The mourning before: can anticipatory grief theory inform family care in adult intensive care?
Although anticipatory grief is a much-debated and critiqued bereavement concept, it does offer a way of understanding and exploring expected loss that may be helpful in certain situations. In end-of-life care in adult intensive care units, families often act as proxy decision makers for patients in the transition from curative treatment efforts to planned treatment withdrawal. Despite there being a developed evidence base to inform care of families at this time, few of the clinical studies that provided this evidence were underpinned by bereavement theory. Focusing on end-of-life intensive care practices, this paper integrates work on anticipatory grief and family interventions to present a family-centred framework of care. Through this it is argued that the complex needs of families must be more comprehensively understood by doctors and nurses and that interventions must be more systematically planned to improve quality end-of-life care for families in this setting.
Faculty of Health Sciences, University of Southampton, Cardiac Intensive Care, D Level, North Wing, Southampton General Hospital, Southampton, Hants, United Kingdom. Maureen.coombs@suht.swest.nhs.uk
Maureen A
MA
Coombs
D001293:Attitude to Death; D003422:Critical Care; D003657:Decision Making; D019317:Evidence-Based Medicine; D005190:Family / Q000523:psychology*; D006117:Grief; D006291:Health Policy; D006801:Humans; D011368:Professional-Family Relations; D006113:United Kingdom