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Published on: August 16, 2021
The experiences among bereaved family members after a left ventricular assist device (LVAD) deactivation
Anne Kelemen1, Hunter Groninger2, Edilma L Yearwood3
1Medstar Washington Hospital Center, USA.
Insights
Bereaved family members of patients undergoing left ventricular assist device (LVAD) deactivation have unique needs. Effective communication and improved post-death care are crucial for supporting these families through their grief journey.
Area of Science:
- Cardiology
- Palliative Care
- Qualitative Research
Background:
- Left ventricular assist device (LVAD) implantation is increasing, with many patients eventually undergoing deactivation.
- Deactivation decisions are ethically considered, but the experiences of bereaved families are under-researched.
- Understanding family needs during LVAD deactivation is critical for supportive care.
Purpose of the Study:
- To investigate the lived experiences and needs of family members whose loved ones died after LVAD deactivation.
- To explore family perceptions of healthcare team engagement throughout the LVAD deactivation process.
Main Methods:
- Qualitative study involving semi-structured interviews with 11 family members of patients who underwent LVAD deactivation.
- Interviews continued until data saturation, allowing for theme emergence.
- Exploration of experiences before, during, and after LVAD deactivation.
Main Results:
- Six themes emerged: hope for survival, communication, spirituality/faith, absence of physical suffering, positive staff relationships, and post-death care needs.
- Families valued positive interactions with healthcare staff and the absence of physical suffering.
- Communication and post-death care were identified as areas needing improvement.
Conclusions:
- Bereaved families of LVAD recipients have distinct experiences and concerns.
- Effective communication throughout the LVAD journey, not just near end-of-life, is vital.
- Enhancing decision-making support and post-death care can improve the family experience.
Background:
The use of left ventricular assist devices (LVADs) is increasing with an estimated 2500 devices implanted each year. When burdens of the LVAD outweigh benefits, most individuals with LVADs will undergo deactivation in the hospital setting. While the decision to deactivate an LVAD is considered an ethical practice, little is known about the experience and needs of bereaved family members.
Objective:
To investigate the experiences of bereaved family members of patients who died following LVAD deactivation.
Methods:
In this qualitative study, 11 family members of patients who underwent LVAD deactivation were interviewed. The semi-structured interviews were conducted until data saturation was reached and relevant themes emerged.
Results:
This qualitative study was conducted to understand the experience of family members before, during and after the patient underwent LVAD deactivation, including their perceptions of engagement with the healthcare team. Analysis revealed six overarching themes from the experience, including 1) hope for survival, 2) communication, 3) spirituality and faith, 4) absence of physical suffering, 5) positive relationships with staff, 6) post-death care needs.
Conclusion:
Bereaved family members of patients undergoing LVAD deactivation have unique lived experiences and concerns. This study highlights the importance of effective communication not only near end-of-life but throughout the LVAD experience. While the positive relationships with staff and the absence of physical suffering were strengths identified by bereaved caregivers, there is an opportunity for improvement, particularly during the decision-making and post-death periods.
