , and when this happens, relatives may feel isolated, disillusioned, frustrated and distressed. [9][10] This makes the need for explicit, honest and understandable information and communication ever more urgent.…”

Nurses' experiences of provision family‐centred care in the postresuscitation period: A qualitative study

“…If the needs of family members are not identified, their quality of life can be affected (Damanik & Chen, 2021 ). As a result, studies have sought to identify the needs of the patient's family members during the postresuscitation period (Douma et al, 2021 ) and tools have been designed to examine the needs of the family members in ICUs (Bloomer et al, 2022 ; Ciupitu‐Plath et al, 2021 ). It is imperative to conduct further research in this area so that such tools can be adopted for use in clinical practice.…”

Family's experience of memory making in adult intensive care and its use in early bereavement: A descriptive qualitative study

“…During end‐of‐life care in the intensive care unit (ICU), medical treatment transitions to comfort and dignity and nursing care transitions to having an increased focus on the family (Bloomer et al, 2022). Due to critical illness, there is frequently a shortened time from when end‐of‐life care for the patient begins and the subsequent death when family bereavement care starts.…”

“…Due to critical illness, there is frequently a shortened time from when end‐of‐life care for the patient begins and the subsequent death when family bereavement care starts. During this time, patient end‐of‐life care and family bereavement care is commonly concurrent and providing care to both the family and the dying patient is an essential part of ICU end‐of‐life care delivery (Bloomer et al, 2022). One potential end‐of‐life and bereavement care intervention for family is the act of memory making.…”