• Karen A Kehl.
• School of Nursing, University of Wisconsin-Madison, Madison, WI, USA kkehl@wisc.edu.
• Palliat Med. 2015 Feb 1; 29 (2): 128-37.

BackgroundThere is widespread agreement that the families of hospice patients need to be prepared for the final days of life, yet current practices preparing families are not well described. Examining the gap between family needs and current practice will inform the development of effective preparatory interventions.AimThe purpose of the study was to describe how hospice clinicians prepare family for the final days of life, including (1) the content of the preparatory information, (2) strategies and timing of preparation, and whether the preparation is tailored, and (3) who prepares families.DesignConventional content analysis guided this study. Individual interviews using semi-structured questions were conducted.Setting/ParticipantsIn all, 19 hospice clinicians who provided care in the home setting from two hospice agencies in the United States participated.ResultsPreparatory messages included information on signs of impending death, symptoms, implications of the symptoms, what to expect next, and instructions on what to do. Commonly used strategies included listening, engendering trust, repetition, collaboration with other disciplines, and demonstrations. Staff tailored content and delivery of messages on patient, family, and hospice factors. Preparation usually occurred over time. All hospice staff provided preparatory information, but there are some differences by discipline.ConclusionsMost content previous identified as necessary for preparedness is part of the current preparation. The knowledge of the current practice in preparing families can be used to develop systematic means of assessing the factors related to timing and tailoring, which may assist in developing preparatory messages that are effective and timely.© The Author(s) 2014.

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