Acute Care Edinburgh

Improving Bereavement Care After Critical Care.

A multidisciplinary team of ICU clinicians and bereavement experts are being led by Deputy Charge Nurse Janine Wilson as part of a £10,000 “Building on the Best” grant from the Scottish Partnership for Palliative Care.

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Janine and the team aim to improve the quality of bereavement care experienced by family members who experience the death of a loved one in critical care over a 12 month period. They plan to improve the processes involved in the components of the current bereavement care programme in the intensive care unit in RIE by introducing a telephone follow up for bereaved family members to provide additional support and a bespoke educational programme for ICU nurses to support communication with family members during end of life care and after death.

The team will also improve their understanding of bereavement care pathways from ICU to primary care, social care and third sector care providers through a stakeholder engagement event and expert project advisors, and integrate this into their care pathways.

Complicated Grief

One in seven people admitted to UK intensive care units (ICUs) die each year (27,000 people). Critical illness onset may be sudden, unexpected, and traumatic. In addition, transitions from life-sustaining treatment to end of life (EOL) care is often short; families struggle to understand and adjust to these events. Highly technical, aggressive ICU therapies can lead to a ‘medicalised’ death.

Consequently, the bereavement journey for families of ICU patients often differs substantially from other acute and community settings. Bereaved family members can experience intense grief that can affect physical, mental, social health and result in socioeconomic impacts.

This ‘complicated grief’ is more frequent in bereaved ICU families compared to the general population. The impact of the first wave of the COVID-19 pandemic highlighted the challenges in providing good end of life and bereavement care in ICUs. This has also motivated members of staff to focus on improvements in our bereavement care programme.

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