Close relatives' experiences of caring and of the physical environment when a loved one dies in an ICU.
OBJECTIVE
The aim of this study was to explore close relatives' experiences of caring and the physical environment when a loved one dies in an intensive care unit (ICU).


METHODS
Interviews were conducted with 17 close relatives of 15 patients who had died in three adult ICUs. The interviews were analysed using a phenomenological-hermeneutic method.


RESULTS
The analysis resulted in seven themes; Being confronted with the threat of loss, Maintaining a vigil, Trusting the care, Adapting and trying to understand, Facing death, The need for privacy and togetherness and Experiencing reconciliation. The experience of a caring relationship was central, which meant that the carers piloted the close relatives past the hidden reefs and through the dark waters of the strange environment, unfamiliar technology, distressing information and waiting characterised by uncertainty. Not being piloted meant not being invited to enter into a caring relationship, not being allowed access to the dying loved one and not being assisted in interpreting information.


CONCLUSIONS
The participants showed forbearance with the ICU-environment. Their dying loved one's serious condition and his or her dependence on the medical-technical equipment were experienced as more frightening than the equipment as such. Returning for a follow-up-visit provided an opportunity for reconciliation and relief from guilt.
Fridh
Isabell
I
Sahlgrenska Academy at Gothenburg University, Institute of Health and Care Sciences, PO Box 457, Göteborg SE 405 30, Sweden. isabell.fridh@fhs.gu.se
Forsberg
Anna
A
Bergbom
Ingegerd
I
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001293:Attitude to Death; D001294:Attitude to Health; D003422:Critical Care / Q000458:organization & administration / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006272:Health Facility Environment / Q000458:organization & administration*; D006801:Humans; D007374:Interior Design and Furnishings; D008297:Male; D008875:Middle Aged; D015404:Nursing Methodology Research; D018907:Privacy; D011368:Professional-Family Relations; D011795:Surveys and Questionnaires; D013548:Sweden; D013727:Terminal Care / Q000458:organization & administration / Q000523:psychology*; D035502:Trust; D014789:Visitors to Patients / Q000523:psychology*