Because of their conditions, intensive care unit (ICU) patients are frequently unable
to communicate their needs and desires at the end of their lives. Family members are
often required to make decisions for their family member and serve as advocates for
their wishes. Families are often the primary source of information about the patient's
wishes and comfort, yet they frequently do not fully understand the patient's condition
or the implications of various treatment options. At the same time, these family members
have their own needs. This article will discuss family considerations in the ICU when
the patient is nearing death. A review of family satisfaction with the quality of
end-of life care in the ICU gives an introduction to the needs the family sees at
the end of life.
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References
- Recommendations for end-of-life care in the intensive care unit: the Ethics Committee of the Society of Critical Care Medicine.Crit Care Med. 2001; 29: 2332-2348
- Needs of the grieving spouse in a hospital setting.Nurs Res. 1975; 24: 113-120
- A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT).JAMA. 1995; 274: 1591-1598
- Family satisfaction with end-of-life care in seriously ill hospitalized adults.J Am Geriatr Soc. 2000; 48: S61-S69
- Measuring family satisfaction with care in the intensive care unit: the development of a questionnaire and preliminary results.J Crit Care. 2001; 16: 142-149
- Family satisfaction with care in the intensive care unit: results of a multiple center study.Crit Care Med. 2002; 30: 1413-1418
- Dying in the ICU: perspectives of family members.Chest. 2003; 124: 392-397
- Measuring the ability to meet family needs in an intensive care unit.Crit Care Med. 1998; 26: 266-271
- Withdrawal of life support: how the family feels, and why.J Palliat Care. 2000; 16: S40-S44
- Needs of relatives of critically ill patients: a descriptive study.Heart Lung. 1979; 8: 332-339
- Half the families of intensive care unit patients experience inadequate communication with physicians.Crit Care Med. 2000; 28: 3044-3049
- Families looking back: one year after discussion of withdrawal or withholding of life-sustaining support.Crit Care Med. 2001; 29: 197-201
- Improving end-of-life care: gathering suggestions from family members.Nursing Forum. 1999; 34: 5-14
- Intensive care nurses' experiences with end-of-life care.Am J Crit Care. 2000; 9: 36-42
- The vortex: families' experiences with death in the intensive care unit.Am J Crit Care. 2002; 11: 200-209
- The experiences of families with a relative in the intensive care unit.Heart Lung. 1996; 25: 467-474
- The family conference as a focus to improve communication about end-of- life care in the intensive care unit: opportunities for improvement.Crit Care Med. 2001; 29: N26-N33
- Studying communication about end-of-life care during the ICU family conference: development of a framework.J Crit Care. 2002; 17: 147-160
- Withdrawal of life support: intensive caring at the end of life.JAMA. 2002; 288: 2732-2740
- Results of a clinical trial on care improvement for the critically ill.Crit Care Med. 2003; 31: 2107-2117
- The role of teams in resolving moral distress in intensive care unit decision-making.Crit Care. 2003; 7: 217-218
- Conflict associated with decisions to limit life-sustaining treatment in intensive care units.J Gen Intern Med. 2001; 16: 283-289
- Choices of seriously ill patients about cardiopulmonary resuscitation: correlates and outcomes. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments [see comments].Am J Med. 1996; 100: 128-137
- Perceptions by family members of the dying experience of older and seriously ill patients. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments.Ann Intern Med. 1997; 126: 97-106
- Withholding and withdrawal of life support in intensive-care units in France: a prospective survey. French LATAREA Group.Lancet. 2001; 357: 9-14
- Withdrawing and withholding life support in the intensive care unit: a Spanish prospective multi-centre observational study.Intensive Care Med. 2001; 27: 1744-1749
- Withdrawal and withholding of life support in the intensive care unit: a comparison of teaching and community hospitals. The Southwestern Ontario Critical Care Research Network.Crit Care Med. 1998; 26: 245-251
- Withdrawing life support from the critically ill.Chest. 2000; 118: 1238-1239
- Increasing incidence of withholding and withdrawal of life support from the critically ill.Am J Respir Crit Care Med. 1997; 155: 15-20
- Withholding or withdrawal of life-sustaining therapy.Hosp Pract. 2000; 35 (95–100, 102): 91-92
- Withholding and withdrawal of life support from the critically ill.N Engl J Med. 1990; 322: 309-315
- Withdrawing life support. Do families and physicians decide as patients do?.Nephron. 1988; 48: 201-205
- Withdrawal of life support—who should decide? Differences in attitudes among the general public, nurses and physicians.Intensive Care Med. 1999; 25: 949-954
- Communication, negotiation, and mediation: dealing with conflict in end-of-life decisions.J Palliat Care. 2000; 16: S17-S23
- Decisions to limit or continue life-sustaining treatment by critical care physicians in the United States: conflicts between physicians' practices and patients' wishes.Am J Respir Crit Care Med. 1995; 151: 288-292
- Two transatlantic viewpoints on an ethical quandary.Am J Respir Crit Care Med. 2001; 163: 818-821
- Withdrawal of mechanical ventilation in anticipation of death in the intensive care unit.N Engl J Med. 2003; 349: 1123-1132
- The SUPPORT prognostic model. Objective estimates of survival for seriously ill hospitalized adults. Study to understand prognoses and preferences for outcomes and risks of treatments.Ann Intern Med. 1995; 122: 191-203
