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

Abstract

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. To explore hospital clinician assessment and facilitation of family needs and practices to support families at the end of life. Descriptive study utilising a retrospective medical record audit. Undertaken in a large public hospital, the sample included 200 deceased patients from four specialities; general medicine (<i>n</i> = 50), intensive care (<i>n</i> = 50), inpatient palliative care (<i>n =</i> 50) and aged rehabilitation (<i>n =</i> 50). Data were analysed according to age; under 65-years and 65-years or over. 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 (<i>p</i> = 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 (<i>p</i> = 0.040) and social work involvement more likely for those under 65-years (<i>p</i> = 0.002). Pastoral care and bereavement support was low across the whole sample. 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.