Characteristics of family conferences in a palliative care unit at a comprehensive cancer center.

PURPOSE

Family conferences are used to facilitate communication concerning end-of-life issues with patients and their families. The purpose of our study was to obtain preliminary information on the characteristics of family conferences that take place in an inpatient palliative care unit (PCU).

METHODS

A retrospective chart review was conducted during a 6-month period that identified 123 documented family conferences. Data including demographic information, type of cancer, and discharge disposition were collected. Timing, number of participants, expressions of emotional distress, conflict with health care providers, and topics discussed during the conference were collected.

RESULTS

Sixty-one patients (50%) were female, 75 (61%) were white, 95 (77%) had solid tumors. Median age of patients was 61. In 74 of the 123 documented family meetings (60%), patients actively participated. Family conferences took place a median of 3 days prior to discharge. During the meetings, questions concerning advanced directives and withdrawal of care were found to be infrequent. Eighteen percent of patients expressed emotional distress, while 40% of families expressed distress which was higher at 47% when the patient was not present.

CONCLUSIONS

Family conferences involved a high degree of patient participation and occurred at the end of a patients stay in our PCU. A trend toward greater expression of emotional distress displayed by family members was found when patients did not participate in the meetings. Further prospective studies that use validated tools to assess the content of the meetings and their impact on alleviating distress in patients and their family are needed.