(Reuters Health) – families of patients who are dying better may feel end of life care in ICU if they are given simple wishes, such as allowing a patient a favorite meal or using a blanket from home, small study revealed.
Researchers interviewed families and carers of 730 terminally ill patients about their experience with the 3 Wishes Project (3WP), a program designed to create meaningful patient and family-focused memories as part of enduring compassionate care. .
“3WP facilitates compassionate care by identifying the underlying dignity of a dying patient and encouraging links among patients, clinicians and family members,” Dr. Deborah Cook from McMaster University in Hamilton, Ontario, and colleagues in the Annals of Internal Medicine.
The aim of the study was to see how feasible it could be to implement the 3WP program at multiple facilities, how much the experiences were valued by families and clinicians, and the cost of the program. it may be voluntary for donation to patients and their families dying on a regular basis.
The program focused on patients dying in intensive care units in four hospitals. Most required ventilation was mechanical to breathe as well as medication to help with their heart's blood. Many of them were also on dialysis because their kidneys were failing.
Prizes varied enormously and included things like taking patients outdoors, putting seasonal decorations in hospital rooms, celebrating events such as birthdays or anniversaries, renewing wedding pockets, allowing unlimited visitors, or assisting with legacies like organ donation or blood drives.
In total, 3,325 wishes were granted. On average, the wants cost only $ 5.19. It appeared that volunteer aspirations were sustainable, since the hospitals offering the 3WP program continued even after the end of the study year.
Family members and clinicians interviewed under 3WP felt that the aspirations of the individual had helped to maintain human contact and helped families, friends, and carers to focus on patient identities as unique individuals.
This is in contrast to an intensive sterile care environment where the severity of illness, dependence on technology, and inability for patients to communicate can provide the best possible care, the study team writes.
Family members were comforted by having the opportunity to connect with each other and create meaningful relationships with clinicians, recognizing clinicians' explicit respect for the dignity of their relatives, researchers note.
Memories activities embedded in 3WP catalyze respectful care that may encourage families to recall positive memories that they love someone as a person, not as a patient, who may relieve sorrow. , researchers also say.
Focusing on linkage and heritage could help some of the sadness, stress, depression, and anxiety experienced by people who die on their ICU family members, researchers note.
The ICU experience may help patients who die to help meet the needs of staff with high levels of decomposition, the study team writes. Clinicians' negative experiences and emotions can be exacerbated when patients who are dying receive care that is inconsistent with their wishes or prognosis or when communication with families is not clearing what might help the section t best to make a bad situation. With 3WP, clinicians and families have a framework to cooperate with patients to observe during their final days, which could help improve job satisfaction for clinicians.
One limitation of the study is that the majority of patients were incapacitated and unable to respond to wishes or participate in interviews about the experiences, the study team notes. This means that the program was judged solely on its impact on families and carers.
SOURCE: bit.ly/2rA3QHF Annals of Internal Medicine, online November 11, 2019.
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