Dealing with relatives in case of patient’s death

Patients’ deaths are a routine thing in most hospitals, especially those catering to critically ill patients. But for patient’s relative it could be the only event and they may have very strong sentiments towards it. There could be a sea difference in the way a patient’s death is taken by hospital in comparison to his/her relatives. This difference, at times, become a reason for dissatisfaction, blame and even litigation on hospital by relatives

In my study on online reviews of different hospitals, posted by patients and their relatives, I found that significantly high number of negative reviews and low ratings were given by those whose patients died in a hospital. The reviews largely blamed hospital/doctor for death of their patients and alleged them with negligence and incompetency.  

(For detailed on this studyplease read article  on ‘Avoiding poor online rating of your hospital')

Most of these blames and allegation seems to appear due to the ineffective ways in which hospital deals with the emotions of a dying patient and his/her relatives. These ineffective handling at times leads to severe consequences such as verbal/physical abuse of doctors and other staff and vandalizing of hospital property. While these behaviour on part of relatives is condemnable, hospitals must also assess themselves to see how can they prevent such outburst of emotion and anger.

A lot of trouble could be saved just by becoming a little more sensitive towards this emotional aspect. Their emotions could be better catered to by just asking a simple question, what are their special needs and how best can we fulfill them. It is not so difficult to understand what people goes through in situations of deaths of a loved one, and once we know their situation, it is easy to determine what needs to be done to comfort them. In most situation, a dying patient and his/her relative can be made to feel better by taking care of following small things

• Providing correct and timely information about patient’s health along with clear communication about his/her likelihood of dying to the relatives. This being a sensitive information, should be ideally be given by doctor in-charge of the patient. The manner in which this information is shared is crucial. It is always beneficial that doctors of the hospital are trained and oriented on ‘how to communicate difficult information to patient/relative’. 

My post on 'Communicating bad news to patient and family' outlines a six step protocol for breaking bad news

•  While possibility of death should be communicated, they should also be assured of all possible efforts on part of doctors and hospitals to take care of their patient. This should be said in words as well as practiced to build the trust of relatives.

•  Financial matters become very critical at this time. A huge cost is involved in caring of patient at the end of his life and for family members it becomes difficult to arrange money. At the same time, they cannot discontinue or even decrease the treatment. If the payments are not done, and families are reminded (sometime firmly) about depositing money, families may find themselves in a helpless situation, which later results into angst against hospital. While getting paid for their service is important for hospitals, they must communicate this in a sensitive manner. Identifying right time and right person from relatives to talk about money matter can be helpful.

• As far as possible, hospital must relax their policies for the relatives. Allowing more number of visitors, conduction of prayers, homemade food for patient, and other minor help that may be required for visitors can be some of the things that hospitals can easily do.

• On death of the patient, the news should be broken again by senior most doctor in a sensitive manner. Here again, the training on ‘breaking bad news’ can be of big help

• Post death, hospital must provide all necessary help to enable relatives taking the dead body from hospital to their place. A lot of time, dissatisfaction peaks because relatives who are already grieving due to death of their patient have also to run here and there to get dead body released from hospital.

Every death situation differs from each other and while above recommendation may work in most cases, an individual assessment of the needs must be done in every situation. A dying patient cannot be saved, but by catering to emotional requirements, satisfaction can be brought to the relatives of dying patient. In my study quoted above there were few reviews where relatives praised the hospital despite death of their patient.

(Please leave your comments below)