- Physician understanding of patient resuscitation preferences: insights and clinical implications.J Am Geriatr Soc. 2000; 48: S44-S51
- Prediction of survival for older hospitalized patients: the HELP survival model. Hospitalized Elderly Longitudinal Project.J Am Geriatr Soc. 2000; 48: S16-S24
- Extent and determinants of error in doctors' prognoses in terminally ill patients: prospective cohort study.BMJ. 2000; 320: 469-472
- Identifying potentially ineffective care in a community hospital.Crit Care Med. 2002; 30: 1803-1807
- What is wrong with end-of-life care? Opinions of bereaved family members.J Am Geriatr Soc. 1997; 45: 1339-1344
- End-of-life decision making in the seriously ill hospitalized patient: an organizing framework and results of a preliminary study.J Palliat Care. 2000; 16: S31-S39
- Family members' experiences with decision making for incompetent patients in the ICU: a qualitative study.Am J Crit Care. 1998; 7: 30-36
- Family decision making for incompetent patients in the ICU.Crit Care Nurs Clin North Am. 1997; 9: 107-114
- Achieving consensus on withdrawing or withholding care for critically ill patients.J Gen Intern Med. 1992; 7: 475-480
- Influence of an advance directive on the initiation of life support technology in critically ill cancer patients.Crit Care Med. 2001; 29: 2294-2298
- Intensive care nurses' experiences with end-of-life care.Am J Crit Care. 2000; 9: 36-42
- End-of-life care in the ICU: treatments provided when life support was or was not withdrawn.Chest. 2000; 118: 1424-1430
- Withdrawing life support and resolution of conflict with families.BMJ. 2002; 325: 1342-1345
- End-of-life decisions in adult intensive care: current research base and directions for the future.Nurs Outlook. 2000; 48: 158-164
- End-of-life conversations: evolving practice and theory.JAMA. 2000; 284: 1573-1578
- Patient-centered interventions.Res Nurs Health. 2002; 25: 246-255
- What matters to seriously ill older persons making end-of-life treatment decisions?: a qualitative study.J Palliat Med. 2003; 6: 237-244
- Decisions about life-sustaining treatment. Impact of physicians' behaviors on the family.Arch Intern Med. 1995; 155: 633-638
- Family decision-making to withdraw life-sustaining treatments from hospitalized patients.Nurs Res. 2001; 50: 105-115
- Family decision making in foregoing life-sustaining treatments.J Family Nurs. 1999; 5: 426-442
- The experiences of families with a relative in the intensive care unit.Heart Lung. 1996; 25: 467-474
- Perceived changes in adult family members' roles and responsibilities during critical illness.Image J Nurs Sch. 1995; 27: 238-243
- Dying and bereavement. The role of the critical care nurse.Intensive Care Nurs. 1989; 5: 39-45
- Diagnosing complicated grief: a closer look.J Clin Psychol. 2002; 58: 747-757
- Anxiety disorders during acute bereavement.J Clin Psychiatry. 1990; 51: 269-274
- On the experience of traumatic stress in anticipatory and postdeath mourning.in: Rando T.A Clinical dimensions of anticipatory mourning. Research Press, Champaign (IL)2000: 155-222
- Symptoms of anxiety and depression in family members of intensive care unit patients: ethical hypothesis regarding decision-making capacity.Crit Care Med. 2001; 29: 1893-1897
- Anxiety and family needs of the relatives of cardiac medical-surgical ICU patients.Can J Cardiovasc Nurs. 1992; 2: 15-22
- Families in ICU: their needs and anxiety level.Intensive Care Nurs. 1989; 5: 11-18
- Perceived and unmet needs of critical care family members.Crit Care Nurs Q. 1998; 21: 58-67
- Needs of the grieving spouse in a hospital setting.Nurs Res. 1975; 24: 113-120
- Family reports of barriers to optimal care of the dying.Nurs Res. 2000; 49: 310-317
- Supporting families in palliative care.in: Coyle N Textbook of palliative nursing. Oxford University Press, New York2001: 363-381
- Symptomatology and management of acute grief.Am J Psychiatry. 1994; 151: 155-160
- Grief and grief management: some reflections.J Pastoral Care. 1976; 30: 198-207
- A comparison of spousal anticipatory grief and conventional grief.Death Stud. 1998; 22: 541-569
- Loss, sadness and depression. Vol 3. Howarth Press, London1980
- The social construction of anticipatory grief.Soc Sci Med. 1996; 43: 1349-1358
- Terminal care: evaluation of effects on surviving family of care before and after bereavement.Postgrad Med J. 1983; 59: 73-78
- Is it possible to prepare for trauma?.J Palliat Care. 1988; 4: 74-76
- Anticipatory grief: the term is a misnomer but the phenomenon exists.J Palliat Care. 1988; 4: 70-73
- Anticipatory grief: a psychosocial concept reconsidered.Br J Psychiatry. 1980; 137: 45-54
- Widows' grief: the impact of age and mode of death.Omega. 1977; 7: 307-333
- Long-term outcome of bereavement.Br J Psychiatry. 1984; 145: 424-428
- Anticipatory grief and aged widows and widowers.J Gerontol. 1975; 30: 225-229
- Bereavement.in: Coyle N Textbook of palliative nursing. Oxford University Press, Oxford2001: 352-362
- Some dynamics of anticipatory grief.in: Goldberg I.K Anticipatory grief. Columbia University Press, New York1974: 3-9
- An exploration of anticipatory grief: the lived experience of people during their spouses' terminal illness and in bereavement.J Adv Nurs. 1998; 28: 829-839
- Anticipatory mourning and coping with dying: similarities, differences, and suggested guidelines.in: Rando T.A Clinical dimensions of anticipatory mourning. Research Press, Champaign (IL)2000: 223-252
- Mourning psychosocial loss: anticipatory mourning in Alzheimer's, ALS, and irreversible coma.in: Rando T.A Clinical dimensions of anticipatory mourning. Research Press, Champaign (IL)2000: 477-492
- Denial and the limits of anticipatory mourning.in: Rando T.A Clinical dimensions of anticipatory mourning. Research Press, Champaign (IL)2000: 253-265
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