Article Title

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.

Keywords

Communication, Culturally competent care, Death, Decision making, End-of-life care, Family care, Frail elderly, Palliative care

Link to Publisher Version (URL)

10.1177/02692163211066431

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