Dying in a Hospital Intensive Care Unit: The Social Significance for the Family of the Patient

Abstract

A four month study of the relatives of patients who died in the Intensive Care Unit of a large Midwestern Hospital was prepared. Four factors related to the Intensive Care Unit (structure of the unit, staff feedback as modification, changes in the physical status of the patient, and role switching) were found to have important influences on the family-patient interaction. Interaction, in turn, had an effect on the family's grieving process. The dynamics of the family interaction-grieving process is illustrated in the following schema:

It was found that, for the family, the critical aspect of the patient's situation was not the illness and death, per se, but rather the means by which the family was able to become involved with the patient. Structured as it was, the I.C.U. became a major constraint upon the family's ability to face the death of the patient.