Providing Emotional Support to the Family

Despite our best efforts, most resuscitations fail. Notifying family members of the death of a loved one is an important aspect of a resuscitation attempt that should be done compassionately, with care taken to accommodate the cultural and religious beliefs and practices of the family.39,40

Family members have often been excluded from being present during the attempted resuscitation of a child or other relative. Surveys have suggested that healthcare providers hold a range of opinions about the presence of family members at resuscitation attempts.41-51 Several commentaries have noted the potential for family members to become disruptive or interfere with resuscitation procedures, the possibility of family member syncope, and the possibility of increased exposure to legal liability.

However, several surveys administered before observation of resuscitative efforts showed that the majority of family members wished to be present during a resuscitation at-tempt.45-49 Family members with no medical background have reported that being at a loved one's side and saying goodbye during the final moments of life was comforting. 45,46,50 Family members also have reported that it helped them adjust to the death of their loved one,50,51 and most indicated they would do so again.50 Several retrospective reports note positive reactions from family members,41-43 many of whom said that they felt a sense of having helped their loved one and of easing their own grieving.44 Most parents surveyed wanted to be given the option to decide whether they would want to be present at the resuscitation of their child.43,52

Thus, in the absence of data documenting harm and in light of data suggesting that it may be helpful, offering select family members the opportunity to be present during a resuscitation seems reasonable and desirable (assuming that the patient, if an adult, has not raised a prior objection. Parents and other family members seldom ask if they can be present unless encouraged to do so by healthcare providers. Resuscitation team members should be sensitive to the presence of family members during resuscitative efforts, assigning a team member to the family to answer questions, clarify information, and otherwise offer comfort.49

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