Palliative medicine family conferences and caregiver psychological distress during prolonged mechanical ventilation

We read with great interest the recent paper ‘Palliative medicine family conferences and caregiver psychological distress during prolonged mechanical ventilation’.1 It explored caregiver perspectives on the role of palliative care and quality of dying and death (QODD) after prolonged mechanical ventilation, to understand the psychological symptoms of caregivers. Several studies have shown that the primary caregiver and other family members of critically ill patients experience significant psychological and physical issues.2 For this reason, effective communication with patients and their family caregivers is central to high-quality palliative care. However, it appears that most family conferences occur without any protocol or formal structure. The absence of a framework in family conferences results in a greater risk of missed opportunities to provide medical information and appropriate support for family caregivers.3 The diversity of patient and family caregiver reactions to end-of-life issues can be understood (from a psychological standpoint) based on a transactional model of coping, where cognitive assessments help establish the possible effect of a potentially stressful event. This model has been widely used in other interventions that help family caregivers feel more trained and better informed about assisting a dying relative and …