Factors associated with the decision to offer memory making in end‐of‐life: A survey of healthcare professionals in adult intensive care

Abstract

Aim Report experiences and behaviour influences with healthcare professionals’ decision to and experiences of offering memory making during end‐of‐life care in the adult acute population. Background Little is known about healthcare professionals’ experiences offering memory making during adult acute end‐of‐life care. Design Survey. Methods Registered nurses, medical practitioners and social workers employed at a single tertiary referral adult intensive care, where memory making had been implemented nearly two years prior were invited to participate between June and August 2017. Reporting adheres to the STROBE checklist. Results Ninety‐six valid surveys (75% response rate: 75 registered nurses, 19 medical practitioners, and 2 social workers) were analysed with 67 participants reporting experience offering memory making. Highest overall agreement scores included believing families value memory making and the offer of memory making being beneficial. Enablers were described as organisational supports, personal qualities and good interpersonal relationships. Barriers identified included the intensive care environment, workload, inexperience offering/facilitating memory making, being afraid to offer, lack of resources and legality concerns. Compared with non‐experienced participants, experienced participants reported higher level of confidence and comfort offering memory making, pride in their ability, ability to spend time supporting families and had observed colleagues offering memory making. Experienced participants were less likely to be afraid to offer, be limited by the family's behaviours, report lack of resources or be time limited to offer memory making. Conclusion Findings identify elements needed for the development and support for offering memory making to assist bereaved families in adult acute care including role modelling, support to reduce negative emotions, workload assistance and leadership/organisational support. Relevance to clinical practice Discoveries have important implications in addressing evidence gaps regarding behaviour influences linked to the decision to offer memory making. Findings inform development and sustainability to integrate memory making as routine end‐of‐life care intervention in adult acute care.

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

“…It was not until after death that they realised very few objects contained sentimental value that allowed them a connection to and remembrance of their loved one. It has been reported that healthcare professionals in adult acute care can believe the family to have enough mementos at home, and it being inappropriate to offering memory making during adult end‐of‐life care (Riegel et al, 2022a), but findings generated from this study highlight the need to allow individuals to make their own decisions in what they want to use in bereavement. It also raises the possibility to actively encourage, rather than just offer, these time‐sensitive mementos in the event individuals during bereavement discover a lack of sentimental objects for use in their bereavement and grief work.…”

“…This suggests any healthcare professional has the potential to engage with loved ones about memory making regardless of the length of time admitted in ICU or the establishment of a rapport. Alternatively, registered nurses are reported to prefer having providing prior care to a person before being involvement in the withdraw of medical treatment (Vanderspank‐Wright et al, 2018), and healthcare professionals have reported that having an established relationship with the family is an enabler for them to offer memory making (Riegel et al, 2022a). It is possible that some families might have declined to receive a memory making object due to poor timing of the offer or not knowing the healthcare professional making the offer, which would not be captured in this study.…”

Bereaved parents’ perceptions of memory making: a qualitative meta-synthesis

“…Insufficient parental preparation can significantly impact the development of memory making, with parents who missed out on opportunities expressing deep regret and a sense of loss [ 49 ]. Rigel’s study [ 50 ] pointed out that nurses, in comparison to doctors, often perceive themselves as the healthcare providers who spend the most time with patients and are better equipped to meet the needs of family members. Nurses can enhance parental readiness for the loss of a child by providing personalized guidance and support.…”