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Family’s voice helping relatives or friends in the last days of life
  1. Mel McEvoy,
  2. John Blenkinsopp and
  3. Eileen Scott
  1. North Tees and Hartlepool NHS Foundation Trust, UK


Difficulties exist with end of life in acute hospitals. EoLC (NHS, 2013). They are not designed for dying patients and families (Caswell et al., 2015). Health professionals struggle to recognise and manage palliative care transitions. Shared understanding between relatives and staff relate to an improvement in care (Gott et al., 2011). ‘The Family’s Voice’ diary improves communication by involving families to document contemporaneously their observations of care (McEvoy et al., 2012).

Can a communication tool developed for family members, in one trust, be transferable to other hospital and health settings? Using a mixed method approach the quantitative approach rated the symptom management of the dying patient, the qualitative data captured the quality of the perceived care being delivered. Combined they provide a comprehensive account of the family’s experience of care. The analysis of the data used SPSS software and the (free text) by Content Analysis.

All sites participated. Scores concerning symptoms control improved. Families felt staff treated the patient well and felt supported. Specific diagnosis and difficulty of symptom management were linked. The categories that emerged were: awareness of approaching death; communication and compassion; symptom management; the environment; concerns about clinical and fundamental care, family’s expectations; building relationship; spirituality and the need to address concerns immediately.

The Diary is used by relatives who record aspects of clinical care. It has been tested across nine organisations. The diary is a process of empowering family members and a measurement of the relative’s perception of care. It develops palliative care skills in clinical staff and promotes spirituality and pre-bereavement management.


  1. Caswell G, Pollock K, Harwood R,Porock D.Communication between family carers and health professionals about end of life care for older people in a cute hospital setting: a qualitative study. BMC Palliat Care 2015;14:35

  2. Gott M, Ingleton C, Bennett MI, Gardiner C. Transitions to palliative care in acute hospitals in England: qualitative study. Br Med J 2011;342:1773

  3. McEvoy M, Pugh E,Blenkinsopp J.Communication diary to aid care at the end of life. Nurs Times 2012;108(17):24–27

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