Improving discussions about resuscitation for relatives in COVID-19

This project explored how discussions about resuscitation can be improved for relatives and carers who had a conversation about resuscitation with a medical professional on behalf of a family member or relative during the COVID-19 pandemic.

Good communication around care at the end-of-life is important for relatives and carers, and can help when coping with serious illness and bereavement.

The issue of communication about resuscitation was especially important during the pandemic. COVID-19 has disrupted the usual way healthcare professionals communicate with relatives and carers because of, untimely, unexpected deaths and restrictions to face-to-face visiting. Complaints about resuscitation communication are common. This is distressing for patients and families and costly for the NHS. Lessons can be learned by listening to the perspectives of relatives and carers around what went well and what could be improved.

Aims

This research aimed to find out how discussions about resuscitation can be improved for the relatives/carers who had a discussion about resuscitation with a medical professional on behalf of a family member or relative during the COVID-19 pandemic.

Research methods

We undertook telephone and Zoom interviews to understand the experiences of relatives/carers who discussed resuscitation/DNACPR with medical staff. The interviews allowed participants to discuss factors important to them.

The experiences of recently bereaved relatives/carers discussing resuscitation in the context of COVID-19 inspired this research question. Relatives/carers have also been involved in the development of the research design. We commissioned an advisory group of bereaved relatives/carers and bereavement specialists to help develop the interview questions, analytical framework and how we share our findings.

Policy relevance

The findings from this research have been presented to DHSC to inform policy in this area, and will be sent to the National Clinical Director for End-of-Life and the National End-of-Life Care Intelligence Network.

Delivery timeline

June 2021 to June 2022

Ethics

This study has ethical approval from the University of Manchester Research Ethics Committee, reference number 2021-11386-19227.

Information for participants

• IDAR Study Poster (PDF)
• IDAR Participant Information Sheet (PDF)

Associated publications and resources

• Improving discussions about resuscitation in COVID-19: Full Report, Summary Briefing, Executive Summary (PDF)
• Tomkow et al (2023) ‘That’s as hard a decision as you will ever have to make’: the experiences of people who discussed Do Not Attempt Cardiopulmonary Resuscitation on behalf of a relative during the COVID-19 pandemic (Age and Ageing). DOI: 10.1093/ageing/afad087      
• Blog hosted by British Geriatrics Society: The challenges of discussing DNACPR during the pandemic