Understanding Bereaved Family Members’ Dissatisfaction with End-of-Life Care in Nursing Homes

2012 ◽  
Vol 38 (10) ◽  
pp. 49-60 ◽  
Author(s):  
Genevieve N. Thompson ◽  
Susan E. McClement ◽  
Verena H. Menec ◽  
Harvey M. Chochinov
Keyword(s):  
Nursing Homes ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Life Care ◽  
Bereaved Family

scholarly journals Course and predictors of posttraumatic stress-related symptoms among family members of deceased ICU patients during the first year of bereavement

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Siew Tzuh Tang ◽  
Chung-Chi Huang ◽  
Tsung-Hui Hu ◽  
Wen-Chi Chou ◽  
Li-Pang Chuang ◽  
...  
Keyword(s):  
Social Support ◽  
Posttraumatic Stress ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Life Care ◽  
Ptsd Symptoms ◽  
Icu Patients ◽  
Clinically Significant ◽  
Bereaved Family

Abstract Background/Objective Death in intensive care units (ICUs) may increase bereaved family members’ risk for posttraumatic stress disorder (PTSD). However, posttraumatic stress-related symptoms (hereafter as PTSD symptoms) and their precipitating factors were seldom examined among bereaved family members and primarily focused on associations between PTSD symptoms and patient/family characteristics. We aimed to investigate the course and predictors of clinically significant PTSD symptoms among family members of deceased ICU patients by focusing on modifiable quality indicators for end-of-life ICU care. Method In this longitudinal observational study, 319 family members of deceased ICU patients were consecutively recruited from medical ICUs from two Taiwanese medical centers. PTSD symptoms were assessed at 1, 3, 6, and 13 months post-loss using the Impact of Event Scale-Revised (IES-R). Family satisfaction with end-of-life care in ICUs was assessed at 1 month post-loss. End-of-life care received in ICUs was documented over the patient’s ICU stay. Predictors for developing clinically significant PTSD symptoms (IES-R score ≥ 33) were identified by multivariate logistic regression with generalized estimating equation modeling. Results The prevalence of clinically significant PTSD symptoms decreased significantly over time (from 11.0% at 1 month to 1.6% at 13 months post-loss). Longer ICU stays (adjusted odds ratio [95% confidence interval] = 1.036 [1.006, 1.066]), financial insufficiency (3.166 [1.159, 8.647]), and reported use of pain medications (3.408 [1.230, 9.441]) by family members were associated with a higher likelihood of clinically significant PTSD symptoms among family members during bereavement. Stronger perceived social support (0.937 [0.911, 0.965]) and having a Do-Not-Resuscitate (DNR) order issued before the patient’s death (0.073 [0.011, 0.490]) were associated with a lower likelihood of clinically significant PTSD symptoms. No significant association was observed for family members’ satisfaction with end-of-life care (0.988 [0.944, 1.034]) or decision-making in ICUs (0.980 [0.944, 1.018]). Conclusions The likelihood of clinically significant PTSD symptoms among family members decreased significantly over the first bereavement year and was lower when a DNR order was issued before death. Enhancing social support and facilitating a DNR order may reduce the trauma of ICU death of a beloved for family members at risk for developing clinically significant PTSD symptoms.

Association between Quality of End-of-Life Care and Possible Complicated Grief among Bereaved Family Members

2014 ◽  
Vol 17 (9) ◽  
pp. 1025-1031 ◽  
Author(s):  
Kaya Miyajima ◽  
Daisuke Fujisawa ◽  
Kimio Yoshimura ◽  
Masaya Ito ◽  
Satomi Nakajima ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Complicated Grief ◽  
Life Care ◽  
Bereaved Family

End-of-life care in community hospitals: the perceptions of bereaved family members

2006 ◽  
Vol 20 (5) ◽  
pp. 541-547 ◽  
Author(s):  
Sheila Hawker ◽  
Chris Kerr ◽  
Sheila Payne ◽  
David Seamark ◽  
Carol Davis ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Life Care ◽  
Community Hospitals ◽  
Bereaved Family

J-HOPE study: Evaluation of end-of-life cancer care in Japan from the perspective of bereaved family members

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9577-9577
Author(s):  
M. Miyashita ◽  
T. Morita ◽  
K. Sato ◽  
S. Tsuneto ◽  
Y. Shima
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Institutional Review Boards ◽  
Life Care ◽  
Knowledge And Skills ◽  
Bereaved Family ◽  
Care Evaluation

