The attitudes and experiences of families with death determination in the home

Abstract

The purpose of this study is to describe the attitudes and experiences of family members with respect to death determination practices for the terminally ill clients of home care agencies. A sample of family 53 members in Southeast Michigan returned survey questionnaires. The findings indicate that police and emergency medical technicians most frequently respond to the call when a person with a terminal illness has died. Fifty percent of the family members reported feeling sad, 35 percent reported feeling relieved and 18 percent of the respondents felt angry about the arrival of municipal personnel. Feelings of anger were significantly associated with the absence of a nurse at the time of death, the use of lights and sirens, disrespectful personnel and the arrival of multiple personnel. Feelings of anger were also significantly associated with continuing thoughts of the day of death by family members. Results suggest the need to rethink state and local laws in regard to death determination and to educate those most likely to respond to families sensitively. Home care agencies and hospices should also encourage attendance by nurses at the time of death.

F Amily P Erspective of M Edical C Are and G Rief S Upport After F Ield T Ermination by E Mergency M Edical S Ervices P Ersonnel : A P Reliminary R Eport

“…Previous reports in the literature suggest the ability of family to be present during final resuscitation attempts/efforts has facilitated their adjustment to death and the grief process. [13][14][15] It also improved their impression of the care provided. EMS staff informed family members of the death, satisfactorily provided answers in response to questions regarding treatment protocols, and provided care not only to the patient but also surviving family members, including grief support.…”

The Evaluation of Two Death Education Programs for EMTs Using theTheory of Planned Behavior

“…One study showed the ineffectiveness of EMTs in these roles (Critz, 1989). It is not surprising that many EMTs seek education on delivering effective death notifications and mitigating the family's grief (Coleman, 1993;Norton et al, 1992).…”

Physicians’ Responsibilities for Deaths Occurring at Home

“…There are important reasons to make plans for death that avoid using emergency medical services. Many families are often shocked and angry at the arrival of emergency personnel, because this may be considered an invasion of privacy and potential insinuation of foul play . One study found that police responded to 74% of home deaths of terminally ill individuals, emergency medical technicians 32%, and fire personnel 15% (total is >100% because of attendance by more than one type of emergency personnel) .…”

“…Many families are often shocked and angry at the arrival of emergency personnel, because this may be considered an invasion of privacy and potential insinuation of foul play. 7,10 One study found that police responded to 74% of home deaths of terminally ill individuals, emergency medical technicians 32%, and fire personnel 15% (total is >100% because of attendance by more than one type of emergency personnel). 7 Because emergency personnel may have negative psychological effects on the family, it is prudent to advise families of terminally ill individuals that they can contact the funeral home directly in the event of an expected home death.…”