The healthcare system is only beginning to recognize what nurses who tend patients with cancer have always known: The loved ones of dying patients also need help managing pain. Julie Cronin, BSN, RN, OCN, an oncology nurse at Massachusetts General Hospital (MGH) in Boston, says failing to address family members’ distress has serious consequences. “If the spiritual, emotional, physical, and mental needs of these loved ones are neglected, the rates of morbidity and mortality, depression, and risk for ineffective coping can skyrocket.”
Cronin is leading a small pilot study to identify nursing interventions that might benefit family members of a patient with gynecologic cancer who is near the end of life. Via an in-person interview, researchers will ask 10 to 15 first- and second-degree relatives of patients receiving end-of-life care at MGH to suggest steps nurses can take to “improve [the family member’s] comfort and well-being during this time.” Researchers will conduct a phone interview 4 to 6 weeks after the patient’s death to elicit additional suggestions from the participants, along with their views on what needs were not met.
The lack of research surrounding this issue prompted Cronin to initiate the study, and she is optimistic that the findings will prompt changes in nursing care that enhance the quality of life for patients and families. “The needs of pa - tients and families are not separate, but rather incorporated together and equally important,” she told The Oncology Nurse- APN/PA, noting that hospitalized patients often worry as much about the well-being of family members as family members worry about their well-being. “Patients want to be reassured that, after they pass, their loved ones will be able to carry on with a full, happy life.” Cronin considers supporting family members visiting the hospital an important first step toward realizing the patient’s wish and helps make the patient’s transition into death more peaceful.
Although nurses generally take a holistic approach to patient care that encompasses the patient’s family, Cronin says “alleviating the patient’s suffering… and provid[ing] a seamless, peaceful, and dignified transition from life to death” take top priority; as a result, the family’s needs often get overlooked. This is a problem because, as Cronin explains, “These family members and loved ones will be carrying on with their lives after the passing of the patient, which often entails caring for children or other family members, continuing to work, maintaining a home, etc.”
Cronin’s unit at MGH has already implemented measures to enhance the care a terminal patient’s loved ones receive, and her study will try to determine which ones are considered most beneficial. “We offer a ‘comfort cart’ to family members that provides family members with food and drink for physical nourishment; spiritual readings of a variety of faiths; music and aromatherapy; diversional material, such as magazines and books; note cards; tissues; journal; and more.” The nurses also try to keep the patient’s room quiet, maintain flexible visiting hours, and make sleeping arrangements for family members who wish to stay overnight with the patient. “We also make it a priority to keep family members informed of their loved one’s status and provide therapeutic communication and listening at all times,” she said.
In addition to evaluating the effectiveness of MGH’s current interventions, researchers hope the study will provide guidance on developing new measures to support family members whose loved ones are receiving hospice/palliative care. Cronin says they anticipate presenting initial findings in May 2012.
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