Quality of dying after acute stroke

Area of Science:

• Neurology
• Palliative Care
• Gerontology

Background:

• Limited evidence exists on palliative care needs for acute stroke patients nearing end-of-life.
• This study addresses the gap by examining the quality of dying from relatives' and nurses' perspectives.

Purpose of the Study:

• To assess the quality of dying and end-of-life care experienced by acute stroke patients.
• To compare the perceptions of patient relatives with those of healthcare professionals (nurses).

Main Methods:

• Relatives of 59 deceased acute stroke patients were interviewed 6 weeks post-mortem.
• The Quality of Death and Dying Questionnaire was adapted to assess overall dying quality and specific aspects.
• Nurses involved in end-of-life care completed a similar questionnaire.

Main Results:

• Relatives reported high satisfaction with overall dying quality (median score 8/10) and care from nurses (9/10) and doctors (8/10).
• Common issues included breathing difficulties (46%), feeding problems (69% unsatisfactory), inability to say goodbye (51%), loss of control (47%), and diminished dignity (41%).
• Palliative medication effectively managed discomfort for two-thirds of patients, and relatives' and nurses' experiences showed good correlation.

Conclusions:

• The majority of relatives were satisfied with the overall quality of dying for acute stroke patients.
• Key areas for improvement include feeding support, facilitating goodbyes, and maintaining patient dignity and control.
• Nurses' experiences offer a practical and reliable method for evaluating the quality of dying in this patient population.