Relatives' participation at the time of death: Standardisation in pre and post-mortem care in a palliative medical unit

Abstract

PurposeThe aim of this study was to illuminate the development of standardisation of relatives' participation at the time of death in the Palliative Medical Unit and to explore if the implementation of standardisation brought palliative care more in line with its ideology. MethodsA registration form was developed and utilized by the Palliative Medical Unit nurse in charge of the patient and family to register to what extent relatives participated at the time of death. The study consists of two data sets named evaluation 1 and 2. Evaluation 1 includes data collected during the period 01.11.1995–31.12.1999, representing 73% of all deaths (N = 244). Evaluation 2 includes data collected during the period 01.01.2003–31.12.2009, representing 71% of all deaths (N = 400). The data was analysed in SPSS, covering primarily the frequency of participation and correlation between evaluation 1 and evaluation 2. ResultsRelatives are more often present at the moment of death, while nurses are less present at this moment. Additionally, Palliative Medical Unit nurses use more time to inform and discuss relatives' participation in pre and post-mortem care, as well as making agreements with relatives after death occurs. ConclusionImportant premises for successful standardisation are fostering Palliative Medical Unit nurses' knowledge about various aspects of pre and post-mortem care through regular evaluation and an educational programme providing staff with necessary time, awareness and skills. In addition nurses also require sufficient amount of time in the clinic.