An intervention for family members experiencing complicated grief when they lose someone in the ICU

Dr. James Downar

Award: Phoenix Project Fellowship (2016)

Co-Sponsor: University Health Network

Healthcare providers in the ICU are experienced in dealing with mortality and supporting people at the end of their lives. Unfortunately, they are less equipped to help a patient’s family and friends. When people die in a critical care environment, their family and friends are at a higher risk of developing complicated grief.  That means severe grief that’s often marked by serious impairment to social, psychological and medical well-being. 

James was disappointed that there is no system in place to screen and support at-risk family members even though this has been routinely identified as needed. Building on his previous research on bereavement, he used his fellowship to begin developing a screening and support service for family members of patients who die in the ICU. He brought people together from different fields such as critical care, palliative care, psychiatry, social work, nursing, and spiritual care to share their ideas. Fourteen ICUs from provinces across Canada also took part. 

A secondary project within James’s fellowship involved developing an automated tool to identify patients who may be nearing the end of their lives. Sometimes, healthcare professionals don’t know a patient is dying until they’re in their final days or hours. When health teams are able to identify these patients earlier, they can address the patient’s goals for care, including a palliative care approach.  

By combining interventions, we can improve end-of-life experiences for critically ill patients and their family members.

Hear Dr. James Downar talk about his work