Still Searching: A Meta-Synthesis of a Good Death from the Bereaved Family Member Perspective

Abstract

The concept of a good death continues to receive attention in end-of-life (EOL) scholarship. We sought to continue this line of inquiry related to a good death by conducting a meta-synthesis of published qualitative research studies that examined a good death from the bereaved family member’s perspective. Results of the meta-synthesis included 14 articles with 368 participants. Based on analysis, we present a conceptual model called The Opportunity Model for Presence during the EOL Process. The model is framed in socio-cultural factors, and major themes include EOL process engagement with categories of healthcare participants, communication and practical issues. The second theme, (dis)continuity of care, includes categories of place of care, knowledge of family member dying and moment of death. Both of these themes lead to perceptions of either a good or bad death, which influences the bereavement process. We argue the main contribution of the model is the ability to identify moments throughout the interaction where family members can be present to the EOL process. Recommendations for healthcare participants, including patients, family members and clinical care providers are offered to improve the quality of experience throughout the EOL process and limitations of the study are discussed.

Retrospective chart review to assess domains of quality of death (recognition of dying, appropriate limitations, symptom monitoring, anticipatory prescribing) of patients dying in the acute hospital under the care of a nephrology service with renal supportive care support over time

“…Achieving a good death is a difficult concept to measure as it is unique for each individual; however, some studies have shown that aspects considered important to dying patients include pain and symptom management, preparation for death, decisions about treatment preferences and being treated as a whole person . In a recent meta‐synthesis of good death from the perspective of bereaved family members, the authors stated: ‘In terms of what components made up the good death experience, [our] results closely align with previous scholarship in the good death literature, including pain and symptom management, clear decision‐making, preparation for death and communication’ …”

“…17 In a recent meta-synthesis of good death from the perspective of bereaved family members, the authors stated: 'In terms of what components made up the good death experience, [our] results closely align with previous scholarship in the good death literature, including pain and symptom management, clear decision-making, preparation for death and communication'. 18 At SGH, there were 31 deaths in 2004 compared with 22 deaths in both 2009 and 2014. While the significance of this is uncertain, it may reflect improved shared decisionmaking and early involvement of palliative care, meaning that perhaps more patients die either at home or in a palliative care unit.…”

Nurse‐rated good death of Chinese terminally ill patients with cancer: A cross‐sectional study

“…It is worthwhile mentioning that clear overlapping aspects to a good death include “pain and symptom management, clear decision‐making, preparation for death, completion, contributing to others and affirmation of the whole person” (Steinhauser, Clipp, et al, ). There is a growing body of both quantitative and qualitative researches on the topic of a good death, including works on a Good Death Inventory and a Quality of Dying and Death scale (Tenzek & Depner, ). Several excellent reviews describe quality of death from the perspective of clinical caregivers (Cipolletta & Oprandi, ; Griggs, ), the dying person (Granda‐Cameron & Houldin, ) or a combination of healthcare participants or family caregivers (Morita et al, ; Steinhauser, Clipp, et al, ).…”

Family Communication at the End of Life

“…The fifth and final theme of this special issue brings to the forefront the importance of exploring, acknowledging, and valuing the perspective of the family members’ experiences and recollections of their communication at the end of life. One article, “Still Searching: A Meta-Synthesis of a Good Death from the Bereaved Family Member Perspective” [ 29 ], reviews a large body of research regarding the meaning of a good death. The authors conclude that family members may experience either a “good death” or a “bad death” of a their loved one based on a number of factors: issues pertaining to the final care experiences of their loved ones, perceptions of the interactions between themselves and their loved one, and their interactions with the palliative care health systems used during and following the death.…”