End of life care: communication – a retrospective survey

Introduction

Approximately one in five patients in the USA dies in the ICU. The majority of these deaths are following withholding or withdrawal of treatment. Communication between the healthcare team and the relatives of the patient constitutes a very important aspect of the end of life care. We conducted a retrospective survey to assess the quality of communication in terms of duration and content of the interview and spiritual care.

Methods

The next of kin of patients who died over a period of 1 year from April 2003 were identified. Those with ongoing complaints and no fixed abode were excluded. Seventy-three patients had died during this period. Sixty-one questionnaires were sent out by post and 32 responses were received. Nine were incomplete and 23 were analysed.

Results

Were you given sufficient information? – 74% and 78% of the responders were satisfied with the amount of information given by medical and nursing staff, respectively. Awareness of what was happening to your relative? – 65% were aware of what was happening to their relative. Were questions and concerns answered? – 74% replied positively. Was the duration of interview sufficient? – 87% replied yes. Was there overall satisfaction with the content of interview? – 70% were overall satisfied. Was spiritual care offered? – spiritual care was not offered to 56% of responders; if it was offered, 85% of them would have accepted it.

Conclusion

Medical and nursing staff appear to have given sufficient information and answered questions and concerns of the next of kin. The duration of the interview was also sufficient. The next of kin appear to have comprehended the information given. It does appear that spiritual care was not offered to the majority of responders. We could improve our quality of communication by offering spiritual care to relatives. A structured interview with the relatives can improve family understanding and satisfaction of the quality of end of life care!