Conversations about children when an important adult is at end of life : an audit

Hanna, Jeffrey R. and Rapa, Elizabeth and Miller, Mary and Turner, Madeleine and Dalton, Louise J. (2021) Conversations about children when an important adult is at end of life : an audit. American Journal of Hospice and Palliative Medicine. ISSN 1049-9091 (

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Purpose: Health and social care professionals report it challenging to have conversations with families when an important adult in the life of a child is at end of life, often feeling this aspect of care is the responsibility of other colleagues. This study aimed to understand professionals' perceived role in family-centered conversations as part of routine care at end of life, and how to promote this element of care in clinical practice. Methods: An audit was completed with 116 professionals who work in palliative care including doctors and nurses that attended a 2-day virtual congress. Results: Professionals (73.2%) felt confident about starting a conversation with adult patients at end of life about important children. However, enquiring about relationships with children was largely dependent on the age of the patient. 64.7% of respondents reported signposting families to websites and services that provide family support. Most professionals (76.7%) wanted training to equip them with the skills and confidence to having family-centered conversations at end of life, with videos demonstrating how to provide these elements of care the most preferred option. Conclusions: Short training resources should be developed to equip professionals with the necessary skills toward having conversations about children with patients and relatives in clinical appointments. There is a need for professionals to ask every patient about important relationships with children.