Memory making in end-of-life care in the adult intensive care

Abstract

Background: Family of patients who die in ICU are at increased risk of prolonged psychological stress during bereavement. One potential intervention is memory making: an activity that provides tangible objects such as handprint or lock of hair, which can help create connections with and provide meaningful memories about a deceased person.

Methods: Two-study arm design adopting pragmatist epistemology. Study 1 was a survey of ICU healthcare professionals from June-Aug 2017 exploring factors influencing provisions of end-of-life care, experiences with memory making. Study 2 was a descriptive qualitative study from a purposeful, convenience sample of family who received memory making at an ICU from May 2019-Dec 2020.

Results: 96 surveys from healthcare professionals were analysed which reported memory making to include creating objects and nontangible activities. Highest overall opinion included believing families value memory making. Enablers to offering included organisational supports and interpersonal relationships. Barriers included workloads, inexperience, being afraid. Participants with experience offering reported higher level of confidence and comfort offering and were less likely to be limited by family’s behaviours.

Qualitative data was collected from semi-structured interviews of 21 family participants. Data analysis generated themes: guidance during end-of-life by healthcare professionals that recognises the autonomy of the family; object used as a trigger to access memories; storage and preservation of the object as an indication of its sentimental value and use in early bereavement.

Conclusion: Healthcare professionals offering and relatives receiving memory making appear to be associated with overall positive experiences. High proportions of healthcare participants offered memory making, and family participants welcomed the offer and commonly described the objects to embody their deceased loved one, which maintained bonds to and memories of them.

I would like the following keywords used in the Library’s catalogue to help people find my thesis when searching. Critical care, End of life, Intensive care units, Memory, Memory making, Transitional object

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