Supporting relatives and carers at the end of a patient's life

All doctors, irrespective of their specialty or the setting in which they work, will care for patients who die. Around half of all deaths occur in hospitals. Evidence suggests that the quality of communication around this process is poorer in hospitals than in other settings, according to responses from relatives who have experienced bereavement. Over half of NHS complaints concern care of the dying.This article discusses how to best support relatives and carers at the end of a patient's life. While the focus is on the hospital setting, the principles are applicable to community and care home settings. In this article, "relative" encompasses family members, care givers, and those close to the patient. The article presumes throughout that the patient has given consent for information to be shared with relatives. 

• Effective support can make a considerable difference to the relatives of people who are dying; helping to allay fears, reducing stress and anxiety, and minimising suffering in bereavement.
• Clear communication around practical considerations (death certificate, funeral arrangements, information around autopsy, etc) and psychosocial support (normalising grief, cultural and spiritual considerations) is key.
• Doctors need to familiarise themselves with local systems and protocols. Written communication in addition to verbal is beneficial.