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Five years experience of critical care bereavement follow-up


We believe that by explaining and answering the questions of those relatives that wish it, we can alleviate the grief caused by the death of a relative in critical care. Death is a common outcome of critical illness and relatives are at high risk of problems with complicated or unresolved grief due to the sudden, often unexpected, manner of that death. We describe the establishment and results of a bereavement follow-up service.


All relatives, since January 2001, have been offered bereavement follow-up. Following the death of a patient in critical care, relatives are informed of the bereavement follow-up service. After death, a booklet is given to the next of kin with information about the service. Four to six weeks later a condolence card is sent, which includes a reminder of the follow-up service. We do not offer a counseling service and details of other organizations providing this are given. Appointments are made by telephone. The interview usually takes place outside critical care and is led by a consultant and a specially trained nurse. Relatives are given the opportunity to ask questions. A monitoring form is completed. A letter is sent to the GP detailing the issues discussed.


In the 30-bed critical care unit in a teaching hospital, during study period January 2001–November 2006, 8,964 admissions and 1,560 deaths (17.4% of patients) occurred (male:female ratio 1.27:1). The average age of deaths was 64.7 years. Eighty-nine families were seen in bereavement follow-up (5.7% of total deaths) and two families attended for a second visit. The male:female ratio was 2.18:1.0, and the average age of death was 42.9 years. A length of stay before death of 1 week or less occurred in 59.6%. Forty-seven per cent of families were seen between 2 and 4 months after the death of their relative. The issues most commonly raised were specific questions about the patient (56.2%), review of information in the notes (34.8%), complaints (23.6%), clarifying misunderstandings (18%) and contacting other health professionals (21.3%).


We describe the results of a bereavement follow-up service for families whose relatives died on the critical care unit at University Hospital of Wales, Cardiff. In total, 5.7% of families took up the service offered. These were usually the families of younger than average male patients, who died with a critical care stay of less than 1 week. We believe that by answering questions still troubling the families 2–4 months after death, we can assist them with their grief. We also believe that this follow-up service by providing further communication can resolve some difficult issues before they develop into formal complaints.

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Voisey, S., Davies, J., Parry-Jones, J. et al. Five years experience of critical care bereavement follow-up. Crit Care 11 (Suppl 2), P494 (2007).

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