Publication year
2015
Citation Title
“He’s on his dying bed”: Next-of-kin’s experiences of the dying body.
Journal Name
Death Studies
Journal Volume
40
Issue Number
1
Page Numbers
10-Jan
DOI
10.1080/07481187.2015.1056565
Summary
Interviews were conducted with the next-of-kin of 78 Veterans who died in Veterans Affairs (VA) hospitals, to discuss their experiences transitioning from home care to hospital care. Next-of-kin expressed concerns over cleanliness and alterations in routine, and recommended speaking to patients.
Key Findings
Interview respondents were grateful when staff spoke to patients, regardless of the patients’ mental functioning.
Moving patients and altering schedules upset next-of-kin, who reported feeling disoriented and unable to monitor care.
Next-of-kin commonly reported being upset when their loved ones’ bodies were not kept clean.
Implications for Program Leaders
Create systems that encourage open communication among families and healthcare providers
Offer avenues for airing and addressing grievances related to care quality
Provide virtual access to patients and hospital staff via mobile phone apps or video calling services
Implications for Policy Makers
Recommend the elimination of restrictions on visitations from family members for seriously ill or dying Service members
Encourage standards of care to include attention to family members' concerns
Promote open communication between staff and family members regarding patient care
Methods
Next-of-kin were recruited through electronic medical records of Veterans who died within one year of the study intervention.
Letters were sent to 362 next-of-kin, of whom 126 responded, and 78 agreed to participate in the study.
Two-hour interviews were conducted with the next-of-kin of 78 Veterans who died in six VA hospitals in the southeastern United States.
Interviews were recorded, listened to, transcribed, and coded by members of the research team.
Participants
Next-of-kin were primarily White (60%), and female (78%), with a mean age of 64 years.
Participants consisted of surviving spouses (40%), adult children (31%), and siblings (17%) of the deceased.
Veterans were predominantly male (98%), and principal causes of death included cancer (30%), heart disease (23%), lung disease (12%), neurological conditions (10%), kidney disease (6%), liver disease (5%).
Limitations
All deaths occurred in a VA hospital. It is unclear how relevant these findings are for civilian hospitals orother non-hospital locations.
Interviews were conducted between three and six months after Veteran deaths, thus transition experiences were told retrospectively and may not accurately reflect lived experiences.
Only one Veteran was female; therefore, it is unclear how end of life care is experienced by families of female Veterans.
Avenues for Future Research
Interview family of terminally ill or dying female Service members
Evaluate the impact of various settings (e.g., VA hospitals, civilian hospitals, hospice, and home settings) on families' experience of a loved one's death
Focus on the transition from home to hospital as experienced by the patients themselves
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
For family members of dying patients who have grown accustomed to providing daily body care, the transition from home to hospital is stressful. The authors used the experiences surrounding death for 78 U.S. veterans who died in a Veterans Affairs hospital. The research is based on interviews conducted with the decedent’s next-of-kin. Secondary qualitative analysis of previouslycoded transcribed interviews was used. Themes of social disorganization and a loss of control over the body emerged. Next-of-kin experienced the physical and functional breakdown of their loved one’s body. Understanding the nature of the loss of control may help alleviate the loss of control may help alleviate the strain on families.
Abstract Document
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