Chapter 1: Strategies for intervening in anticipatory grief and trauma
Removing life support
“Everything changed when I made the decision to withdraw life support… Taking in all the information was overwhelming; but I knew that the decision we made was honouring my husband’s wishes”. - Family member
The decision to withdraw life support is usually an agonizing process for families. Regardless of who is making the decision, it is a heavy burden. Whenever possible, the decision should be made collaboratively among the patient, family, and your team.
After the decision has been made, family members may feel some degree of relief, coupled with guilt as they question their choice. Support the family by:
- Asking how they are feeling.
- Reinforcing that everyone did their best under very strenuous circumstances.
- If appropriate, reassuring them that the decision was consistent with the patient’s previously expressed wishes.
- If appropriate, reassuring them that your team agrees with the decision. Reinforcing why withdrawing life support was the best course of action may be useful.
- Often the guilt families feel relates to the idea that they gave up too early. Let the family know that it is not entirely your decision or theirs, but that if you thought that they were making a bad decision, you would tell them.
Shared burden of decision making
Conversation Prompts
“How are you feeling about this? I am asking because a lot of families feel conflicted or even guilt. We can talk about that if you want”.
“Based on our experience, withdrawing life support was the best and only course of action. [Patient’s name] had little quality of life and wasn’t going to improve. We considered every option and tried everything we could to reverse their condition. And you did the best you could too, being with them”.