9577 Background: The Japan Hospice and Palliative Care Evaluation (J-HOPE) study was conducted in 2007 and 2008. The aim of the study was to evaluate the quality of end-of-life care at regional cancer centers (CCs), inpatient palliative care units (PCUs), and home hospices (HHs) in Japan from the perspective of bereaved family members. Methods: A nationwide cross-sectional mail survey was conducted in 2007 and 2008. The survey was sent to bereaved families 6–18 months after the death of a patient at 56 CCs, 100 PCUs, or 14 HHs. Outcome measures were the good death inventory, the care evaluation scale, and overall satisfaction with care. The protocol of this study was approved by the institutional review boards of each participating institution. Results: Of the 13,181 bereaved family members that received the survey, 8,163 (62%) participants returned their responses. Among bereaved family members, significantly fewer responded that patients were free from physical distress at CCs (50%) than PCUs (80%) and HHs (73%) (P<0.0001). Significantly fewer patients trusted the physicians at CCs (79%) when compared with PCUs (83%) and HHs (88%) (P<0.0001). Significantly fewer patients were valued as people at CCs (83%) than PCUs (93%) and HHs (95%) (P<0.0001). In addition, significantly fewer participants felt physicians should have worked to improve the patients' symptoms more quickly at CCs (55%) when compared with PCUs (78%) and HHs (77%) (P<0.0001). Significantly fewer participants felt nurse should improve their knowledge and skills regarding end-of-life care at CCs (51%) when compared with PCUs (76%) and HHs (78%) (P<0.0001). A total of 51% of participants reported that nurses should improve their knowledge and skills regarding end-of-life care. Finally, significantly fewer participants were satisfied with the end-of-life care provided by CCs (80%) when compared with PCUs (93%) and HHs (94%) (P<0.0001). Conclusions: Overall, the bereaved family members appreciated the end-of-life care provided by CCs, PCUs, and HHs in Japan. However, in some situations, the quality of end-of-life care provided by CCs was lower than that provided by PCUs and HHs. No significant financial relationships to disclose.

scholarly journals Bereaved family members’ perceptions of the quality of end-of-life care across four types of inpatient care settings

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Kelli Stajduhar ◽  
Richard Sawatzky ◽  
S. Robin Cohen ◽  
Daren K. Heyland ◽  
Diane Allan ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Inpatient Care ◽  
Family Members ◽  
Life Care ◽  
Bereaved Family

Insights from Bereaved Family Members about End-of-Life Care and Bereavement

2020 ◽  
Vol 23 (8) ◽  
pp. 1030-1037 ◽  
Author(s):  
Sue E. Morris ◽  
Manan M. Nayak ◽  
Susan D. Block
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Life Care ◽  
Bereaved Family

Bereaved Family Members’ assessments of the quality of End-Of-Life Care: What is Important?

2011 ◽  
Vol 27 (4) ◽  
pp. 261-269 ◽  
Author(s):  
Kelli I. Stajduhar ◽  
Laura Funk ◽  
S. Robin Cohen ◽  
Allison Williams ◽  
Darcee Bidgood ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Life Care ◽  
Bereaved Family

‘It was peaceful, it was beautiful’: A qualitative study of family understandings of good end-of-life care in hospital for people dying in advanced age

2019 ◽  
Vol 33 (7) ◽  
pp. 793-801 ◽  
Author(s):  
Merryn Gott ◽  
Jackie Robinson ◽  
Tess Moeke-Maxwell ◽  
Stella Black ◽  
Lisa Williams ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Advanced Age ◽  
Local Context ◽  
Life Care ◽  
Good Care ◽  
Compassionate Care ◽  
Care Model ◽  
Bereaved Family

Background: Hospitals are important sites of end-of-life care, particularly for older people. A need has been identified to understand best practice in hospital end-of-life care from the service-user perspective. Aim: The aim of this study was to identify examples of good care received in the hospital setting during the last 3 months of life for people dying in advanced age from the perspective of bereaved family members. Design: A social constructionist framework underpinned a qualitative research design. Data were analysed thematically drawing on an appreciative enquiry framework. Setting/participants: Interviews were conducted with 58 bereaved family carers nominated by 52 people aged >80 years participating in a longitudinal study of ageing. Data were analysed for the 21 of 34 cases where family members were ‘extremely’ or ‘very’ satisfied with a public hospital admission their older relative experienced in their last 3 months of life. Results: Participants’ accounts of good care aligned with Dewar and Nolan’s relation-centred compassionate care model: (1) a relationship based on empathy; (2) effective interactions between patients/families and staff; (3) contextualised knowledge of the patient/family; and (4) patients/families being active participants in care. We extended the model to the bicultural context of Aotearoa, New Zealand. Conclusion: We identify concrete actions that clinicians working in acute hospitals can integrate into their practice to deliver end-of-life care with which families are highly satisfied. Further research is required to support the implementation of the relation-centred compassionate care model within hospitals, with suitable adaptations for local context, and explore the subsequent impact on patients, families and staff.

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